New to Board: violent cat won't let me meter test

Hello everyone:

I am new to the board and come to you overwhelmed and exhausted from fear. I have a lovely 15 year old companion (been with me for 12 of those years), Caesar, who was diagnosed with diabetes nearly two weeks ago after I took him in for severe self mutilation (pulling off chunks of hair, skin, deep wounds with bleeding) and a terrible twitching I'd never seen before (thought they were seizures, but it is actually diabetic neuropathy). I almost made the decision not to bring him back home because Caesar has serious behavioral problems from two prior abusive owners that have required me to use drugs such as Prozac and Amitriptyline to keep it under control and I was scared he would not let me give him injections. Luckily, if I am fast enough and after he has eaten at least half the food, then I can give him insulin without much more than a low growl. However, the monkey wrench in all this is I cannot meter test him. I attempted to pierce his ear with a lancet and he became highly agitated, hissing and meowing threats. Keep in mind this is a cat that has violently attacked on at least four occasions in his life (two just this past year) to the point that he did not even recognize me until he came back down to earth. The vet has said these are moments of "insanity" and that he does not even know it's me in front of him when he has these episodes which are usually kicked off usually by something or someone he sees as a threat. Luckily I can now see the signs when its coming and distract him from a potential situation at hand, but it is very important that he does not see me as the source of any threat and this interferes with the ability to take blood glucose readings. Note he must be knocked out for every vet exam since it took a doctor and two vet techs to get him back in the carrier after an "episode", so this may give you some sense of how wild and crazy he can get.

Now I have been up and down the gamut with "use treats", "try the burrito wrap", "sneak up on him", etc. and I know this cat well enough after all these years that none of these ideas will work, especially the wrap since he hates being confined in anyway (nearly broke his teeth on the carrier gate last vet visit and that was AFTER a tranquilizer was given). If I lose his trust in any sort of way in terms of handling him, then it's over because he will not let me give him injections. As a result, I am now on my 22nd page of behavioral observations over a two week period to help determine what his dose might be only to find out from the vet that it needs to be increased (he is getting hungry way too soon, the twitching is still evident, restless behavior, dry skin). I feel like the Jane Goodall of cats, but I wish so very much he just would let me meter test because the worry is wearing me thin. While I fear high blood sugars, I fear hypoglycemia even more (he's on high protein, low carb Evo canned food) and I'm scared that one day, he might produce a bit of insulin and crash on me after I've left for work.

Does anyone have any suggestions other than keep on observing? Do they make a meter he can perhaps wear for a day or two to help with periodic curves? He is willing to wear a soft cone. Otherwise it's a guessing game between watching him, urine sticks and fructosamine tests. If "keep observing" is the best bet, then can anyone share the subtle differences between hyper and hypo? Based on the last four to five days of watching, it was easy for the vet to determine it was too high and he needed more insulin. I, of course, thought it was hypoglycemia since he was weak in the legs and shaking.

Thanks,

Julie

P.S. Stats if anyone wants them: Neutered, 9 lbs (lost weight for his large frame), BG 508 at vet, no damage to kidneys or liver, was 2 units of Lantus twice daily, but is now 3 after tonight. He is on a Evo 95% chicken and turkey/5% other stuff - 3/4 of a can at each meal.

P.P.S. he's a long hair. Any tips to avoid fur shots? I'm ready to carve some holes in his fur

P.P.P.S. I'll take emotional support too if you have it because my anxiety levels are off the charts. I know he sounds like a handful, but he really is sweet and loving to me... except when I'm sticking him with sharp things ;-)

You are a wonderful mama! You're doing great so far. You are right to fear hypo more than hyper (with the exception of diabetic ketoacidosis--that's really bad!). You may be able to test for ketones in his urine, though without freaking him out too bad. Have you tried that? You can buy keto-diastix from most pharmacies. They test for ketones and glucose in the urine. This will help you to know if his sugar is getting dangerously high, or if he is spilling ketones into his urine.http://catinfo.org/?link=felinediabetes#Collecting_Urine_for_Ketone_and_Glucose_Measurements Here is some info on that. Now, those ketodiastix will also tell you if he is spilling sugar into his urine, and give it an approximate numerical value. That may be helpful for you, too, BUT those results are not indicative of his glucose level at that exact moment. It lags behind, so it may be the approximate value for a couple days prior. But any information is better than no information at all. I have never dealt with a difficult cat like this, so other than that I don't have any good tips for meter-testing him.

My only other concern is the quick rate that the dose has been increased with very little testing data to go by. Since Caesar obviously gets stressed by the vet :evil: his numbers there may be radically higher than when he is more comfortable at home. Usually Lantus is increased in no more than 1/2 unit increments. Hopefully some more Lantus folks will stop by with some good info for you on that.

You are off to a great start. You cannot let this run your life or overwhelm you. You are one person, you do what you can do to the best of your ability. If that means using the urine dipsticks to protect yourself, then that's what you will do. It will work out.

I feel sorry for both of you, what a mess!

Was he diagnosed at all with a fructosamine test or just blood gluocse? I ask because stress can elevate bgs and make it appear a cat is diabetic when he may not be.

the hair pulling doesn't sound like diabetes although with his history it might be, but it sounds more like allergies or psychological. How are his meds? My dog is on amitriptyline btw so I am familiar with it in canines.

I think you will have to follow the link about urine testing, and really learn to watch his behaviour, his urine input and output. Some cats cannot be tested, some cannot get needles. You do what you can...

Sending good thoughts

Jen

Often we develope a stronger bond with our diabetics over the course of treatment so maybe over time he will learn to trust you enough to get testing. He will come to connect the feeling better with what you are doing to him. For now it sounds like urine testing might be the best option unless you got a cone on him and tried a paw pad test, but that sure wouldn't increase trust for him! Good luck. It is overwhelming when we have somewhat cooperative cats, I can't even imagine what you are going through with an agressive cat.

I urine tested Moonie for 11 mths..I used a product called Purina Glucotest Urine Detection system which is available on line, I believe at amazon.com--It is tiny squares which are put into the scoopable litter, and as the cat urinates on them, they change color--There is a chart on the bottle that tells you what the urine glucose is at that time, BUT remember the urine stays n their bladder for 3-5 hrs, so it is not testing the Bg at that exact moment as a regular BG test does--However, I managed to test her 2-3x per day, or whenever she would go, and that way I had a means to sort of know where her BG was...
Look the only way I was able to test my Wild Child(cat) was to finally put down food for her & while she was distracted by the food, I tested her--Someone from the board came over to show me how to test, and we have been doing it ever since, several times a day..
Another member also had an outdoor cat that she managed with the Ketodiastix, and that kitty lived a very long time that way--It is manageable, and hpefull at some point you will be able to BG test--GOOD LUCK, you just need to stabilize him & win his confidence--With cats, its' ALL About Trust!

Hi Julie!

I recall feeling the way you do, very well! My Calliope was some kind of fractious when it came to testing, but I think Caesar may be even more of a challenge. I urine tested with the ketodiastix for the first days until I could finally get the testing done via burrito wrap and it was dramatic every single time. However, as was suggested, Calliope and I developed a special bond and it got a little easier. She was not cooperative by any means, but her fighting level did go down in intensity a bit.

One thing that helped me was buying Halo Liv a Little freeze dried chicken treats. I tried all the other low carb dried treats, but she sneered at all of them, but Halo and many folks on the board use them to entice the kitty to test and as an after reward. Might be of help to you in testing or even shooting the insulin. I had to order mine and I just google them and find the cheapest usually with free shipping since i order a lot at one time. I haven't heard of a kitty yet who doesn't act as if those treats are crack. Over time, they might work for you in one way or another. The lowest I've found them is between $6 and $7 a jar and that's usually when there's a discount sale going on. If you can find them between $7 and $8, you're doing okay. This is where I ordered them, last week. They already went up again.

http://www.vitacost.com/Halo-Purely-For ... ein-Treats

Here they are for $6.44.

http://www.swansonvitamins.com/HL013/It ... =129498486

You might check in your area to see if any stores carry them.

Be sure and read the "how to treat hypos" sticky at the top of the page and get the supplies for the "toolbox" as suggested just in case you face a hypo situation. I see that you jumped from 2 units to 3 units without any daily testing going on. We don't usually increase insulin by units without that, so I admit that it makes me nervous. Might be a fine dose, but we have no way of knowing that without data. Urine glucose testing will at least give you something to go on, though it won't be as accurate as blood glucose testing. For some folks, this is all they can do and they have been successful in keeping the kitty safe that way, so there is a light at the end of the tunnel! Watch that increase, closely, though. It takes time for lantus to settle and you might not see a result for several days until a dose settles. I would also recommend that you go to the lantus forum and read the stickies about lantus at the top of that page. It helps to understand the insulin and how it works.

We have seen many cats go into remission when the disease is caught and treated early. Calliope went into remission after 18 days and she was 500 at the vet when originally diagnosed. The switch in food along with insulin in low doses did the trick.

Some folks with long haired kitties shave the shooting area or cut the hair, whatever you can do to be able to see better to avoid the fur shots.

Pat yourself on the back, because I can tell you are a great mom just by reading your very caring and informative post. You have already educated yourself to give us a lot of information and you're really trying to help Caesar in the best way you can considering his history and fears.

Until you can get the purina glucotest, try and catch Caesar peeing with the ketodiastix. Calliope wouldn't allow me to interfere with her "private moments", so when I knew she hadn't peed in a bit, I put a disposable litter box where her other one was and I put in a garbage bag with just a wee bit of litter so the urine would pool for me to dip the stick. I'd just have to leave her in the room with food and water and keep checking every few minutes to see if she went. It was tedious, but the only way I could get any info at all. I used the glucotest after that for a few days until I was able to figure out the meter testing. I had to put her on the counter on top of a blanket and wrap her quickly. Had to have her up high so I would have control. I would spray the blanket with catnip spray before hand, which was of some interest to her. I couldn't free hand with the lancet because I had to hold her and figure out how to test at the same time. Finally got my rhythm on it. I used vaseline on her ear before testing so the blood would pool. Just a few tips in case you get that far. I know how difficult it is and if you don't get there and can only ug test, then that's the way it is and you just do your best with it. It's not optimal, but it's not the end of the world, either!

Hug your kitty and I hope some of what I've written helps you!

Hi dear Julie! I feel your pain!
This sounds like what i have been through with my Smokie girl.
Smokie is now 17 years old and a diet controlled diabetic with CRI.

I have used the urine testing twice with Smokie and was susccessful both times in
getting her OTJ.
She was diagnosed with diabetes at 14 years and went into remission in one month.
She went out of remission July 4th of this year after an injection of Depomedrol.
With some insulin and the urine testing she is again diet controlled.
It wasn't easy but can be done.

Roni gave you some good information. If you want to use the Glucotest Urine Detection system it is available on line at amazon.com
You may also find it at a Vet clinic in your area. Some Vets carry it.

I was able after a few attempts to collect urine when Smokie used the litter box.
I used a tiny plastic one fourth cup measuring cup and was able to slip it under her with
her seeming not to notice. Be sure and wait until Caesar begans to pee before you slip
it under him.

You can get the Diastix for testing urine glucose at Walgreens if you want to use the strips.
Also get the Ketone test strips. You need to test for Ketones also each time.
Ketones are very serious and need to be reported to Vet immediately.
Check the urine as often as you can and see if the numbers start to drop any.

The 3 units of Lantus is awfully high. That would really scare me to give that much.
Hopefully someone here will be able give their thoughts on this.

Is Caesar any better today? How are you feeling?
I am so glad you brought him home and are helping him. You are a good Mom to him.
Just tell yourself "i'm doing the best i can for Caesar," and try to take it a step at a time
each day. He may even become diet controlled in awhile!!!

HUGS, Maryjo


Hypoglycemia....look for the following signs in your cat: In mild cases, your cat may seem lethargic, weak or tired. Twitching or shivering can occur too.


In moderate cases, your cat may act "drunk", ie. uncoordinated and disoriented. You might notice her bumping into things or acting different (aggressive, yowling, walking in circles, walking with her head tilted).
In severe cases, your cat may suffer a seizure and/or become unconscious.
Hypoglycemia can be very serious and lead to death (if untreated), so a quick treatment is necessary.

Hypoglycemia vs. hyperglycemia
Hypoglycemia:
Hypoglycemia is the medical term for low blood sugar. Diabetics have the opposite problem of hyperglycemia, or high blood sugar.
Diabetic cats can develop hypoglycemia (low blood sugar) when their diet and treatment is managed incorrectly. Symptoms of hypoglycemia include:
Abnormal hunger or disinterest in food
Restlessness
Weakness or lethargy
Shivering
Staggering or uncoordinated movements
Loss of eyesight
Disorientation
If your cat experiences symptoms of hypoglycemia it is recommended to contact your veterinarian for advice. In the meantime, you can try feeding the cat some of its normal food. If the cat is unwilling to eat, try encouraging the cat by offering a small amount of corn syrup on the food. In cases of extreme condition, contact your veterinarian and take your cat in immediately.

Hyperglycemia:
Hyperglycemia is when your cat's blood sugar levels are too high, resulting in the primary symptoms of feline diabetes, including:
Increased thirst
Sudden increase in appetite
Sudden weight loss (despite an increase in appetite)
Increased urination
Increased lethargy

Generally, hyperglycemia is not life-threatening and can be controlled through administering insulin. Your veterinarian will work with you to develop a regimen for testing and controlling your cat's blood sugar levels to avoid hypo- and hyperglycemia.
© 2011. Boehringer Ingelheim Vetmedica, Inc.

I know some people with fractious cats have used the clothespin trick to test with great success. Here's a link: http://chcats.acmaurer.com/the-clothespin-trick

You may get some snapping putting them on, but for the most part even crazy cats will calm down for it. It will probably hard at first--but after a week or so even difficult cats calm right down and accept the testing, especially if you use treats and neosporin + pain relief. Basically, as soon as the cat associates the test with food, it gets a thousand times easier(and they don't feel pain anymore after the scar tissue builds up a little bit in a week or two).

Don't use the skinny lancets (30-31g). Get some that are 26-28g so that you have a better chance of getting blood on the first shot. The faster you can get the test over with (and it's so hard to do that when you're first starting out), the less irritated the cat is.

I am really concerned with your dosing, though, especially since you're not hometesting and he's completely switched over to a wet diet. Most cats on a low carb wet diet never need more than 1u of insulin. 2u was too high a starting dose, and 3u is a very high dose of insulin. You won't be able to tell by observing if the dose is too high until it's too late and you have a deadly hypo situation on your hands. Too much insulin looks exactly like too little insulin--when a cat is on too high a dose, their liver dumps glucose into their bloodstream as a survival mechanism and keeps their blood sugar high. So the cat is in double jeopardy from both high and low blood sugar. Until you have some way to get a reading on his blood sugar, I would really urge you to reduce that dose to 1u and urine test for ketones. Here is the dosing protocol for Lantus: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581. A starting dose should be 1u (unless there is a complicating situation like diabetic ketoacidosis and should only be raised in .25-.5u at a time.

Good luck! I hope you can find a way to test! You're doing a really great job!

You have already received some great advice and I won't repeat it.

Does he trust you enough to let you pet him? If so, start petting him around his head including massaging his ears. That will get him used to you touching his head and ears. The massaging also helps to get the blood flowing. It may take a few days or possibly weeks, for him to get used to it and possibly begin to enjoy it. Don't worry about trying to test his ears yet, you have already been given advice on other testing methods. Also begin rewarding him with treats when you pet him. You want to get him to associate you touching his head with good things.

When you do begin testing with a glucose meter, I suggest that instead of trying to use the lancet pen that comes with the meter, use the lancet free-hand. To me it is more accurate and since most of the pens "click" when you use it, that could frighten the cat. Use the larger guage lancet. Try to have everything ready when you test - lancet uncapped and strip in the meter. And when you are successful at testing without Ceasar getting upset, even if you do not get blood, reward and praise him.

Since he is long haired, you could ask the vet to shave away a spot so you can avoid the fur shots. You also may find it easier to give his shot when he is eating since he will be focused on his foods. Also, get some Methyl B12 vitamins and put it in his food. That will help with the neuropathy. Make sure the B12 is Methylcobalamin and not Cyanocobalamin, that is the only B12 that works for neuropathy. You can find it online or in many health food stores.

Clothespin trick never worked on Calliope, but it's definitely worth a try. Calliope never accepted testing. She was a drama queen and had to be burrito wrapped for the rest of her life in order for me to test her and she retreated thereafter, though she always forgave me, eventually. LOL! The treats did help somewhat. She didn't fight me quite as hard, but she still fought.

Mary Jo knows what it's like not to be able to test. She just had to get Smokie back into remission again. I live around the corner from her and even went over there to try and help her test, but no dice.

Try all the tricks, though. You never know what might work until you try and it may even be that when Caeser feels better, he gets easier to handle because he feels that you have helped him feel better. Those things do happen.

I would definitely change the food your feeding. It's counter-productive to feed that dry food. However, I would also lower the dose before the switch. When I switched Calliope to Fancy Feast low carb wet, her sugar dropped pretty dramatically. I never went higher than a 1u dose, even though my vet wanted me to start at 4u. Thank goodness I didn't do that especially since I was ug testing. First reading I got on Calliope was a 40. The food made a real difference. I returned all the unopened bags of the Hill's I'd bought at the vet.

gingerand((calliope))(GA) said:

I would definitely change the food your feeding. It's counter-productive to feed that dry food. However, I would also lower the dose before the switch. When I switched Calliope to Fancy Feast low carb wet, her sugar dropped pretty dramatically. I never went higher than a 1u dose, even though my vet wanted me to start at 4u. Thank goodness I didn't do that especially since I was ug testing. First reading I got on Calliope was a 40. The food made a real difference. I returned all the unopened bags of the Hill's I'd bought at the vet.

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I believe Julie mentioned that Caesar is already on a wet, low carb diet--he's eating EVO 95% Turkey & Chicken. This is a great food--I feed it to Bandit, too.

You're right. I'd actually read another thread and got the two confused. Thanks for catching that!

Hi again everyone:

Apologies for the late reply, but I have been observing him as closely as possible when I get home from work and time for internet is short. I greatly appreciate all the wonderful advice and support. At the moment, the increase to 3 units has not affected him in terms of hypo (yet) and I have noticed that his coat is "silkier" than before. I first started the increase Tuesday evening at the 6 pm feeding (eats at 12 hr intervals) and he seemed to be fine except that this morning he woke up extremely hungry and drank a lot of water last night which may have been the result of a "fur shot" last night. I'm pretty sure I got under the skin this morning and will be sure to keep measuring his water intake.

For those curious...

@ Jen & Squeak - Caesar was diagnosed with a blood glucose meter at the vet while they had him under anesthesia. She stated, "based on this reading and looking at his physical state (dry skin, evidence of starvation), I can tell you right now he is diabetic." I am confident in agreeing with her diagnoses because I see the signs of diabetes coming on in retrospect. I'm ashamed to say I mistook a lot of what he was displaying outwardly as an "old age" thing, such as the neuropathy being "an old creaky cat" and the drinking of so much water I thought for sure was the result of two abscessed teeth he had removed about a month or two prior.

@ Melanie and Smokey - I may have a better chance at getting it out of his ear. I do plan to cross my fingers and try again, but may do so after he has eaten and it less agitated. Will be sure to follow with a high protein treat.

@ Roni and Moonie/Ginger and Calliope/Maryjo and Smoky/Julia & Bandit/Lisa and Witn - thank you for all the details on the stop gap suggestions and will head to the pharmacy today. I realize this does not take the place of meter testing and I hope to try again at some point very soon, but it's been a very slow process with the bottom line being if he loses trust in me, then I will not be able to give him insulin at all. He is very high strung and (I think it was Jen & Squeak that mentioned behavioral issues), yes, it was present long before this arrived although the vet seems to think that the presence of diabetes encouraged him to strip hair and skin from his body due to extreme discomfort and not feeling right (this has been a real pain BTW in finding usable spots to inject since some of of his wounds were an inch wide by three inches long).

I do have two more questions to help ease my anxiety:

I realize that a hypo episode could occur at any time for a multitude of reasons, but if it should happen to occur after feeding and insulin administration, then about how much time would theoretically pass before it shows up? Thirty minutes, an hour, two hours? It may not make a difference, but I have been making sure to feed him 1.5 hours before I leave the house for work. Then I lock up my other cat, Squeeky, just in case he vomits and instinctively tries to eat it, but if she does then he's toast (yep, it's gross but we all know what our pets do ;-) ). Besides, I notice that she has been roughing him up lately in the morning since starting him on insulin and I feel better knowing she is isolated while I'm away.

I asked my vet about Methyl B12 and her reply was something along the lines of "it's actually the regulation of blood sugars that takes care of this". I think she was trying to nicely say to me that there's not a well proven benefit that it works. While I do follow the guidelines of my vet, I am open to listening to what others have to say. Thoughts?

Again, thanks to all of you for the warm welcome and support. I need to run off to work soon, so if I missed anyone or any specific questions, then please let me know!

Take care,

Julie

Mrs. Julie,
My Sugar Bean is not a big lap cat....only when she wants it....This is where we do testing...I started her with her treat which is Tuna Flakes Treat made by Petco, I put a towel across my legs, and put her up on my lap, and receive 2-3 treats before I start the test (pokey poke). I have a table next to me and get all of my items ready before I towel my lap. She also was not big on the petting around her face much less the ears (to warm).
I did this routine for a couple of days, probably 2 wks before I started to test to get her used to the spot, love, treats...Once I received the test supplies, I brought them to the test spot, and layed them out, and played with the lancet pen, pushing and clicking while holding her but not putting it around her face, just to get used to the sound...then we progressed to around the face...she did not really care for that sound at first, but we did this 2 times to 3 times a day ....then I put the pen to the ear, without the lancet so she would get used to the noise next to her face/ear without the shock of the poke....By the time I did use the lancet, she was much better...Mommy was a little better as it took me quite a few times of failing before I got it done....but she always gets gooood, sweet talking to, and if I took too long to get it all ready to do, I would let her down, give her a few before I would offer treats again, get her back on my lap and mommy try once more....
I was a slow process for us...mommy was very, very scared, and I think she knew it too.

I wish you luck with the testing of those wonderful ears...just sharing some tips that I used for a kitty that really did not like lap time unless she ask first! Now, she sees the small wicker basket that I have all of her supplies in, I call her, show it to her and start for the chair for our pokey poke time, and she is wanting in my lap before I can sit down.....I am hoping for the same for you....perhaps Caesar will get used to it in the long run!

you've gotten a lot of good tips already -- I will just add that you may want to consult an animal communicator. I recommend Dawn Allen -- she helped me with my cats - one of whom is violent at the vet. After a few sessions, we actually are at a point where we can now get a blood draw with no anesthesia. A major victory!! We do use a muzzle/mask and I hold his front end at all times to reassure him, and they draw the blood from a back leg. (he is Hyperthyroid, so we have to check T4/free T4 every 3 months or so)

www.dawnallen.org

Edited to add: I used Humulin N insulin with my first diabetic cat Norton for 18 months before I learned about home testing here. We did however adjust dose based on once a week tests at nadir time at the vet's office.

Humulin N is very different insulin than Lantus -- it only lasts 8 to 10 hours in most cats

smellycat40 said:

Apologies for the late reply, but I have been observing him as closely as possible when I get home from work and time for internet is short. I greatly appreciate all the wonderful advice and support. At the moment, the increase to 3 units has not affected him in terms of hypo (yet)

Click to expand...

Julie, I want to emphasize again that shooting 3u without testing and after a recent switch to canned food is REALLY dangerous. 3u is a high dose and most cats do not need that much insulin, and the dose was not raised to 3u correctly. If you're not testing PLEASE lower that dose until you find some way to figure out how the insulin is working. If you're not testing in some way, you're not going to catch a hypo incident until it's too late. Also, a too high dose of insulin will keep his blood sugar just as high as a too low dose of insulin.

I second what Julia said. But I recognize the serious difficulty of your position.

I also have a rescued previously-abused cat that was scheduled for euthanasia due to several vicious biting attacks. (After six months of respecting his terror about being cornered and grabbed, he is a lovebug.) also I have several ferals. one I just had to catch the other day to treat/crate for ringworm and let's just say she fought like a demon. It had to be done, but I was very concerned this would ruin our fragile truce. But she has (mostly) forgiven me and I can medicate her with surprisingly little fuss now. So I can understand your concerns.

If you are less nervous, it will be less stressful on the cat. One thing that may help you is getting a pair of cat gloves, the long ones that go up your arms. They have leather hands for excellent dexterity and kevlar arm sleeves for great protection. See animal-care.com. these saved me from multiple bites and ripped arms with the ringworm feral. Also, I think it helps when they see you are not afraid when they are biting etc... otherwise if you back off, biting and clawing are mentally deemed successful tactics. If you remain calm and talk soothingly, it seems to help a lot with calming the cat. Lavish treats too are critical -- use whatever treat is the ultimate most loved treat. A cat will tolerate a lot for what it perceives as a primo reward. Now I don't need the gloves while treating the crate ringworm feral. In your case you would be doing ear handling, beeping the meter etc. Working methodically to desensitize the cat to the activities that eventually would build up to testing. I would say always do it in the exact same location, etc.

Lastly I wonder if you used a numbing agent first, before poking... that could really help if the pinprick of pain is the problem. Maybe something like dental Anbesol would be stronger than neosporin with pain relief?

Best wishes,
laur

Hi Julia, Laur and others,

I'd called the vet after reading this and even though Caesar seemed to be doing ok on the three 3 unit doses of Lantus I'd given him (two mornings and a night on this measurement), she said if I was uncomfortable then we could drop it back to 2.5 units. Unfortunately, since doing this (over 24 hours) the following symptoms have surfaced:

-increased thirst. He was down to 2/3 a cup in 12 hours on the 3 unit dose. Today he drank nearly a cup (7/8ths).

-clearing of the plate and not having to chase him down for food. Continuing to come into the kitchen after fed looking for more food

-lethargy. His legs are weakening again and splaying out when he sits to eat. The front leg is also jutting out again at times.

-he feels very warm to the touch all over his body (he was in my lap). I am suspect of elevated temps due to high blood sugar.

-the neuropathic twitching has returned. It nearly stopped the other day on 3 units. Now it is back in the fronts and I think I even saw a hind leg slide out a tiny bit when walking this evening

He honestly seemed to be improving on 3 units (silkier fur, engaging more with the other cat, less restless), but now since dropping back to 2.5 he's seeming to back pedal. I just emailed the doctors with the symptoms listed here and hopefully they'll get back to me tonight as sometimes they check email late, otherwise it's a call tomorrow. If it' helps, the dry food I'd taken him off was was higher in protein than other dry foods (Evo Ancestral diet) and he'd been on the canned for almost a week and at 2 units before the doctor said bump it up.

In the meantime and afterI last posted, I was riding into work when I thought "why not fire an empty lancet device at his ear, followed by a treat?" (Ohbell, I believe you'd had a similar thought!). I've been doing this for about two days now and hope he'll let me pop him with it and I can get a reading soon. Today, I added a cotton ball to the inside of his ears during the mock test and I held onto his ear for a length of time, then touched it with the glucose meter (sans strip). Of course it's all up to him. The less jumpy he is then the more comfortable I'll be hitting him with a full functioning lancet. I hope this works because I am exhausted.

Hi Julie,
Laura mentioned a numbing agent. Hope you can try it.

"Lastly I wonder if you used a numbing agent first, before poking... that could really help if the pinprick of pain is the problem. Maybe something like dental Anbesol would be stronger than neosporin with pain relief? "

Let us know how things go and Good Luck!!

maryjo

Thanks Maryjo. I'd missed that (I think the general feeling of being overwhelmed is setting in). I will look into this! ;-)

Smellycat40:
Yes, you are right....we played - test at home - for a few days or more, so not only could Bean Girl get used to the routine, but so could mommy!!!! I did not get blood the first 3-5 times with the lancet in the pen, but when I did not get blood, I only tried once more in one setting as Bean was getting ressless, and mommy was getting upset and she could tell..... I really think the practice runs that we did helped her and me both..... I would also like to say that if one ear does not bleed, please warm and try the other.....I believe the first test I was able to do was with the other ear that I had not tried yet! GO FIGURE. Now, we only use that ear (left), as I still cannot get that right one to produce!

Goood luck and I love the idea of the practice practice practice without the pricking just yet! I think he is getting used to it!

I hope he gets his insulin down and sooon!!!!!

hello Julie !

Julie when my callie showed signs of nuropathy I asked my vet about it and she said it was to early for this to be happening to callie ! well callie would walk a little ways and have to rest , she was not going up and down the stairs and she was not jumping on anything ( table, chairs, window sills ) which she always did before, I know my cat and sometimes we have to decide what is best for our cats without our vets approval ( who knows our babies better than us ) ;-) cat_pet_icon .

I started callie on zobaline about 3 weeks ago and she is running up and down the stairs and jumping on the table and running after her sister ( tesse ) I listened to what my heart was telling me and I'm glad I did it for callie !

here is the link check it out and see what ya think ;-) :YMHUG: cat_pet_icon hang in there your not alone !


http://www.lifelinknet.com/siteResource ... baline.asp

I understand your frustration, but without testing it's impossible to know how the insulin is working. In most cases, cats on a low carb canned diet do not need more than 1u of insulin. Switching to canned food in most cases drops a cat's blood glucose levels by 100-200 points overnight. There are secondary medical conditions that can require larger doses of insulin, but if your cat has not been diagnosed with any of these then it is dangerous to have him on a high dose because of the threat of a hypoglycemic incident, which can be deadly.

2.5u is still too high dose of insulin for a cat on low carb diet without other medical conditions. You cannot dose based on observation of symptoms alone--too much insulin will still keep the cat in high numbers and symptomatic and look exactly like too little insulin. It's possible he is presenting more symptoms because you dropped the dose, but it's also very possible he's presenting more symptoms because his body has been continuously dumping glucose into his blood to keep him alive on that dose of insulin.

I'm not trying to scare you or make you feel bad--but blood testing is the only way to know how the dose is affecting him when it's that high. You're doing great conditioning him for it ahead of time! I understand that you have a special situation with Caesar that requires you to approach testing slowly. But if you're approaching blood testing slowly, I would strongly recommend dropping the dose down to 1u and urine testing for ketones and glucose (you can get ketodiastix at any pharmacy that tests for both). After 5-7 days on 1u, if the urine strips still show high glucose, you can raise by .25u or .5u depending on the range (if in 200s, you would raise by .25u, if in 300s by .5u). If he's presenting ketones you would want to speed up the blood testing process and dose more aggressively. This would be a much safer way to dose until you can hometest Caesar. However, this method will not work unless you drop the dose down, because if the dose is too high to begin with Caesar would still show a high glucose range on the urine strips. Hypoglycemia cannot be detected via urine testing.

If you're going to keep him on a high dose, I would urge you to start blood testing immediately, even if it's difficult for you. I just want Caesar to be safe.You're doing an amazing job caring for Caesar and he's very lucky to have you. I understand that it sounds crazy that I'm asking you to take the advice of someone on the internet rather than your vet, but people show up here every day with their cats on too high doses of insulin that their vets recommended, and discover their cats have been continuously hypoglycemic once they start testing. Hypoglycemia should be taking very seriously, and should be considered a bigger concern than hyperglycemia. Yes, hyperglycemia is not good and you risk diabetic ketoacidosis, but that is a smaller risk than a cat becoming hypoglycemic on too high a dose.

At the very least, please give the attached article and a copy of the Lantus dosing protocol to your vet, and see if they would be ok starting over at 1u in the manner I recommended until you can hometest. Here is the protocol: http://felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf