01/21 Ethan - Vet Dental Update

Discussion in 'Lantus / Levemir / Biosimilars' started by Erin Ethan, Jan 21, 2023.

  1. Erin Ethan

    Erin Ethan Member

    Joined:
    Jan 10, 2023
    Yesterday's post.

    I was only able to get 1 good prick test from Ethan yesterday (at 01/19 PMPS+11.25). Made other attempts where I was able to get a blood drop but not get it on the strip. I did see a tip about using Vaseline to help keep the drop from smearing into the fur so I will try that.

    This morning we went for a second opinion on Ethan's teeth. This vet does not think that Ethan has stomatitis- and while at least some teeth need to be removed due to decay (if not all), it would not need to be as intense of a procedure as is required for stomatitis (where every tiny piece of bone needs to be scrupulously removed to stop the immune response).

    We took pictures and sent them to a veterinary dentist and will make an action plan once we hear back.

    She also suggested an abdominal ultrasound might be worthwhile to check for signs of IBD- as apparently there is a link between IBD and pancreatitis (the root cause of Ethan's young-onset diabetes remains a bit of a mystery).

    I am going to continue practicing prick testing, and in a week or so either do a full-day curve of tests, or otherwise get another Libre sensor if we are still struggling with testing consistently.
     
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  2. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    Warming and massaging his ear might help with getting blood. You could also look at using a lower gauge lancet (26-28G) till his ears "learn" to bleed. I often have to "milk" Bandit's ear after poking to increase the size of the blood drop.

    Getting his teeth fixed would definitely help his blood sugar. If he showing any symptoms of IBD or pancreatitis?
     
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  3. Erin Ethan

    Erin Ethan Member

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    Jan 10, 2023
    Thanks @Bandit's Mom for all the tips!

    We seem to have the 28-guage lancets. I have been trying to warm and milk the ear...Ethan has been quite fidgety when I touch his ears- even just to warm them he won't let me hold the rice sock on for long (I do check the temp/wait to make sure its not too hot for him).

    I think with the very first test he was not suspecting it so he let me handle his ears no problem. Now even just gently rubbing his ears twitches them or moves his head away repeatedly. I am wondering if one of the pokes was more painful for him, and now he's made a negative association with me touching his ears.

    What I am trying to do is go through the whole routine including the poke- but if the test fails I leave it so he doesn't get too put off (rather than trying and trying to get the right size drop). I am hoping with this he will start to see it as "no big deal" just like getting his insulin shot. I'm also trying to play with his ears outside of doing the test.

    RE: IBD/pancreatitis- I don't believe he has pancreatitis symptoms, but IBD is a possibility. We actually thought he had a food allergy as he was very gassy and sometimes passed soft stools - he was put on a hydrolyzed protein diet just prior to his diabetes diagnosis. Since starting insulin and the low-carb food though his poops have been excellent and he is no longer gassy...so its a bit of a head-scratcher. He's never been on medication in the past.
     
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  4. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Oct 18, 2019
    Does he get a treat before and after the test? Nothing like some bribery to get things done ;)
     
  5. Erin Ethan

    Erin Ethan Member

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    Jan 10, 2023
    Thanks @Bandit's Mom :)

    I only recently started giving treats based on recommendations in a previous condo- I bought dried anchovies but they don't seem to be exciting enough that Ethan will come and wait for them...might have to try freeze-dried chicken.

    One thing I have been doing that I am questioning now- I had been giving him a small snack of food to try to keep him distracted while doing the test. I am wondering if he is getting frustrated with being handled while trying to eat...

    I could try to poke him while he's sleeping...but somehow that seems like a recipe for mistrust :bookworm:
     
  6. Hendrick Cuddleclaw

    Hendrick Cuddleclaw Well-Known Member

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    Jan 12, 2022
    using a tiny bit of vaseline, to me, is a must. I never was able to successfully test without it. And yes you definitely want to condition Ethan to think of pokey time as a happy time of pats, purrs, TREATS and a little tiny ear prick. If you are consistent with treats, whether or not you get a successful test, most kitties end up at a point where they actually look forward to the BG test! Hendrick would go to the spot we always used and sit there sometimes, look at me all hopefully...it was amazing

    another good tip is to frequently do ear rubs, pats, even a treat at the designated area but actually don't do a BG test. Cats are creatures of habit and this can help get Ethan used to the idea of the ear rubs, pats, treats...and not mind a quick ear prick as well when it is worked in.

    I have never heard of someone doing a test while the cat is sleeping, I agree that is probably not a recipe for success.

    far as the rice sock, we ditched that for a usb-C rechargable hand warmer from Amazon like this one


    https://smile.amazon.com/gp/product/B08FMSJ1NN/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1
     
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  7. Dan and Marc

    Dan and Marc Member

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    Feb 7, 2019
    Chronos has let me do it while he is sleeping, he just doesn't care. He doesn't care what we do really, very lucky in that regard. But yes the warmer the better, only his AMPS is annoying to get cause his ear is so cold since our bedroom is colder in general, so the blood doesn't pool nicely.
     
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  8. audravincent

    audravincent Well-Known Member

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    Feb 16, 2022
    Jinx loves fancy feast savory cravings as his test treat. It makes him excited for test times. He'll sit in his test spot early sometimes waiting for them. I talk nicely to him, give him pets, and get him excited to test...haha. I'm glad it wasn't stomatitis. Jinx struggled with a lot of pain before getting nearly all of his teeth removed.
     
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  9. Erin Ethan

    Erin Ethan Member

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    Jan 10, 2023
    Thank you so much @Hendrick Cuddleclaw, @Dan and Marc, and @audravincent for all tips and tricks...I greatly appreciate it! I'll keep working on making test time something Ethan looks forward to (or at least doesn't mind).

    This morning I pulled out the anchovies again, let him have one then just played with his ears (meanwhile he was dancing around haha). Got a tiny poke in that he didn't mind, but not enough to draw blood. I left it with that and gave him another.

    His dental work is scheduled for March 14th. We will need to do a full curve a few days before that so my goal is to get to to the point where we can confidently do the curve at home...don't want to have to take him to the vets for that if we can avoid it. That way we'll also be able to monitor him more closely after the procedure to see how the dental work affects his BG #s.

    @audravincent it sounds like Jinx is doing well now even though most of his teeth are gone? Did you notice a change in his BG #s post-extraction, or was he not diabetic at the time?
     
  10. audravincent

    audravincent Well-Known Member

    Joined:
    Feb 16, 2022
    He's doing good. He sometimes gets flare ups and is on a low amount of atopica to combat that. He didn't get diagnosed with diabetes until after the teeth extraction.
     
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  11. Erin Ethan

    Erin Ethan Member

    Joined:
    Jan 10, 2023
    Sorry I know this thread is getting a bit long! I've been working on a system that seems to be helping a bit--

    I started putting the reward inside a very small glass jar where he can see it and smell it but he can't manage to eat it right away- this serves a dual purpose of distracting him and letting him know that a reward is incoming (before he didn't seem to fully get the memo of "hang around, another treat is incoming post-poke!")

    While he's busy sniffing the treat and trying to get it out, I give his ear a tiny poke then praise him and give him the treat. I've been able to do that 2x today with minimal fuss.

    Not the whole test yet (still have to build back his patience/trust for the full gamut of warming/poking/holding the strip in place long enough) but I am trying to get him comfortable with the poke part & strengthen the association between the poke and the reward.
     
  12. Melinda and Kitkat

    Melinda and Kitkat Member

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    Dec 5, 2022
    Nicely done! Thats a great strategy. :cat:
    I too would open the bag of treats and let him get a good sniff,,, keep it in front of his face as he sniffed and I poked, every cat is different and every option for a new strategy is great! He WILL appreciate your love and patience at this, and I strongly suspect he will reward you in the end for your efforts. I too needed a good while to get my chubby to come around. (all cats are different.... but they are all like a 3 year old child !!!! lol) We each figure out what works best, and then share this info :D:p
     
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  13. Hendrick Cuddleclaw

    Hendrick Cuddleclaw Well-Known Member

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    Jan 12, 2022
    sounds like you're on the right track, that's a clever trick!
     
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  14. La-La Leo

    La-La Leo Well-Known Member

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    Dec 22, 2021
    I ordered this handwarmer & used it for the first time tonight. Leo seemed shocked I wasn't using the black bean-filled little sock, and let me poke hospital least favorite ear without a swipe or ear flick. Seemed to get a good blood dot (drop), so happy with this tip. Thank you.

    It will take awhile to feel natural, so we'll see how it goes.I still have the sock, if needed. I am curious how you deal with the Vaseline and the hand warmer. Do you put the handwarmer in a sock to keep it from getting slippery? Maybe you're just neater than I am.

    Thanks, again! :bighug:
     
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  15. Hendrick Cuddleclaw

    Hendrick Cuddleclaw Well-Known Member

    Joined:
    Jan 12, 2022
    we use the handwarmer first, then once the ear is nice and warm and massaged, I turn it off, set it down and get a tiny dab of vaseline on the ear at the spot where I will poke. Then poke, get droplet, get BG reading.

    the handwarmer and vaseline never cross paths :)
     
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