Work and Testing

Just picked up my first batch of insulin last night! We're starting on Lantus, 1 unit 2x a day. I decided to wait until Saturday am for first shot, as I'll be home for a few hours after. I'm very nervous about the 1st couple of doses and how she'll react. Doing a more relaxed Lantus protocol to start but I'm curious how people test when not home that often. I leave for work around 8am and get home between 6 and 8pm most weeknights. I can do a curve on a weekend day but how do people deal with the 12 hour absence? I'd love any feedback/ideas/best practice...

Thanks!

 

I do pretty much what it sounds like you'll be doing. I test before EVERY shot (AMPS and PMPS), which gets me two tests a day. I do that to make sure Chester's BG is high enough to get a shot. I do not give him a shot if his BG is under 200. That helps to keep him safe.
Sometimes I can get my husband to get me a mid-day, pre-lunch test. Sometimes I remember to get a bedtime test.
When I want more data, I can run extra tests on the weekends when I have some time off. That's when I can run curves - testing every 2-4 hours for 12 hours straight.
I'd like to be able to get extra tests more frequently, but my schedule just does not allow for that.

I started Chester on insulin over a weekend so I could be around for the first few doses. Makes sense to me.

 

Thank you! This is all freaking me out a bit. I have a "difficult" cat, so I'm not sure if she'll let me test. I know her BG is high now, so I feel ok giving her shots tomorrow without testing, but I'm going to try and start testing tomorrow night or Sunday before shooting if I can. Unfortunately, she's a biter and damn quick about it, so I have my doubts. I couldn't believe when my vet said he had people who don't even use ketodiastix, I can't imagine giving insulin and having NO IDEA of whether it's working/needed. :shock:

 

You've got to work the testing and shooting schedule around your other obligations in life, like work and family.

If you leave for work around 8, I'd suggest trying for a 7 am start time on your test, feed, shoot cycle. Then, try for 7 pm also on those days that you will be home that early. You said that sometimes you work later so we understand that and know that some evenings you will be shooting later. It happens.

I was really slow in getting into a good routine for testing. It used to take me 30 minutes or so to test, get the food ready, shoot the insulin. I got that down to 10 minutes or so and that included getting food ready and feeding 2 other kitties.

Get all you testing supplies out and ready. Preload the test strip in the meter but do not push it all the way in yet to turn the meter on. Go find your kitty Nikki and take her to your test area. Warm ear, push test strip all the way into the meter, prick ear, sip up the blood drop onto the strip.

It takes practice. If 3 pokes and no blood or not enough blood, hang up your meter and try again in half an hour to an hour. Give a freeze dried treat for every test, successful or not.

One thing you should do if you haven't already, is set up a spreadsheet and link it into your user control panel here on the board. Directions here: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It will help other people here on the board see how your cat is doing and suggest changes if needed.

Good luck this weekend.

 

Thank you so much! Will be sitting down with a spreadsheet this weekend for sure. I can't tell you how much better I feel knowing I have a place to go. My vet's feline diabetes paperwork even directs people here! :smile:

 

Really??? That's fantastic that they tell new diabetes clients about us.

Keep asking questions. We want to keep getting those referrals.

 

I work also and am having trouble testing. Part of the trouble is I am so nervous about using the lancet. Is there any other device that is easier to use on a squirmy cat? Also, must it be done on his ear. The ear I know has a vein, but it is so small an area that it is hard for me to stick and get blood. Help!

 

My cat was just diagnosed last week when I took him to the vet because he wasn't eating. Turns out he was DKA so we went right over to one of the animal hospitals here in NYC, and they also directed me to this site as a resource.

I'm new here so my opinion is worth much less than everyone else's, but I have been having an awful time getting blood from the ear. I would say that two out of three sticks don't do it. Until tonight. I took a flashlight and slid an empty pill bottle over the end (my flashlight doesn't have a plastic lens on it so there was no flat surface, but that's the only reason for the bottle). I then held his ear against that (so the light was underneath shining through the ear up at me) and the vein was clear as day. One stick, instant drop of blood. I highly recommend giving that a try if you are having trouble. It's like a little light table for glucose testing.

And I can relate to the nerves. I hate needles and I hate the thought of doing anything that hurts him. But I can honestly say that it's only been 6 days and it is already much easier. I'm getting less edgy about it and he is getting more used to it as well. And even when I have had to poke him 3 times he doesn't react at all, so I can't imagine that it is really bothersome to him (he squirms because he hates being held, but that's it).

Hope any of that helps.

 

Will do! He's more relaxed about testing, but I'm too anxious to shoot without testing so I'm so glad to have this site...

 

This is what I have to do with my hours between work and classes. I am in "Relaxed Lantus" also, my boy was on PZI for over 1 year with ok results just not the best, so my vet changed him to Lantus, learning right there with you. Welcome this is the "best" site ever.

 

Testing anxiety on the part of the bean (that is our slang for a human being) is perfectly normal. In fact, the beans are usually much more nervous than the sugarcats are! :shock:

If your cat does not like to be held, is there a position that he likes a little better? Maybe in your lap, up on the bed, someplace to make the cat feel more comfortable.

If you are a multiple pet household, I suggest blocking the other pets out of the room while you are doing the home testing. They can be a major distraction and you need to be calm, cool, collected and concentrating on your patient, I mean kittycat. :razz: Take deep breathes, lots of deep breaths. That and a little chocolate always helps to calm me down. :lol:

There is a really good article on the psychology of testing your cat, making it more comfortable for your cat and easier for you. Article was written by member Kpassa and I do not see that I have pointed it out to Nikki's mom yet. Here tis: https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology

And MNYC, don't you dare put a lesser value on yourself because you haven't been here long! I'm scolding you because even being a new person, you give a perfect example of a piece of useful information for another member- using the flashlight to highlight the ear and see the vein.

That is what this board is all about, helping each other. If you have learned a new tip, please pass it along to someone else. Everyone here can always use some encouragement and we all can do that, no matter how experienced.

I tend to be way too serious in my responses to posts so I need other people to help lighten up the situation. I'm a "just the facts" type of person so I tend to write that way. I also tend to get really wordy. ;-)

Folks, remember that this new sugardance we are all participating in is a marathon and not a sprint. It's an ever changing cycle of dance steps that can have us doing the salsa one moment and a foxtrot the next. Bet you didn't know you were all going to be taking the impromptu graduate level crash course in treating feline diabetes. Welcome to the club!

Hang in there, we are all here to help you along the way. It does get better, I promise.

 

Thank you (again). When I say difficult, I mean that Nikki has always been very defensive about her space. She bit the vet tech 3 times at her last visit just when being weighed! I'm hoping that if I go slowly and just get her used to me touching her ears that we'll get to actual testing in short order. Unfortunately I can't treat because of her special diet, but she loves being brushed so I'm planning on rewarding with that...fingers crossed it works!

 

What about a little piece of plain boiled chicken? The Hill's Z/D is basically chicken and rice with added vitamins and minerals.

If you don't want to try that, then some loving with a hug or ear scritches or brushing are all good ideas for substituting for a food treat.

 

I would try and stick to as close to every 12 hours as you can as Lantus works best that way - if you shoot early or late (more than 30 minutes) it behaves like a change in dose which isnt ideal.

How does this work for you? And then during weekends you can get some spot checks in at other times

8am shoot test feed
6pm - occasional 1xweek test if you are home early.
8pm shoot test feed
11pm before bed test
3am - occasional (2x week) set the alarm and get up and test and back to bed FYI humans sleep pattern is around 4 hours anyway so you will be in light sleep at that point and it wont be as painful to wake up briefly.

Oh and here are some testing tips : https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Wendy

 

I'm sort of at a loss for procedure. The vet said I should do timed feeding 2x a day. Nikki is a reallly slow eater, so he suggested I leave food for 20 min and then shoot. From what I'm reading here that seems to not be best practice? She has to stay on z/d which is relatively high carb, so I'm not sure what order I should be feeding, testing, and shooting.

It''s amazing that the shot giving is the easy part with all of this!

 

Generally we test, shoot and then feed. Some people feed and shoot while they eating. We withhold food for two hours before the test so that the test number isn't inflated by food.. Especially important when they are low.

How did he used to eat? We do all sorts of things here. Some people like me free feed all day, some feed many mini meals, really it's up to you.

 

Ain't that the truth! :lol: ;-)

I'm not familiar with what z/d is used to treat for, but knowing what I know about most "prescription" foods, it's probably snake oil (with the pet food companies as the snake oil salesmen and the vets as their unsuspecting peddlers). Maybe I missed it, but why was she prescribed the z/d in the first place? What is it being used to treat?

As to feeding, there's a great discussion about how often to feed newly diagnosed kitties that I recommend reading through to give you some more ideas.

And to answer your original question about work and testing: eventually, testing will become so routine that it'll take you less time to test (and give a shot) than it does to feed Nikki. :lol: What I do is always test before every shot and grab a before-bed test every day. Then, on the days I'm working from home or it's my weekend, I test randomly and every so often, I.e. if Mikey goes to his test spot because he wants to be fed or given a treat or if I look at the clock and it's an hourly increment from his shot time (for example, if his shot was at 7:30, whenever I happen to notice the time at XX:30, I'll grab a test).

On the days I'm working in the office, I'll also sometimes run home on my lunch to test (I live close enough that I can squeeze this in my lunch hour). Other than that, if I'm home at night, I try to get some more spot checks in as well.

 

Z/D is a hydrolyzed protein diet used in cats with severe food allergies. If it works to manage those, then you treat the diabetes around that.

Unless you can find a way to break down the protein into its constituent amino acids at home (papain?), the Z/D is the only one with which I am familiar.

Just Googled - Royal Canin may make one for cats too.

 

Nikki's had digestive issues for several years now. At first, it was the occasional diarrhea. Then, it became several days worth of diarrhea with a few decent weeks in between. By last fall it was pretty much constant diarrhea. It got to the point that I'd have to bathe her because her rear end got so sore :sad: We've tried a holistic vet (aloe juice, omega-3s, and prozymes), limited ingredient food (venison and lamb varieties), grain-free food, low residue food, and a couple of other foods. Nothing worked. By last December she was so miserable I was thinking of putting her to sleep. Bloodwork was fairly normal, ultrasound showed no abnormalities. Flagyl didn't help. No worms were found in fecal. We're not sure if she has a food allergy, IBD, or cancer (although ultrasound should have shown any lumps). Finally we tried prednisolone as a last ditch. After 2 weeks of her getting worse, she turned the corner. I got her down to one pred half dose a week and the z/d and she was doing really well on that. Unfortunately, the pred may have been what sparked the DM. So, we stopped the pred entirely and now her digestive system rests solely on the z/d. I've tried so many foods that I'm afraid to change anything for fear of re-igniting the issue. She's had issues on Nutro, Wellness, Orijen, Royal Canin low res, Royal Canin limited ingredient, and Instinct Limited Ingredient (and those are just the ones I remember!)

Thanks for the feeding link though, I'll definitely check it out! Unfortunately testing tonight did not go well. She cried piteously the entire time and I got some blood but not enough yet. I'll try again tomorrow!

 

When you are first starting out with home testing, it takes practice and repetition. One thing you might try, is to test at times other than the shot time. Yes, we want a pre-shot test number but cats can be very squirmy, especially if you are doing multiple things at one sitting like test and shot.

By testing at random times during the day, you are giving yourself fewer tasks to accomplish. You are only testing, no shot. It can make it easier and give you more practice. Remember to treat with the test. Since Nikki can only have the Z/D food, you could give a tiny bit of that with a test, maybe 1/4 t to 1/2 t I think would be plenty. I also know the Z/D comes in a dry form and a piece or two of that could be used for a treat if you have some. If not, maybe the vet has an open bag of the Z/D and could give you a sample.

I understand totally on the constant diarrhea. In my cats case, being on the Z/D was actually what was causing the nonstop diarrhea. A switch to the Hill's d/d novel protein venison and green pea helped some but still very expensive. Vets always seem to assume that a novel protein will 'cure' ibd or constant diarrhea issues. After getting no help from my vet on alternatives, I did some research and tried grain free foods. That did the trick finally. No more litter box avoidance.

I understand your reluctance to use another food for Nikki. Until you decide to do allergy testing to narrow down the digestive issue cause, then staying on the Z/D is the way to go. You will simply have to adjust the insulin dosage around other contributing health issues she is dealing with.

 

My biggest struggle right now is testing. She hates being touched without permission, so by the time I warm her ear, she's already trying to bite me. I've tried both using lancet free hand and not, and have a hard time getting enough blood, plus as soon as the needle hits her ear she starts squealing. It's awful :sad: I got the Relion Confirm, but haven't gotten enough blood yet to run a test...

 

Could you distract her by feeding her a little bit of food first? Just a tiny bit. It takes the food at least 30 minutes or more to have any impact.

Also, sounds like you need to get Nikki used to the fact of being touched more, period. Do more touching and petting and ear touching outside of test time. No pokes, no insulin, no nothing. Just some lovin. Get her more used to being touched everywhere, especially around the head. Most cats love ear scritchies.

How about it Nikki, can mommy try some more ear scritchies on you without you biting her?

Maybe touch her ears while you are brushing her. To get her more used to having her ears touched.

Another idea is to play with her for 15 minutes or so before you test her. Some active play can end up being relaxing and then maybe she won't try to bite you when you touch her.

Is she growling at you, maybe batting out a little, nipping a little with her teeth? Or is it more like she becomes a demon, struggling to get away, clawing you, screaming at the top of her little lungs, biting hard, and struggling fiercely, just freaking out? If so, you may want to try the 'kitty burrito'.

 

She's not really struggling, it's more that she's whining about being held, but the pitch changes to a "Mom, you're hurting me" cry when I poke her ear. :sad: She's also being a little touchy about the shots, so maybe it's just too much change at once.

I'm going to back off on the testing and start fresh in a day or two. Will try touching her more to get her used to it. Unfortunately I gave her some treats that she could tolerate while on pred, but now that she's off pred they gave her a little loose stool, so treating seems to be out. She is boycotting the z/d dry food so I can't use a piece of that as a treat. It's very frustrating dealing with her, she's never been an easy cat and I feel like I'm trapped right now with her. My whole life is revolving around getting her fed on time, her shots on time, and stressing about testing her and whether her digestive issues will flair up. I'm having a really hard time dealing with it all.

 

While you continue to work on the blood glucose monitoring, there are some Secondary Monitoring Tools in my signature which may be helpful.

 

Thank you! One thing Nikki is good at is peeing with her rear end facing the front of the litter pan, so I've been able to get ketones and urine glucose tests done almost every day so far.

 

Who knew that her peeing style would turn out to have some advantages!

It's not only a lot of change for Nikki but a lot for you to deal with too. My Wink used to whine before I ever got the lancet within a foot of his ear. It's the being held part they don't like much but you may be able to find another way.

Here is a link on Ear Testing Psychology written by member Kpassa:
https://sites.google.com/site/michelangeloprofilefdmb/feline-diabetes/ear-testing-psychology

The article talks about how to make your cat more comfortable with the ear testing process.

 

One thing that might help with the testing is that as soon as you have the blood drop scoop it on your fingernail and lightly pinch the ear with your other hand for about 3 seconds. THEN finish putting the strip in the meter and test from the drop off of your nail.

It might help.

Also, I do rub Sneakers ears at other times during the day just to get her used to it. She wasn't a can that liked treats so she never got into the treat thing- (but I found out she will let me cut her nails if I give her freeze dried shrimpies :lol: ). Her food was her 'treat'.

No, she didn't like the testing at first and there are some good methods to use if Nikki continues to protest- the burrito and the mohawk are both effective methods.

 

Nikki's now fighting me when I give her shot. I've been giving it while she is face down in her food, but as soon as I tent her skin she attacks and runs. Ugh. :sad:

 

Mikey went through that stage for a bit. I figured out three things: 1) he prefers longer needles over shorter (or I've got better technique with longer :lol: ), 2) he prefers me to give it in his right side over his left and 3) once he caught on that he was getting shots twice a day, he no longer tolerated the sneak approach and I discovered by simply alerting him, "ready for a shot?" made him much less jumpy and he cried out less. It also made him realize he could turn it into a game of tag. :roll: :? When he does that, I get out the cat toys and play with him for a bit to get his excess energy out before giving him his shot.

 

I have to admit I freaked out and called the vet. Her various illnesses just seem overwhelming. I can't treat or change her food because of the gastro issues. Her food is high carb so she'll probably not get OTJ. And she's a witch on top of it. I was at my wit's end yesterday. I'm feeling like I can pin her down to shoot if I have to, but I can't ask anyone else to risk getting bitten. I live alone and like to travel. I'm missing my mom on Mother's Day because she lives too far away to go for just the day and I have no one to take care of Nikki.

BUT. I sucked it up last night and pulled out a Wellness Pure Delights treat, which she could tolerate when she was on the pred. I don't think I can give 2 a day without her intestines freaking out, but shooting in morning is easier, so I"m going to give her one when I shoot at night and see if I can get her past the protesting. I know the shot doesn't hurt, so I know she can get over fighting it. Hopefully she'll tolerate the treats enough for this to happen. I'm also being a bit more careful about using the best technique I can for the shot. I really hope we can get past this stage. If I can get her to where she's not fighting the shot it will be easier for me to find someone to look after her when I need to be away from home and maybe we can all settle in to this new normal.

 

What size needle are you using? I use a short one and barely tent tiggy at all, I just pull the skin up by pulling on the fur a bit and make sure I go in at a very shallow angle.. Not even 45degree.

Maybe it would help if you practice on something like a potato so that you can get it into her quicker when she is busy eatingafter.

 

Yes! This is actually what I use for training my "surrogate shooters," as I like to call them. :lol: I cut an apple in half and have them give water/air shots to it so they can see the angle of the needle as it goes into the Apple skin and the depth of penetration, as well as how hard they need to push on the plunger. It really helps them visualize what they're doing when giving a shot.

 

I like the idea of an apple for teaching! That's definitely better than sticking my other cat (the docile one) for practice!

I discovered tonight that she's really just being a witch. She complained and tried to leave when I tented so I corralled her loosely with my arms while trying to hang on to a bit of skin. After a minute she got bored with complaining and stuck her nose back in her food, so I shot and she didn't even notice. Oy this cat!

Working on testing a bit too. Picked out a spot and am hoping her insides tolerate non hydrolyzed treats. I still need to work on my technique there. Freehanding isn't working for me when she's got her ears pinned back and is squirming. The lancet device that came with the Relion doesn't seem to poke out very far (even on the highest setting) so I may try getting a different one. Since her levels were only in the low 400's at the vet I really want to get that blood out of her ear!!

 

cool! sounds like you made progress.

The way I like to think of it is that my cats are totally spoiled. They have no worries in their lives unlike us. They don't worry about money, safety, where their next meal is coming from. And then when you try and do something to take care of them they object just because its not what they wanted to do. They need to get over themselves.. It's a very very minor inconvience. So I bear that in mind when Tiggy is being a pain in the xxx, and sometimes I even get a sick sense of satisfaction poking him! especially when he is meowing at 3am because he doesn't like the look of the food in his bowl. H yeah well then poky poky for you!

 

I'm trying! She's always been horrible to handle, but now my lack of getting her into being handled is biting me in the rear end.

I'm still sort of feeling like I'm hurting her when I poke her ear and she cries. :? I know I need to git 'er done but my lack of ear poking no-how is killing me. I did just realize that the lancets that came with my meter are only 30 gauge. Rectifying that issue tomorrow. I suspect that may be why I poke and poke and don't get any blood. If all else fails I'm going to make my vet show me when I take her in for her first follow up. :razz:

 

I heard testing is as painful as a mosquito bite. You could try and put some neosporin on it first to ease any pain but I suspect she is just objecting to the whole experience. Remember the post testing treat!

Are you putting something firm behind her ear to press against?

 

I have a hard time treating as she's just recovering from a round of gastro issues late last year. She's only been able to handle Hill's z/d so far. We just took her off pred about 2 weeks ago. I'm starting to sneak some other food/treats in that she likes but I'm balancing between treating and bringing back the horrible diarrhea she had. She was almost put to sleep when we finally got a handle on things last year.

I've tried a cotton ball behind the ear. No joy. I have a small pill bottle that I'm using to warm her ear. Maybe I should poke against that?

 

Yes, the pill bottle behind the ear gives a nice firm surface to poke against.

 

Just the other day, someone mentioned that their kitty's digestive issues had been much better since they started using ReNew Probiotic and I immediately thought of you. Have you ever heard of it or tried it before? It might be something worth looking into that could help.

 

No, we haven't tried that one. She's been on FortiFlora or Proviable over the last 6 months. On their own they didn't help, but now that she's back off the pred it certainly couldn't hurt to add a new probiotic...I'll check it out!