7/5 Jessi,UPDATE: vet visit today, gave .5 with LC then MC, attempted BG tests, nervous

Stefania S

Active Member
https://www.felinediabetes.com/FDMB...hat-a-mess-could-use-some-help-please.279151/

I was just told yesterday by the Vet that I would have to bring Jessi in with me to get more tests done, when I thought I was going alone to meet with the specialists. And just today I was informed that she had to be fasting from 8:30am tomorrow morning.

They are telling me it's no problem, I can always rub syrup on her gums if her BGs get too low, meaning, I don't have to skip the shot. But first, I have no way to test her, no sensor and still only practicing BG test. Even if they test her there it will be way past the nadir and it will be only once, not ongoing, second, giving the shot with the plan to spike her BG with sugar, doesn't seem like a very good plan to me! But you tell me what you think. I will definitely take food with me, but we will be well past nadir by the time they are done with tests and I haven't once been able to get Jessi to eat when we are away from home.

Normally I give insulin at 6am and 6pm but today I overslept and we were about 47 minutes late, first time I was ever that late except for stalling!

So the earliest I could give her insulin tomorrow morning before the visit would be 6:30 if all goes well. But this means that on the other end, we may not make it back home for that time.

Let's say I give her insulin at 7, then I can only feed her until 8:30. Do I just give her a whole lot of food, is that even a good idea? She will gladly eat it since she is pretty ravenous these days. I bet she'll eat a can and a half, she might even eat two, but is that going to diminish the chance of a hypo around +5 +6?

I'd rather not skip because on the other end I have no idea what time we'll get back and so what time we will get the shot done. Plus, judging by her behavior and symptoms, I'm guessing she's in the high ranges these days, but I can't confirm that right now.

And now I'm just realizing that she will be so many hours without food that even the PM shot will be risky, won't it? Plus her BGs might get high from stress, as they usually do and then crash back down, as they often do later, sometimes one or two cycles later...

OMG, I have no idea how to handle this. HELP!

Wouldn't it have been nice if I had a little more time to plan for this?!:mad:
 
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When you say "sick of the organisation here" where is "here"?
I'm in Bologna, Italy. The clinic is the University of Bologna Veterinary Clinic where I have been taking Jessi for exams and where I first took her to see an Endocrinologist, whose team of Vets have been 'following' us, sort of, and semi monitoring the Libre sensor info which they usually apply when we go, because I haven't yet gotten to the stage of putting it on myself. I don't follow their dosing instructions. But I am now relying on them because of the SCC tumor that has grown rapidly since they applied the first sensor.

Here's the link to my thread on the SCC in the Main Forum:
https://www.felinediabetes.com/FDMB/threads/jessi-7-5-scc-tumor-update-and-more-questions.278911/

They have done a series of tests up until now and they are recommending surgery. I didn't know how much information to repeat in this thread. Hope that helps.
 
She has to be fasted from 8:30am, but at what time do you have to drop her off at the vet and how long will she be there?
To answer one of your questions, feeding her a whole lot vs just feeding her a little at +2 will not make a difference later in the cycle.

If you shot at 6:47am today, you can shoot at 6:30pm this evening and maybe even back to 6am tomorrow (if you shoot).
 
She has to be fasted from 8:30am, but at what time do you have to drop her off at the vet and how long will she be there?
To answer one of your questions, feeding her a whole lot vs just feeding her a little at +2 will not make a difference later in the cycle.

If you shot at 6:47am today, you can shoot at 6:30pm this evening and maybe even back to 6am tomorrow (if you shoot).

I could do that, getting her back to 6am but then the other end, we may be late with the evening shot depending on what time we get back from the appointment.

Yes, sorry, the appointment is at 3:30pm
 
I could do that, getting her back to 6am but then the other end, we may be late with the evening shot depending on what time we get back from the appointment.

Yes, sorry, the appointment is at 3:30pm
If you shoot at 6 or 6:30 then at at least you can feed till onset 8/8:30 am. Without test data (and this is not criticism), it is hard to know what she is doing on this dose. And whether her being hungry is a sign of high numbers or low! You could always feed HC at 8-8:30 to give her a bump.
 
It does make me nervous not being able to feed her after 8:30, which I might stretch to 9 because I know they are exaggerating the number of hours and because they never take us right away, and yeah, of course since I can’t rely on testing in the moment I have no way to know what’s happening.

But you think I should do the shot anyway?

I could reduce to .5 to play it safer...
 
I just made another attempt. It’s the third time I get blood, but can’t get it onto the stick before she shakes her head or yanks away making the blood spread out. I even managed to avoid the marginal vein this time and got what I think was the sweet spot. It was the perfect amount of blood and she barely noticed until I tried to hold her still while reaching for the stick and glucometer. What a waste of blood! :banghead:

And it would have been perfect preshot time too! :(

As for the AM shot/fasting question, I don’t know what to do other than postponing the blood tests, but that means postponing surgery too...

So you’re saying that even if I reduce or skip the shot the depot could still cause low numbers?
 
I just made another attempt. It’s the third time I get blood, but can’t get it onto the stick before she shakes her head or yanks away making the blood spread out. I even managed to avoid the marginal vein this time and got what I think was the sweet spot. It was the perfect amount of blood and she barely noticed until I tried to hold her still while reaching for the stick and glucometer. What a waste of blood! :banghead:
Applying a thin layer of vaseline to her ear will help the blood form a drop and not spread into her fur. What some people do it transfer the blood drop to their nail so you don't have to keep the cat still till you can touch the strip to the blood.

As for the AM shot/fasting question, I don’t know what to do other than postponing the blood tests, but that means postponing surgery too...
I don't think you want to do that. If she doesn't have a history of ketones, you could just skip if you aren't comfortable giving the shot. Or shoot the dose and feed HC at +2.
 
Applying a thin layer of vaseline to her ear will help the blood form a drop and not spread into her fur. What some people do it transfer the blood drop to their nail so you don't have to keep the cat still till you can touch the strip to the blood.


I don't think you want to do that. If she doesn't have a history of ketones, you could just skip if you aren't comfortable giving the shot. Or shoot the dose and feed HC at +2.

I tried once to scoop with my fingernail and the blood spread out on my nail. I ended up wasting a test strip trying to get the blood onto it. when it was too thinned out.

I can try again. The fact that sometimes I'm so nervous my hands are shaking, doesn't help. :oops:

My high carbs are either 16% or Fancy Feast which will spike her so much it might not be worth it.

If I give her the 16% in place of her usual LC mini meals, that might get a bigger bump....right?

This is making me so nervous right now not knowing what is the best choice. On top of that, Jessi is looking very off for days now. She is so super sensitive, it could be because there is a lot of stress in the environment, but that also affects her BGs. Not knowing what they are is making me crazy. I will keep trying, maybe I'll get lucky at preshot...
 
Update: I gave .5 units ,reduced from .75 and fed her up until 9am (past the limit I was given because I'm sure there is some room leeway). I fed a can of her normal LC and then a half pouch of a MC food. She seems pretty stuffed, and now she's a bit conked out. I shouldn't feed her anymore until after the blood test, and I don't have any way to test her.

I made another BG test attempt this morning before and after insulin. She got more and more resistant. It's like she's onto me and now she jerks away sooner. I did manage a couple of pokes and did get a tiny bit of blood, much less than the other times, but it wasn't enough and she was not having any of it, so I let her go.

I'm trying not to traumatize her, but I really would like to know what her levels are right now at +5
 
I made another BG test attempt this morning before and after insulin. She got more and more resistant. It's like she's onto me and now she jerks away sooner. I did manage a couple of pokes and did get a tiny bit of blood, much less than the other times, but it wasn't enough and she was not having any of it, so I let her go.
Fortunately for me, Bandit is a very cooperative cat and I've never had any trouble with testing or shooting or pilling her. My civvie is an entirely different story. But what I have seen CGs with cats who don't tolerate testing is that, what really works in the end, is telling yourself you can do it and not being anxious or stressed. Your kitty can sense your uncertainty and anxiety and feed off it. It's great that you are tying to test her and I am sure you will get there sooner or later. :)

Good luck at the vet's today! :bighug:
 
Thanks for your support Bhooma! It was a pretty awful visit for Jessi, took way too long and so many people in the room. They did some more biopsies and they will let me know next week what their suggested plan is, but it looks like surgery is most likely.

We did fine yesterday with less insulin and some MC before fasting. They made us wait so long before testing that I could have even fed her until +4 but oh well.

We have a new sensor now, although I have to say my trust in these things is waning. During the visit her BG was 251 on my glucometer, which I had brought with me. Theirs was 261 if I recall. When I got home and did a scan on the sensor it was through the roof at 435!! No way it went up that much in just a couple of hours and she almost never goes into the 400s, except on the sensor! How can ever believe the numbers I see if there are so many variables and so many wonky moments?

For now, I'll keep using it as a way to just have a sense of which direction the BGs are heading and how fast, until we can get more solid with BG testing.

Unfortunately, they sent me home with medicated gauze compresses that they are telling me to change 4-5 times a day. This will seriously diminish my chances of doing ear pricks because her patience will be tried by doing that all day long leaving little left for ear pricks we she already doesn't tolerate.

They're also suggesting a cat onesie, especially for post op. I have been trying out shirts on her and boy does she hate them! I can't even imagine a onesie!

I'll start a new thread soon. I just wanted to get back to you with an update.

:bighug::bighug::bighug:
 
Thanks for the update, Stefania. Sorry for the late response! Vet visits are stressful enough without the kind that involve fasting and multiple tests and procedures! :(

We have a new sensor now, although I have to say my trust in these things is waning. During the visit her BG was 251 on my glucometer, which I had brought with me. Theirs was 261 if I recall. When I got home and did a scan on the sensor it was through the roof at 435!! No way it went up that much in just a couple of hours and she almost never goes into the 400s, except on the sensor! How can ever believe the numbers I see if there are so many variables and so many wonky moments?
I think the first 12(or it is 24?) hours of a new sensor are supposed to give wonky readings. It's also possible that stress sent her BG through the roof.

:bighug:
 
Thanks for the update, Stefania. Sorry for the late response! Vet visits are stressful enough without the kind that involve fasting and multiple tests and procedures! :(


I think the first 12(or it is 24?) hours of a new sensor are supposed to give wonky readings. It's also possible that stress sent her BG through the roof.

:bighug:

Yeah, I heard that about the first 24 hours and yesterday the BGs were coming down already but then today she got stressed about someone coming to do some work in the house and they’ve shot up again at about +3.5...hopefully they’ll come down a little again.

I haven’t started putting in readings because they seem so exaggerated. Should I put them in anyway?
 
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