Lynn and Kitten/BG Number High?

Hello all. My husband figured out how to do the ear prick sucessfully. Kitten's level was 310 mg at 11:15am. This seems too high to me. Her level at the hospital for a recheck this past Tuesday was 270 mg. Kitten receives 1.5 units of Lantus insulin at 8am and 8pm. She has been sleeping for a couple of hours and has not eaten much since 8:30am. She was agitated with us about 20 minutes before the 310mg reading because we tried it a few times without luck before we went back and tried again. But she was very scared at the hospital and it was lower at 270mg. The hospital vet is due to call me today with the results of her Fructosamine test done on the 18th and to discuss insulin adjustments. Kitten is due for an etube feeding soon. The testing will be easier when the etube is removed, and we can hold her head still without worrying about crushing the etube and her esophagus. We are going to test in again in two hours from her last reading. I am very concerned. Do I feed her? Help? Lynn and Kitten

 

Lynn --

There's not really a difference between the 270 and 310. There's roughly 20% that's attributable to meter variance so the numbers are largely the same. It's easier on your nerves if you don't get focused on one test result. The trends and patterns are more important.

 

Yes, Lynn, you can feed her. 310 is really not a high number. It's no cause for alarm. And it's just a snapshot of that moment in time. As you continue to do this, you'll see ups and downs, and patterns will emerge. What matters is how her numbers go over the course of the day, or several days. Look at a few spreadsheets and you'll see what I mean. How the numbers relate to when Kitten eats, when her shots are, things like that. At this point, you are just gathering data. Over time, that data will begin to make sense. You guys are doing great
Carl

 

Thankyou both. Kitten just had an asthma attack from the stress. The etube feedings and now the ear pricking is too much for Kitten. Plus the weaning of two meds. Kitten gets very stressed when fed thru the etube. Also with the ear pricks. This is Kitten's disposition though. She likes to be left alone. Period. She is a challenge to care for. I just want her quality of life to be good esp since they have not given her tons of time. I want her to be happy.

 

Hi Lynn,

Why is Kitten being fed through the Etube? Is the Etube in all the time? Is it possible to give treats when it's in? Can you tell us a little about her?

I guess I missed your post where you explained. It would be helpful to you and the people who will help you also if you started keeping track of Kitten's BG's on her spreadsheet and did a profile for her when you have time. (That will save you from explaining again).

Melanie & Racci

 

Melanie,
These might help people trying to catch up
http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=84706

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=85170

Carl

 

Thanks Carl! I'll check the links out. :smile:

Melanie & Racci

 

Re: Lynn and Kitten/BG Number High

I am having Kitten's etube removed tomorrow at 3pm. They are giving me an appetite stimulant just in case per my request.I think it will help her make the transition to independent feeding. It is a good back up. Kitten is eating wet and dry food independently the past few days. She only shows signs of nausea when she is fed thru the etube. I waited all day for her IM specialist to call with the results of her Fructosamine test. Instead, her nasty vet tech called. She said the results were good. No changes in Insulin at this time. I requested the doctor call me herself as I had questions about her asthma med and recent asthma attacks. The tech was very rude and confrontational. Why??? I would also like to know what "good" means. What was her average? I want to focus on her insulin and BG levels now and maintain her weight. The doctor was supposed to go over protocols with me today??Good thing I have this board. I am not pleased. Kitten is too fragile to have a vet tech play doctor over the phone and I told her as much. Long sigh..I guess I have to be the vet.
Lynn and Kitten

 

I'm sorry, Karen. That's frustrating. It's one thing if the vet asks the tech to provide you with information so you have complete information quickly. Somehow, the vet tech has lost sight of the fact that you're one of the people helping to pay her salary. I would hope the vet will call you back.

One thing I've found useful is to ask my vet to e-mail me Gabby's lab results. If you look at her spreadsheet, I have a tab where I keep track of her lab tests. It's not only easy for me to access, people here can look if I want input and my vet has a link to Gabby's spreadsheet to the information is all in one place for easy comparison.

 

Hi Lynn, or is it Karen?,

That is frustrating to have to deal with a tech that thinks she knows it all. It will be good to have the feeding tube gone. I hope Kitten eats once it's removed. That has to be terribly annoying. I'm sure it will be easier to test her blood glucose & give her injections also. When you test her be sure to give her treats afterwards. In the beginning what's most important as far as testing times is to do it before shots and mid day between the shots to figure out what the nadir is (the lowest point of the day). The nadir is what the dose is based on and the pre-shots keep you from overdosing kitten. We try to time the tests so they are about 2 hours after meals and no longer being influenced by the food and feed them after the test rather than before.

Please ask if you have any questions about anything. We're all happy to help.

Melanie & Racci

 

Lynn

I know you are very busy with Kitten but is it possible to start putting some numbers in her SS so we can see them and make suggestions to you?

 

Here's a picture of Kitten that Lynn emailed to me.
In time , she'll get the hang of all the little technical aspects here.

 

My name is Lynn.. Kitten is eating on her own. She is eating Wellness Core which I happened to have on hand and dry DM. The etube feedings are making her miserable and sick. ( It saved her life and I would so it again) .The vet called late last night but I missed her message. She wants the etube left in, but Kitten is eating and cannot get the BS tests done with the tube in. Kitten has been fed wet DM thru her tube and now hates it. I do not want her eating that garbage anyway. Catinfo.org said her insulin will have to be adjusted when a cat is going to a low carb diet or cat can go into insulin shock. She said process has to be slow. So what do I do? Vet is calling in morning and and I will ask her. But since she so highly recommends DM and does not accept the fact that Kitten has a food a aversion to it....IDK Kitten is very stressed with the ear prick and the tube feedings and had an asthma attack. I need to go slow. Plus she needs a little restraining, and not as easy with tube to be mindful of. Thankyou

 

Rhiannon, you posted Kitten's pic!! Love it! Thank you for pulling me into FDMB when I was in desperate need. Thanks for the email about how to draw the insulin. You said to plunge the syringe first which is what I thought was best. But, my nurse friend told me tonight to shoot the air into the vial??? Confusing. The tip about twisting the plunger is great. I cannot center the air bubble. If I tap too hard, the needle bends in the bottle. Hubby and I worked on it together tonight because it was making me sick. I want Kitten to get the right dose. i am also shooting blind which is not good. Plus, Kitten has been feeling her shots. Hubby came into watch me and said I am not pulling the skin up high enough and angling down too much and she is feeling it. Knowing I hurt her, is hard to take. Hubby has a needle phobia and it is not easy for him to see this. I also am freaked by it. I am up at 4am now thinking about the morning insulin dose. That is enough whining. I have to figure it out. I watched a video online and the woman said that the beveled side of the needle should be facing up to make it glide into skin easier. Or do I have it backwards?. My nurse friend had no idea what i was talking about. Lol. But the needle is beveled. It must be for a reason. Lynn and Kitten

 

Hi, Lynn. First, wet DM is okay as far as carbs but has low quality ingredients and has no magical qualities making it better than any low carb supermarket food. No point wasting money on it, especially if Kitten doesn't like it. Dry DM is not good for diabetics, like any other dry food, and you will want to phase it out. Core is a very good food, low carb and good quality. Wellness is also very good. Fancy Feast Classic flavors are okay. Some kinds of Friskies and Nine-lives too. Have you found the Janet and Binky food charts? I don't have the link handy.

Sadly, many, many vets do not know a lot about feline diabetes. If you feel comfortable with your vet you could discuss the food issue with her. If not, you can smile and nod and then do what you know is best. Many of us here have had to become our own vets. This board has more collected knowledge and experience of FD than almost any vet.

With Lantus you should not inject air into the cartridge. The person you spoke to may have been thinking of Humulin in vials, which requires different handling. What most of us do is:

Unwrap the syringe and first of all work the plunger back and forth a few times to get it sliding smoothly.

With the plunger all the way in, insert the needle into the cartridge and draw at least a half unit more than needed.

Remove the needle from the cartridge. Holding the syringe needle-up, flick the syringe with your fingernail to get the bubble to the top. Gently twist and press the plunger until the bubble is out and you have the correct dose. Don't worry if a little air is still in there - it can be next to impossible to get bubbles completely out.

You may find a magnifying glass will help. I bought one of those jewelers magnifying headsets.

Also you might find syringes with short needles and half unit marking to be easier. I believe American Diabetes Wholesale has them, and I know Hocks does. Depending on what state you're in (or if you're in the US) you may or may not need a prescription. It should cost less than a local drugstore, too.

I hope some of this helps!

 

Lynn and Kitten/ syringe drawing

Camille, your reply does help. I have been doing it wrong. I have been trying to tap air bubble out with syringe in the bottle. This can bend the needle and does not work for me. I have the half mark syringes from Rite Aide. The magnifying glass is a great idea esp a jewlers! So, a little air bubble is okay? How long can the insin be in the syringe safely before administering? Does laying the filled syringe flat like on a plate cause bubbles? After I inject my cat, I notice if I push up the plunger, an insulin drop forms. Does this matter? I have tried to push it more firmly in my cat's skin , but she felt it! I went thru three doses and syringes this morning . I had trouble drawing and I also missed my cat's skin and it went into her fur. I do not think any insulin went in. The shot was an hour late and I gave her a bit less incase she did get some. This happened to me on my first injection two weeks ago. I am tempted to cut some hair off where the pouch is in the extra skin. I am ordering a baby scale today. I read here the dose has to be adjusted for weight. I wanted her etube out today but I am afraid the Wellness Core which is more low carbs than the DM will effect her BG and I will be giving her too much insulin and put her into shock. My friend I spoke of has experience injecting her sister's dog with insulin for years. Maybe it is different for dogs or she was doing it not the best way. Thanks again
Lynn and Kitten

 

There is lots of misinformation out there among vets, vet techs, how to do the shots, where to do the shots..

Ask here for clarification on anything.....
People here have the most experience and live this every day and we all refine our technique with each other.

You can practice with an old syringe on an orange or banana to get more comfortable using the syringe.
Your technique will improve over time.
In the beginning, we feel clumsy and slow. And we hurry for our cat's sake which can lead to a furshot.
You'll also get more light handed over time There often is a little residue drop after it's over because it's very hard to get that last drop
inside. Some of us push the plunger a little extra right at the end of the shot process to try to get that last bit in....

 

.
Good morning Lynn,
If I understand this right, you tried a shot, it looked like you "missed", and then gave another shot? For future reference, that's a definite "no-no". Because like you said, you don't" think any insulin went in". You don't know that for sure. When that happens again, and it will, you just call it a "fur shot" and go on with your day. Fur shots happen to everyone. But for the sake of safety, you just have to live with them.

Carl

 

Carl... Thanks.. My last fur shot I just skipped the dose..I will also in the future. I hope she is okay today. Her fur was very wet... Fingers crossed. . Lynn and Kitten

 

"When in doubt, poke her ear" :lol:
Carl

 

That is good advice. I am monitoring her closely for signs of Hypo..Is sleeping in her litter box bad? Just kidding.. She is on the floor napping. But, she was lying in her box last night and the other night, but it is for feelings of diarrhea and she wants to be close to the box. She is very clean. Carl, the above post refers to a cartridge? I call Lantus a vial? Can you explain the difference in terminology. Thanks cat_pet_icon

 

Lynn,
Better than that..... watch this Video that Julie made. It shows how to draw insulin from either a vial or a cartridge/pen, and you'll see the differences. The big advantage to the pens is cost. You get, I think, 5 pens when you buy them. Initially it costs more, but long-term, it's more cost effective. The first instructions show the pen, and the vial is shown about 3 minutes in.

http://www.youtube.com/watch?feature=player_embedded&v=u4KtK_skpmQ#!

There are also pictures of the pens in this sticky thread:
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

Carl

 

Hi Lynn and Kitten. I don't know what part of RI you're in, but I'm in central Mass and can try to give you a hand if you're going nuts. It's hard at the beginning -- I'm sure others have told you that.

MJ

 

You've gotten more excellent advice! Don't worry about that teensy drop left in the syringe after injection - unless/until you get down to micro doses it's not enough to make any difference, and by that time you'll be a pro. Also, we don't dose by weight, we dose by how low the bg goes during the cycle. You'll get a lot of guidance with that here too. As you transition off DM, you'll probably need to reduce insulin - just go slowly and ask about anything you're not sure of.

BTW, where are you injecting? I swear by the scruff of the neck - cats hardly feel it there. Some people say insulin isn't absorbed as well there but I've never seen a difference and a lot of people use it.

What I do is prepare the syringe, then recap it (a no-no according to some), dish out and serve the cat food, then inject Salem (and Cyclone before him) while he's eating. Kitty hardly notices the injection while distracted with food. The filled syringe is lying flat on the stove for up to maybe 5 minutes.

Be sure to give a treat after testing! As Kitten learns what to expect and you become less nervous, it will get a LOT easier.

 

Lynn

I fixed it so you are the owner of Kitten's SS. All you have to do is fill in the blocks when you can. I sent you the instructions to your gmail account email the other day.

 

had this email today from Lynn, she sent it on 12/21.
I was driving from NM to TX.

 

Lynn posted on Health.

 

thanks...

 

Thanks. Kitten hates her scruff touched..so that is out of question. Kitten has not had the wet Dm really that much as she had been eating on her own and I reduced the etube feddings last couple of days. But she has the dry DM. I picked up another crap script of diabetic food today but could not find it. I will try tomorrow until she is stable...etube out which was done last night and kitten calms down from these appts...the ear pricks can begin she had an asthma attack last time we did one and looks like she is going to vomit.. i will try soon if i need to. my mother is a nurse and we practiced today with the syringe... everyone has diif techniques and it is confusing she said it is easier with her larger human doses to get bubbles out we also went over the shot itself which is getting easier for me still hate it have to change my mindset when i can get bg numbers i will feel safer with it right now she is regulated and her level are fine to good. I think this crap dm food is making her sick and the IM specialist wants me to continue with crap food...she also told me yesterday that assist feeding a cat is impossible...i am sending her link to FAF website..my mom did it for years i habe been consumed with this etube and kitten not tolerating it well and all the meds when she came home. now i can focus on diet/insulin it is one crisis averted at a time...

 

Here's the link to Kitten's thread on Health from today. I just posted over there.

 

Thank you for your time and help. I am attempting to do it now. :razz:

 

Thank you for the offer..I have had help since to muddle through.

 

Lynn

If you are going to post in LL...and we'd love for you to, could you please start a new condo each day and link the previous day? That way your thread does not get too long and we can stay current on what's going on.

Thanks very much. Hope her cough is better today and she is doing better overall.