Trying to Figure It Out

Discussion in 'Welcome to the Group - Post an Introduction Here' started by Vicki, Mar 10, 2015.

  1. Vicki

    Vicki Member

    Joined:
    Mar 9, 2015
    Hello,
    I have an almost 15 year old cat, Elizabeth, who has never had any health problems. We live in Louisiana. Last November Liz had excessive thirst and urination, so I took her to the vet and he did full lab work on her. Her lab work looked good - BG level was normal at that time, but she did have a bladder infection. She was put on antibiotics, but I had a lot of trouble giving her the liquid meds. Liz was not a good patient so the medicine seemed to go everywhere but in her mouth. I always wondered if the bladder infection totally cleared up.

    Three weeks ago, she started having excessive thirst and urination again, so I took her to the vet thinking the bladder infection had flared up again. This time her BG was elevated - high 400s. Maybe it was 500 - I can't remember exactly. I was going out of town for over a week, so I boarded her, and they worked on trying to get her BG level down, but did not have much luck. The days that it was low (normal) it turned out she hadn't eaten, but was given her insulin.

    Since I have brought her home a week and a half ago, I have been giving her shots: 2 units of Lantus 2 x a day. The vet tech gave me 100 unit syringes (they didn't have any others at the time), but a couple of days ago I bought 30 unit syringes. I took her in last week to be checked, and her BG level was in the 400's. The vet suggested I try 3 units one morning and bring her in 6 hours later. I have not yet tried the 3 units. Some days she has excessive urination, but other days she does not. When it's excessive, I assume her BG level is high, as it was the day I took her to get checked.

    I told my vet about the information I had found on the internet about diet, home testing, etc, and he is not one of those vets who believes in home testing, and he didn't see any reason to take Elizabeth off of dry food since the dry food is specifically for diabetic cats. There are actually multiple vets in this office, and they all have the same theories. However, my vet said he would work with me. They all discouraged me from testing at home saying it just isn't going to work. From this forum I see that a lot of people do it and I think I can, too. I have been successful giving the shots -she doesn't even notice, and I have spent a lot of time playing with Elizabeth's ears so that when I am ready to test she won't find all the ear attention odd.

    Since her diagnosis Elizabeth has been eating canned food and dry food - both Hill's M/D. She is not overweight and never has been, and in fact seems to have lost some weight. She has always been a free eater with dry food (Hill's) out at all times, and a half a can of wet food at night. Now I have cut her back on the dry food - 1/4 cup a day, or less, and she eats less than a 5.5 oz can of wet food. I did not take her totally off the dry food, as I read that is not desirable. My vet thought it was crazy to consider taking her off dry food, mentioning that it helps keep her teeth clean. Liz is not a big eater during the day (she has always done most of her eating at night), and the vet said to make sure she eats at least a couple tablespoons of wet food before giving her the shot 30 minutes later. I really have to coax her, but so far she has eaten that much, and I have given her the 2 units 2 x a day. I usually give her more than the 2 tablespoons in the morning and evening, and then let her eat the rest during the day/night. And I leave that little bit of dry food out.

    I really want to try testing at home, but am very nervous about it. I want to use whatever has proven the easiest and most successful. This is a lot of information to take in! I didn't even know there was such a difference in syringes until Liz was diagnosed. Any help and advice is greatly appreciated! It's nice to know there are so many dedicated cat lovers out there!

    Vicki
     
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  2. Mogmom and Goofus

    Mogmom and Goofus Well-Known Member

    Joined:
    Dec 9, 2014
    Home testing is EASY, if the ears don't work for you try the paw pads, they don't have much feeling in them. My vet recommended home testing, it's the best way to have a clear picture of whats really happening at all times. He showed me how to do it and talked me thru it over the phone when I had a meltdown because it didn't go well the first time. I actually poked right thru Goof's ear! That's when he suggested the pads.

    I use the AlphaTrak 2 meter, but it's expensive and the test strips are really pricey! A lot of people on here use the ReliOn from Walmart, I'm thinking of switching because the test strips are MUCH cheaper!

    I was so overwhelmed at first hat I cried everyday and had this constant feeling of sadness, but it does get better and easier! People here are really willing and happy to help.
     
  3. Marycatmom

    Marycatmom Well-Known Member

    Joined:
    Oct 24, 2014
    Home testing is definitely something you can and should do. You would never give a child insulin without know it was safe, so why would you do that with your kitty child? I use a relion micro meter from Walmart, but some people use the Relion Confirm instead. While strips for an Alphtraks will cost over a dollar per strip, you can get reliostrips for around 33 cents each. Huge difference! There are youtube videos that will show you just what to do. It's not nearly as hard as vets make it out to be. I got blood the first try. The peace of mind you get from testing is priceless. One trick to home testing is to give your cat a low carb treat such as freeze dried chicken right after he gets pricked. Pretty soon, the cat will be asking you to prick him, so he can get the treat. It will take some time to get the routine set up, but before you know it,you will feel like your back in control of your lifes.
     
  4. Vicki

    Vicki Member

    Joined:
    Mar 9, 2015
    Thank you for the replies! How often do you test, and at what point during the day? I assume the reading dictates how much insulin you give? Is insulin given only twice a day or more often? I suppose I need to read more! I have watched the you tube videos, but am still quite nervous about it. Where do you get the low carb treats? I will look at the different meters you have suggested. I want this to be as easy as it can be, but the cost of over a dollar a strip does sound expensive.
     
  5. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    It is a myth that dry food cleans a cat's teeth.

    We test before we shoot to make sure it is safe.

    We test around the nadir, the lowest glucose post-shot, whenever we can (days off, weekends, or even setting an alarm in the night sometimes) to make sure the glucose doesn't go too low, nor remain too high. The nadir is roughly +5 to +7 hours post shot and may vary.


    Nadir data is used to guide dosing based on the insulin protocol you are using.

    Insulin is given every 12 hours for most cats when using ProZinc, Lantus, Levemir, or BCP PZI. Only agree to one of those insulins as the others will not last 12 hours in the cat.


    The WalMart ReliOn Confirm or Confirm Micro, or the Arkray USA Glucocard 01 or 01 Mini (unbranded version of the Confirms, from ADW), work very well with feline-specific reference numbers. See my signature link Glucometer Notes for more details.
     
  6. Tiger(GA) and Ruth

    Tiger(GA) and Ruth Well-Known Member

    Joined:
    Apr 15, 2014
    Welcome to the best place-that you never wanted to be! :bighug: We have all been in your shoes-You can do this!! I congratulate you for wanting to home test- it is the absolute best way to keep Liz safe! Not to innundate you with more info, but this video helped me when I was just starting out(My kitty wasn't as nice as Buddy :p) : Home Testing Your Cat at Home. Rub Liz's ears often during the day, offer a kitty treat (My kitty Tiger loves Chicken Pure Bites that I get at Petco) Then when you do start testing, offer a treat after every test, regardless of if you get blood or not. Make sure her ear is warm enough before you poke- many use a baby sock filled with rice,heated in the microwave. The other thing, try to find lancets that are 28-29 gauge. The fine tipped 31 gauge is a little harder before your kitties ear learns to bleed. I don't love WalMart, but I do use the Relion Micro meter- it uses the least amount of blood and that was so helpful when we were just starting out. I also get my syringes there as well. I would encourage you to look at putting together a Hypo Kit as well- it will include high carb food(such as Gravy Lovers Fancy Feast), Karo Syrup, extra test strips, plus printed out instructions for How to Handle Low Numbers and Hypos.
     
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  7. Marycatmom

    Marycatmom Well-Known Member

    Joined:
    Oct 24, 2014
    You can do it! It's scary at first, but you'll be an old pro before you know it.
     
  8. Vicki

    Vicki Member

    Joined:
    Mar 9, 2015
    Okay, I got an AlphaTrak II, because that's what my vet uses. I figure I can change to one with less expensive strips later, but this is the one that fills my comfort level needs right now. I go the Chicken PureBites. I've watched the videos. If the ear doesn't work, I will try the paw. Are the lancets in the AlphaTrak II a good choice to start with? The settings are 1-4. Also, is it best to set the AlphaTrak so it doesn't beep when it's ready - seems like the beep might have a startling effect?

    I saw one post where the cat owner tested her cat the first time/day every two hours in a 24 hour period. I don't think Lizzy's ears up are for that! I saw another post where it was done every two hours for 12 hours, and another where the testing was done every 3-4 hours over a 12 hour period. Any advice would be appreciated. There is such a wide variety of information here, and many differing options. Still trying to figure it all out! I don't even know if I am posting my reply correctly. :/

    Thank you!
     
  9. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You want lancets for alternate site testing, as they are 26-28 gauge, rather than very fine (30-33 gauge), so you'll be more likely to get a blood droplet.
    Barring that, you can do 2 quick pricks next to each other to improve the chances of a big enough blood droplet.
     
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  10. Stacym20

    Stacym20 Member

    Joined:
    Sep 17, 2014
    Since Elizabeth has been on a steady dose of Lantus for over 2 weeks now, it would be a good idea to get a curve on her as soon as you feel up to it. For a curve, you take readings every 2 hours for 12 hours or every 3 hours for 18 hours. This will give you a good idea of when the insulin is kicking in, when it's peaking, and if you need to increase or decrease the dose. You don't have to do curves all the time, just when you need the big picture of what her numbers are doing. Otherwise, it's recommened to test at least before giving insulin, and then maybe one other time during the cycle. I test for preshots and then right before I go to bed during the week, and then I try to fill in the blanks as much as I can over the weekend.

    It's all very overwhelming at first, but hang in there! It does get easier!
     
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  11. Nancy & Cootie (GA)

    Nancy & Cootie (GA) Member

    Joined:
    Oct 16, 2014
    I also started off with the AlphaTrak II, then switched to the Relion Confirm (from Walmart) because the strips got too expensive, and it's more convenient for me to get new test strips from Walmart than from my vet's office. Even though I switched meters I still use the lancing device & lancets that came with the AlphaTrak II. (Walmart carries the lancet replacements too). At first I had to use a 3 or sometimes 4 setting to get a blood drop, but after I got more used to testing (and Cootie's ears got more used to testing!) I dropped the setting down to 2. I left the beep turned on Low--it's never bothered Cootie, but she's pretty mellow. One more thing about this lancing device--I use the clear cap that covers the lancet. It took me a while to get used to where the needle actually poked, but I didn't feel comfortable free-handing the lancet. The lancets that came with my AlphaTrak II lancing device & that I still use are "Freestyle" by Abbott, 28 gauge. They're not real pricey.

    Cootie has gone OTJ (off the juice, diet-controlled) but I still test her regularly since she has other health issues & she's already been OTJ once previously before I got her.
    Stacym20's advice about the testing is the same as I used to do when Cootie was getting her ProZinc insulin shots.

    Since Liz is getting Lantus you may want to check out the Lantus/Levemir Insulin Support Group on the Forums page. They have several Stickies with a lot of useful information and that group is very active when you have questions or need help re: Lantus.

    Good luck! It does all seem overwhelming at first but gets better with a little time!
     
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  12. Vicki

    Vicki Member

    Joined:
    Mar 9, 2015
    OMG I did it! First try on her ear on setting of 3 (I probably would have used 1 had I not read the message). It took me two hours to get set up and get the nerve to do it, but it was successful and the reading is 289.

    I used everyone's suggestions - petroleum jelly, cotton ball, freeze dried chicken treat....watched more videos on the paw pad in case the ear didn't work. I tested, now fed, do I have to wait the 1/2 hour to give her the insulin as I have prior to being able to test? Advice appreciated. Thanks again to all y'all with your great suggestions!
     
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  13. Stacym20

    Stacym20 Member

    Joined:
    Sep 17, 2014
    You can feed and shoot at the same time. Congrats on your first test! My first test did not go that well... Lol
     
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  14. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Woohoo! Well done, you! :woot:

    Not many people get a successful test the very first time they try it. :)
     
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  15. Vicki

    Vicki Member

    Joined:
    Mar 9, 2015
    Turns out I had beginners luck. This morning it took 4 tries. The first two tries I missed the ear altogether (trying to stay near the edge), the third try not enough blood, so I moved the lancet up for a deeper stab to #4 and the 4th time was the charm. :) The reading at 8:30am was 161. She didn't get her insulin until 10:30pm last night because it took me so long to get organized with my first test, and her BG was 289. She usually gets 2 units of Lantus, so wondering if 2 units is appropriate right now with BG 161. I will see if I can find that chart I've seen on here somewhere (and try to decipher it), discuss with the vet, and ask for y'all advice again!
    Thanks!
    ps - When I saw "Elizabeth and Bertie" I thought ohhhh...another person with a cat named Elizabeth! :cat:
     
  16. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

    Joined:
    Sep 6, 2010
    Hi Vicki,
    The general advice for those new to dealing with diabetes is that no insulin is given if the blood glucose (immediately prior to the shot) is below 200. That's just until the caregiver has got the hang of hometesting and has got an initial idea of how the insulin is working in the cat.

    Elizabeth's blood glucose may be dropping a bit as a result of the diet change also...
    :D:D:D
    .
     
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  17. Vicki

    Vicki Member

    Joined:
    Mar 9, 2015
    I just spoke to the vet tech (who spoke to the vet), and the suggestion was to give her breakfast (but she doesn't eat much in the morning) and go with the usual 2 unit shot. I found a chart that said .5 units if under 170. I'm so worried about hypoglycemia I don't think I will give her the 2 units. It's going to be .5 units or none. Feeling the stress. :confused: Should I be putting these questions in another area?
    THANKS!!
     
  18. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Thank you so much for this little nugget of information. I like the Alphatrak lancing device and I've been looking to see if I might find cheaper lancets to use with it. I've just checked online and I can get the Freestyle ones in the UK. Excellent! :)
     
  19. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    The starting dose for Lantus may be calculated as follows:
    What is your cat's weight?
    What is your cat's ideal weight?
    Take the lower value (ie, lean weight)
    Convert to kilograms (pounds / 2.2)
    Multiply by 0.25.
    Round down to the nearest 0.25.
    That is the starting dose, to be given every 12 hours.
     

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