Hello! Food and insulin questions

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Chris and Miles, Dec 16, 2020.

  1. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi all,

    I am Chris - this is my first post and I recognize that I know very little. I just got my cat Miles' diagnosis earlier today.

    Miles (11, male) was actually showing symptoms of what seem to be two different things; a congestion problem which I didn't think much about, but then I also realized he was overgrooming for some reason (thin fur on his forelegs) and that he had lost weight. He was also sleeping/resting on the floor at the end of the living room instead of jumping up to a perch or the chair or sofa, his favorite areas.

    His appetite has been fine and he has been at least as affectionate as ever. Lately he has taken to taking over the top half of my pillow in the morning, which I find awfully cute. At first I thought maybe he was just really bored so I have started putting "cat TV" videos on the TV. He doesn't pay them too much attention but his sister Ella has always been more interested in playing and so on.

    My vet connected the overgrooming with his congestion and took some other samples and came back today with the diagnosis of diabetes.

    As just a very very first step I got some DM Purina food from the vet. (I have some concerns about this since I now know it is owned by Nestle, but right now... whatever). The cats certainly LOVE it as I knew they would. I have trouble separating Miles and Ella at mealtimes so right now I am just feeding it to them both. Miles seems to be still crying about being fed more - previously I was feeding them a dry food and I hope that I am feeding them enough and he isn't actually hungry.

    I am trying to figure out where to order an AlphaTrak (2) from. I think I've seen that there are some other posters here in Ontario - for starters, aside from reordering supplies, where you did you get your machine from?

    I haven't put him on insulin yet. Is that wrong!?
    And now that I am reading the "new diagnosis" article, my vet didn't say to bring him in again soon. Is THAT a bad sign?

    Thanks,
    Chris
     
  2. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Welcome, waving from the Kawarthas. Feline diabetes is a steep learning curve. We have all been where you are.

    What tests did the vet do? Was it just a glucose test (what the blood sugar was at the time)? Or a fructosamine test (an idea of what the blood sugar has been like the last two weeks)?

    I'm not familiar with overgrooming being a symptom of diabetes in cats. I think something else is going on there. Allergies? UTI? Infection? Did the vet say anything about the congestion? More people will respond and chime in on this one.
    @Wendy&Neko

    The DM food. There is nothing special about it except the price. Most people here feed Fancy Feast or Friskies pates. There's also some of the Wellness and Tiki. you are looking for carbs under 10%.
    Here is a link to a low carb food list put together by a vet. A number of the foods are not available in Canada.
    The only dry food in Canada that is low carb is Dr. Elsey's Clean Protein.

    An regulated diabetic cat cannot process the nutrients in food properly. Feed him more.

    Through your vet or from a place such as https://www.petsdrugmart.ca/en/Product/AlphaTRAK-2-Kit-118745/3108
    A forewarning. AlphaTrak strips in Canada are incredibly expensive. $2.00/strip
    Most Canadians use a human meter. That is what vets used before the pet meter was invented. A human meter works just fine and even then the strips in Canada are expensive. We can direct you to what works and what won't break the bank. Do you have a relative, friend, or neighbour who is a diabetic? And could you borrow their meter for a day or even a couple of hours to home test? Some cats run higher at the vet.

    (Some insulins in Canada such as Lantus are relatively cheap compared to the US.)

    Very few diabetic cats go into remission just by changing to low carb food. And yes, no follow-up is a bad sign. Can you ask the vet clinic for a copy of the lab work? You are legally entitled to it. The lab work would help us figure out if your cat is diabetic.
     
  3. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi Red & Rover, thanks for the welcome!

    The vet said the overgrooming was actually - I think running his nose because of the congestion or drip. I think those two things are connected and unrelated to the diabetes.

    I don't have much more time to answer right now but all I know about the blood work is a general "geriatric blood profile". I will have to ask for a copy of the blood work. They may be overly busy - I had to wait a week for his appointment in the first place. Fortunately it is a very short distance from me.

    Any idea what percent more food I should give Miles? What you say explains his weight loss.

    PS no, I can't think of anyone I could borrow a device from
     
  4. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
  5. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Right now I'm just waiting over the next two weeks to see if the antibiotics clear up his congestion and hopefully also the overgrooming/loss of fur.

    I remember now that the vet talked about the potential for insulin being dangerous if his levels are already high? So maybe she wants me to get the monitoring device first

    Ok so plan for today
    - call/email vet and ask for lab results (as you say, by email if they can, that'll be fastest)
    - find out if they can sell me the device... honestly I have some personal anxiety issues and I don't think I can plunge into trying to figure out what human device to get. If the AlphaTrak works, even if it's expensive, I can afford that I think.
    - check to make sure if I understand the vet's position re insulin/followups
    - actually I want to know what they weighed him in as, for food calculations, but I don't know how much more to feed him than normal
    - need new rubber lids for wet cat food unless mine are up in a cupboard, so that I don't have any smell or drying out issues from partly open cans of food
     
  6. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    You're gonna use a lot of strips. It's not a joke. I use 200 a month. That would make it $400 just in strips, and that's a lot :oops:
    Walmart? The relion meter is cheap and working just fine.
     
    phakewishard and Chris and Miles like this.
  7. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    200 strips a month? Gaaah. I guess I don't understand the routine.

    I just spoke with someone at the vet's and got his current weight (5.4kg).

    Visiting Walmart in person is not an option. If I can order the Relion online that would be fine too.

    P.S. I understand the vet's position now: start with putting him on good food and monitor his levels and then decide on insulin or further visits. I guess that makes sense. They are also sending me his lab reports by email.
     
    Last edited: Dec 17, 2020
  8. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Hi Chris, welcome to the forum! I am also in Canada. Most people here are from the US and will recommend stuff from Walmart but we can't get the Relion meter here easily.

    When I got Dixie diagnosed, I felt pressured to get the Purina DM Dry kibble and Wet food, and also the Alphatrack meter. I actually couldn't find the Alphatrack meter anywhere. I tried to order it from the US but they cancelled the order after a couple of weeks. I then tried to get it from my vet and they said that their supplier didn't have it... I then stressed out for a while and put off researching the "perfect" glucometer. Basically, it ended up with me not testing Dixie for a month :facepalm:. I will try to help you avoid that situation.

    Also, I am very glad that I didn't order the Alphatrack meter. The majority of information on this site is calibrated for Human meters (whereas the Alphatrack meter is calibrated for pets). Most spreadsheets I see also use human meters. So don't get too caught up with what your vet says.

    I think the best thing for you to do it get a meter right away and learn how to start testing. You will waste a ton of test strips in the beginning while you get the hang of things, so I think it is better to get a meter now rather than wait for an expensive meter.

    If you want to get started testing right away and for cheap, then I recommend you get this:
    Shipping is around $13 CAD and I have found it is extremely fast (usually a day or two). I am very happy with this site!

    So you can basically get the glucometer, 100x test strips, 100x lancets, and a lancing device for just $60.97+tax CAD It will get to you fast and no stress of researching :)

    Some optional things you can order are
    I use this Bravo glucometer and lancing deving on Dixie (you can check out my spreadsheet). $0.40/strip is a lot nicer than the Alpha track's $2.00/strip! The meter reads slightly higher than some other people's meters on here, and you can see a discussion about it here (but if you are stressed out, please don't read this now! Just get the meter). I don't think this will be a concern for you though if you have a recently diagnosed pet because the numbers will be high anyways.

    So yeah, just bite the bullet and spend that $60 bucks now and get the ball rolling. Then get that insulin from the vet. You will be happy that you did! The meter is free so it really isn't a waste at all. Then you can start researching your own meters later on when things are less hectic :) You can even switch to the Alphatrack later if you prefer... but the best thing you can do now is just get started.
     
  9. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    It is definitely possible to get all the supplies online (I haven't picked up any supplies in person!). If you do get supplies online then make sure that you account for shipping delays. Diabetesexpress.ca has been really good for this, but even then I will still make sure to stock up on test strips. I tried out the One Drop meter, and the shipping was over a week. With the Alphatrack test strips from the states... who knows how long that would have taken! It took weeks for them to tell me that the order was even cancelled.

    Regarding your question about 200 test strips... some people (like SashaV and I) test a LOT! This isn't required or anything. I just do it because I work from home and am often up late at night. I also really like gathering data hehe. So that is why I might go through quite a few strips. Don't feel intimidated by it though because you can find a routine and dosing protocol that works for you.

    In the beginning, I also went through a lot of strips, but that is because it was tough to get the hang of testing Dixie. To get the cat's BG level, you need to poke their ear with a lancet, then get the blood to bead up, and then bring a test strip to the blood. Stuff can go wrong here, like not getting enough blood, or the blood soaking into the fur. Then you will inevitably bring the test strip to the blood spot that is too small, then the strip doesn't absorb and tada... wasted test strip!

    This gets a billion times easier though. I used to microwave a hot rice pack and use it to warm up Dixie's ear, and I would waste a couple strips each time. Now, all I need to do is rub her ear for 15 seconds. And I can even use the smaller lancets (30G which I found for a bit cheaper) because her ear bleeds so well. I only mess up few a few strips a week now!

    As far as food goes, I switched from the Purina DM Wet and Dry to the Friskies pate which is also low carb. Specifically, I alternate between Friskies Pate Chicken Dinner and Friskies Pate Turkey & Giblets Dinner. They are $.60/can at my Walmart and I can do grocery pickup to get them. It is also Purina (Nestle), but at least it is cheaper than the Purina DM stuff! (I can't remember... $2.40/can?). Then you can do more research on better food later on. I think the names of the foods differ between the US and Canada, but the Friskies names I just gave you should be the Canadian version.
     
  10. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Is there like a reliable way of converting the results from a particular device to the real values? I mean don't those real values have real meaning? :confused: I guess there must be info about this to read.

    It is good to know about the procedure for using the lancet. I guess it doesn't hurt too much for the cat? Have you tried giving your cat a (low carb) treat after testing to encourage them to be cooperative?

    I have a local pet store which does free delivery, although I don't know if they have any food which is cheap. I don't have a car, so if I can get the food without increasing the size of my grocery shop that will be good. At least they have a website so I can look at the brands of food which have been evaluated for nutritional content and then look at their site to see if they'll probably have it.

    I guess I have a question: I understand that I want a low-carb (<10%) high protein food. What is considered "high" protein? 30%? 50%?

    And are there any sort of up to date charts of nutritional info, as I see that a lot of the work by Janet & Binky is >10 years old and probably all the product names have changed...?
     
    Last edited: Dec 17, 2020
  11. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Pet meter values are similar to lab analyser values. There's no direct conversion between human meter and pet meter values but the relationship would be more akin to percentage-based than linear, in that at lower numbers the meter readings are closer together but the divergence between readings is very significant at higher 'actual' BG levels.

    Instead of trying to convert between the two meter types, one uses the appropriate reference range for the meter being used, e.g.:

    Normal feline BG reference range on a meter calibrated for cat blood: 3.9-8.3mmol/L | 70-150mg/dL.

    (Note: This is the range my vet provided for use with my Alphatrak. FDMB uses 3.8/68 as the lower bound.)

    Normal feline BG reference range on a meter calibrated for human blood: 2.8-6.7mmol/L | 50-120mg/dL.

    (This is the range used in FDMB dosing method literature and is based on published studies where human meters were used to measure cat BG levels.)

    Feline renal threshold as measured on a meter calibrated for cat blood: c. 14-16mmol/L | c. 250-290mg/dL (varies from cat to cat, range would be lower on human meter).

    (The pet meter range is from the online Merck Veterinary Manual.)


    Mogs
    .
     
    Last edited: Dec 17, 2020
    Reason for edit: Grammar.
    FarmKitty likes this.
  12. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    They don't have as many nerve endings at the edge of their ears as humans do in their fingertips.

    Absolutely! Many, many caregivers include a diabetic-friendly treat (e.g. freeze-dried proteins, small pieces of home baked chicken) as part of the testing routine. For cats that aren't as food-motivated, fuss fests or time being groomed are possible alternative rewards.

    If you identify some suitable foods and would be in a position to order by the case, if your local pet shop don't normally stock them perhaps they might consider ordering them in for you as specials? (I'm in the UK and our local pet shop is quite good about stuff like this: it's more business for them.)


    Mogs
    .
     
    Last edited: Dec 17, 2020
    Reason for edit: Grammar.
    FarmKitty likes this.
  13. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi Mogs,

    Thanks for the wonderfully helpful information. Now I know I can order the equipment with confidence.

    Interesting idea about the delivery. I don't know, but it's worth asking. I also might assemble a list of the wet foods they carry and post here to see if anyone is using those.
     
    Critter Mom likes this.
  14. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I live alone and I'm completely housebound (agoraphobic) so I rely completely on getting stuff delivered. I think it's definitely worth asking your local pet shop. The worst that can happen is that they say no. :D


    Mogs
    .
     
    Kittykat511 and Chris and Miles like this.
  15. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    I asked for the lab work - they did send me this.

    MilesCamfieldResults - Copy.jpg
     
  16. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Sorry if I'm asking dumb questions, but - I tried to calculate how much food Miles should have (diabetes aside) and came up with about 1 can/day. A vet employee did a lookup of a feeding guide for the food and came back to me with 1.5-2 cans a day. Which is, yeah, a lot expense-wise.

    With an all wet-food diet do you find finding them twice a day enough or do you split it into 3 meals?
     
  17. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    You are not asking dumb questions! It is great that you are posting here to find more information. I was just reading that it is quite common for diabetic pet owners to not treat their pets or to just stop treatment after a while, which basically is a death sentence. So we are all very happy that you are being proactive in Miles' recovery!

    I don't think I am hurting Dixie at all with the pokes. However, people will say here that cats don't like their ears being fiddled with and that is something that you really have to try out yourself to realize what people are talking about :D. Dixie will kinda roll her head into me while I am touching her ears so it can be hard to get a good test in sometimes. If you want to get Miles prepped before you order the test supplies, you can just sit down with him and give him some pats and see if you can gently massage the tip of his ears and then reward him. Try to do it in the same spot of your home each time.

    I'm sorry, but I don't know the answer to this one! I am still feeding Dixie the basic Friskies Pate that gets recommended on the forum. As you can see by her spreadsheet, she is doing very well and is now on 0.25 units of insulin. I would eventually like to do research into a higher-quality food for her, but it hasn't been as big a factor for lowering her BG as I had originally thought!

    If you want to search the forum, then there is a search bar in the top right. I prefer to use Google to search the forum, so I would google something like "high protein diet site:felinediabetes.com" and then it will combine all the forum searches at the top of the results. If you can't find any good info there, then you can create a new post in the general forum with the question as the title and hopefully some knowledgeable people will stop by!

    https://catinfo.org/ by Dr. Pierson gets recommended a lot around here. There is a lot of info there though, so I don't think it's necessary to read it all up front. I usually just use the food chart they have which was updated in 2017.

    I found this difficult to figure out as well. When I started feeding Dixie low-carb wet food, I used an online calculator and got ~200 calories a day (she is 10 lbs and didn’t need to gain weight). At the advice of the forum, I increased it to 225 calories a day because unregulated diabetic cats don’t utilize their food very well, so more is better in the early stages. I weight her occasionally by holding her while I step on my scale at home and her weight has been consistent! So it might take you a bit of trial and error to figure out how much to feed. I’d guess that more is better for now, but every cat is different and I’m not sure if your cat has any weight issues!

    I am not sure how relevant my answer will be since you may not need to start on insulin (depending on how the food change goes), and it will depend on the BG data you collect when you can get a glucometer. But in my case, when I started Dixie on insulin I used to just feed her twice a day (vet’s orders), but I also learned from this forum that that can be bad for the pancreas. So I started adding extra meals throughout the day. I eventually picked up a timed feeder which has made this process very easy. Dixie now gets 8 meals a day, and the feeder ensures that she has no food available 2 hours before shot time! I added some pics here if you want to see how you can set things up. When I went back to the vet and told him what I was doing, he said it all made sense and that he was glad I was doing it. It can be annoying how vets are inconsistent with their advice :facepalm:.

    I did a lot of research on which timed feeder to buy, and this one came out on top. It seems like everyone on the forum uses it here. It sucks that it is twice the price in Canada, but it is so worth it. Manually giving Dixie her +2 meal and getting up early to remove her food got old fast! I also feel more comfortable knowing that she will have fresh meals available at her nadir (the time when her BG levels get the lowest while she is on insulin).

    Here are the Canadian links to the stuff I have:
    I have found conflicting research about how many times a day to feed cats. Some say that they should get several small meals a day. But since Dixie is suffering from constipation lately, I found some info online about how bigger meals can encourage them to poop... decisions, decisions :D

    @ChrisC did you find a glucometer and test strips that you can get delivered?
     
    Critter Mom likes this.
  18. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi FarmKitty,

    Sorry that's a lot to take in - I'm working from home and have to pay attention to that right now. But I did order the Bravo meter and lancets that you suggested. Thank you!

    Cheers,
    Chris
     
    FarmKitty likes this.
  19. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Yes, it looks like your cat is a candidate for insulin.
    If you change the title of this thread, you will get more eyes to look at the lab work.
    Go up to the top righthand corner of this thread.
    Click on "Thread Tools."
    A small box will drop down "Edit Title."
    Click on that.
    Change the title to something like: Insulin and food questions.

    In Canada, Lantus insulin is the best (and least expensive) option.
     
    Chris and Miles and FarmKitty like this.
  20. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    FarmKitty and Red & Rover thank you for your replies. Of course I should have thought of using google search although I think some forums may block it. I just used it to change my name to Chris and Miles. I'll try to get a new picture of Miles and show him to you.

    As far as handling ears is concerned I don't anticipate a lot of trouble. My two have always been pretty tolerant even if Miles will push my hand away from his belly. He is sitting next to me on the sofa (I have a bird video on the TV) and he is letting me massage his ears, or finger the tips of his ears, without a squawk.

    I should get some new scales because mine broke - I think from leaving bags of litter on top of it.

    FarmKitty thanks for telling me about how much you increased Dixie's food by because of the nutrient absorption issue. I will have to recheck but I think that the vet may have suggested too much food. I think I calculated - I think I said - 1 can per day, and now I've gone up to 1.5, and maybe it should be more like 1 and a sixth or something.

    The timed feeder is interesting. I suppose you probably have it set for 8 equal intervals so your Dixie can get meals even in the middle of the night? I am a little worried about Ella nabbing his food instead.

    (You know what, as far as that congestion thing goes? I may be imagining things, but I think his paws are already starting to look better.)

    The food table looks very useful and I also forwarded it to someone else at work with a cat. Much appreciated!
     
    Critter Mom likes this.
  21. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Miles is driving me kind of crazy because he loves the food (Purina DM) so much. I fed him a can and a half today - 1/2 can at 7:30, 1:30, and 7:30. That's... almost 300 calories? Maybe I underfed him yesterday (only 1 can, I think). He complained about food frequently at least an hour before feeding time and ... it was really hard. I still feel kind of stressed. I just took some cups to the kitchen and I was afraid he was going to appear and start crying for more. Thank goodness, he didn't. Maybe tomorrow will be betetr.
     
    Critter Mom likes this.
  22. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Awesome! I hope they arrive quickly!

    That is excellent because getting them to tolerate the ear touch is half the battle! Dixie is also very docile and I could touch her ears right from the beginning, but it still took at least a full month of tests before things started to get easier. The main issue is that poking with the lancet will draw such a tiny amount of blood at first. The Bravo meter requires 0.5 uL of blood. There are a few meters that require only 0.3 uL of blood, but their test strips will be at least double the price. At first I tried the lancing device but I didn't really know how to use it, so then I followed what the forum recommends which is just holding the lancet with your hand (and not using the lancing device at all). After a month of this, I went back to the lancing device and haven't looked back! I like the one that comes with the Bravo meter because the part where the needle comes out is transparent so I can line up the device with her ear at the perfect spot each time.

    Yeah, I measure out her food in grams, so there is usually always a partially full can in the fridge. I have settled into the routine of giving her:

    Set up feeder for the day:
    • AM insulin shot time: 40g
    • AMPS +2: 30g (Dixie hits lowest BG level here)
    • AMPS +4: 20g
    • AMPS +5: 10g
    • AMPS +10: chicken flakes
    Set up feeder for evening:
    • PM insulin shot time: 40g
    • PMPS +2: 30g (Dixie hits lowest BG level here)
    • PMPS +4: 20g
    • PMPS +5: 10g
    • PMPS +10: chicken flakes
    I have the pet feeder set to turn 8 times in a 24 hour period (and I think it actually supports up to 9 separate times). I have it set to turn at +10 (10 hours after her insulin shot) so that she won't have any food available for 2 hours before her insulin shot. This way, I can ensure that when I test her blood that it won't be temporarily raised from any food. I put a couple of freeze-dried chicken flakes in the feeder because I feel bad it turns and she walks up to an empty dish :p

    Hmmm that is a good point. I haven't had to deal with that but I bet others on the forum can offer good advice. I have seen this fancy automatic feeder that will only open if it detects a microchip or a collar tag. When I read the PetSafe 5 Automatic Feeder comments on Amazon, some people said that they bought two of them and put them at opposite ends up the house and configure them to go off at the same time. Then their cats would split up to go to them and wouldn't eat each others food. Another option is to get one of the pet feeders that has bigger food slots, put all the food in it for the day and then just set it to turn a couple of hours before insulin shot time. Then your cats can still free feed but won't be influenced at shot time. I have also heard that some people will put their cats in a separate room to feed. But definitely do a search for it on here but it seems like some people have a lot of cats! :D

    That is so great to hear! Go Miles :cat:

    I am looking into different food options for Dixie as well and I spent yesterday researching. I found this post that lists the 10% carbs and under foods https://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-less-than-8.94685/. I found it easier to look at than the other big chart. I see what you mean about pricing... I think I spend $24/month right now on food but I looked at some of the Weruva foods and they might run me $150/month (and others $240/month) :nailbiting:. I think I will wait till next month when I get her blood tests so that I can see if she needs any specialty foods (low in phosporous, etc.)

    Was Miles free feeding before? Or did he always have set meal times? When Dixie was diagnosed, she had dry food out all the time and would get a bit of wet food twice a day. One day she ate so much dry food that she drank over half a litre of water as welll... When I switched her to only set meal times she would do the same thing as Miles! Begging for food non-stop and going crazy over it. She also loved the Purina DM wet stuff. I think it only took a few weeks for her to adjust to the feeding times though... and we haven't looked back :)

    Also, I checked your blood work and the glucose measurements look almost identical to what Dixie's was (her blood glucose was 22.6 and the glucose in her pee was 3+), so I think it is a good idea to mentally prepare for the vet to suggest insulin. I think it is good that your vet is knowledgeable about the difference switching to a low-carb food can make. People here always warn others about how switching to a low-carb food AND adding/increasing insulin could cause the BG a bit too quickly! Do you know how many carbs Miles was getting previously? You mentioned some dry food.
     
    Critter Mom likes this.
  23. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Here are some things that you can get started on while waiting for the glucometer to arrive

    1. Get helpful supplies for testing
    Here are some things that you will want to look into for testing Miles' BG:
    • Hot rice bag (put rice in a clean sock and tie it off)
    • Vaseline to help the blood bead up
    • Headlamp (this was extremely useful for me because I don't have very good natural light in my place)
    • Low-carb treats for after testing, such as freeze-dried chicken treats
    • Container to put everything in
    Some people also use some sort of anti-bruising cream (polysporin maybe?), but I don't use it and I don't want to recommend you the wrong thing. I think there is a safe version of it.

    The main thing that made a difference for me was the headlamp and the hot rice pack. The vaseline did nothing for me, but others find it very helpful!

    The container has also made a huge difference later on. I would shake the container with the lancets and I guess she has associated that noise with a treat now. All I need to do is pick up the container and she will wake up out of a deep sleep and come running for a test :cat:.

    test_supplies.jpg

    This page goes more in-depth about how to test.

    2. Set up your forum signature. This is how people can see important info about Miles at a glance without asking.
    • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
      • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
      • Add any other text, such as
      • Caregiver & kitty's name (optional)
      • DX: Date
      • Name of Insulin
      • Name of your meter
      • Diet: "LC wet" or "dry food" or "combo"
      • Dosing: TR or SLGS or Custom (if applicable)
      • DKA or other recent health issue (if applicable)
      • Acro, IAA, or Cushings (if applicable)
      • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
      • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
    Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

    3. Set up a spreadsheet to enter Miles' BG numbers into
    We use spreadsheets to easily track the blood glucose trends. Everyone uses the same template and colour coding. Here are the instructions to set up the spreadsheet.
    The U.S. uses a different measuring system than us, so you will want to use the 'World Spreadsheet Template'. It has two sheets. You will enter the Bravo meter results on the 'World mmol/L' sheet, and then the spreadsheet will automatically convert those values (by multiplying them by 18) to the U.S. system on the US mg/dL sheet.

    Most people here seem to use the U.S. mg/dL system. It can be a bit annoying mentally going back and forth between the two systems when you look at other people's spreadsheets. You will get very good at dividing stuff by 18 :D.

    Here is a forum post that explains how to read the spreadsheet. You will want to add a link to your spreadsheet in your signature. You can see how I have a link to Dixie's at the bottom of my signature.
     
    Critter Mom likes this.
  24. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hey,

    Sorry for lack of replies. Sorry I'm feeling kind of anxious right now as I write this because I just fed them which means for the previous hour so they were whining about food.

    I haven't been free feeding them. I was feeding them twice a day (7:30am and pm) and have now split it to 3/day (those two times and 1:30pm). When I give them the DM it is all gone within 5 minutes. Miles is licking every possible scrap out of both bowls, pushing them around, and it's really distressing to see because I'm doubting myself about how much I am feeding them. I realized that maybe the first day I underfed them so I gave Miles some extra, maybe a mistake because I wasn't thinking about BG (that is blood glucose, right?) - Ella seems more ok with the portion she's getting. But I am literally giving Miles what must be 225 grams/day of the DM.

    I was previously feeding them Natural Balance Fat Cat dry food, about 2/3 of a cup a day - Ella is still quite chonky and Miles was as well, before his diabetes developed. I admit it's entirely possible that this is a high carb food - I haven't been able to find out - and that this may have been partly involved in the onset of diabetes. Who knows.

    It is encouraging that your Dixie settled down after a few weeks on her new diet. I can only PRAY that Miles does the same.

    I understand what you mean about food $. If I were to feed both cats this DM for all the future I think it would cost hundreds of dollars a month. I will have to talk to the pet store tomorrow to find out (a) if they can special order cheaper stuff and (b) if they have any freeze dried treats, as I don't have anything.

    I can at least start by trying to feed the two cats at different places in the kitchen, and see if that will happen.

    The glucometer has arrived. Do you wash Dixie's ear before taking the sample, like the instructions show for a person?

    Oh and I can right now hear two rooms away Miles, poking around in the food bowls for anything left.
     
  25. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Nope! You just need to warm up the ear with a hot pack (you can make the rice + sock one pretty easily and then microwave it). Try taking a flashlight and shining it underneath Miles' ear. You might see some very tiny red capillaries and maybe a bigger red vein. Then apply the hot pack for 30 seconds and shine the flashlight underneath his ear again. You will see that the red veins/capillaries are a lot bigger!

    [​IMG]
     
  26. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    I haven't noticed any lack of reply! You are being very proactive with all of this. I hope my long replies aren't intimidating. I have just finished my school term so I am on a break and have time :)

    Honestly Dixie was the same way when I gave her the DM stuff. With her original wet foot (whiskas? can't remember), she would eat maybe half and leave some. When I introduced the DM she LOVED it and would eat it all right away. She took to it so quickly that I didn't properly switch foods (by gradually adding the DM and removing the old food) and she ended up throwing up quite often (maybe because it was new or maybe because she ate so fast), so I had to go back to the old food and slowly made the switch to the DM. She still ate the DM fast when I made the switch and I had to figure out ways to slow her down, such as spreading the food out on a large dinner plate.

    I don't think you need to change the food intake based on how fast Miles is eating the food! He is diabetic so he is probably hungry all the time.

    You mentioned that Miles lost weight. What did he weigh before? Was he overweight before? I think Dixie was 16lbs and when her diabetes was caught, she was 10 lbs. Since 10lbs looked pretty good on her, I have just been feeding to maintain her 10 lbs. Do you know if Miles is at an ideal weight or not? There are some charts I can send you if you don't know.

    I like to use these ones. I tried freeze-dried shrimp but Dixie wouldn't touch it :facepalm:. You can also make your own treats by cooking some chicken and tearing it into smaller pieces.

    If you are feeling overwhelmed at the moment, then you might want to stick with the DM stuff for a month or so. I went through 2 cases of the DM stuff with Dixie before I felt comfortable switching to the Friskies Pate. I think your top priority should just be to get into the routine of testing Miles' BG levels and to calculate how many calories Miles needs to be at his ideal weight.
     
    Critter Mom likes this.
  27. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Here is the chart I was talking about. It'll help you judge his weight
    [​IMG]
     
    Critter Mom and phakewishard like this.
  28. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Good morning!

    The chart is not showing up for me. Would love more information there, particularly if it is based on a skeleton size : weight determination. Miles and his sister Ella look almost alike but Miles is simply bigger. Ella is a sort of "mini-me" :)

    Thanks for the treat recommendation! I hadn't thought of dog treats but when the treat is 100% chicken of course that will be just fine.

    You are probably right that my top priority should be testing Miles' levels, this is where I feel kind of anxious (which is the sort of thing which makes me procastinate/"choke" on all kinds of things) but I guess I do have everything. I can easily put rice in a sock and tie it - I have a large bean-filled heat pack which might work but might also be too clumsy.

    I've decided to make a spreadsheet with the grocery delivery options and to check the store websites to see which one have the Friskies or whatever. Unless my vet comes through with more DM in the next couple of days I am going to be stuck. They promised to get me a case but they haven't called me. I guess I will call them a bit later this morning anyway.

    PS I don't know what Miles weighed before - he was overweight but I have a suspicion he might be underweight now, at least just based feeling him to be a bit "bony".
     
    Last edited: Dec 21, 2020
  29. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ok actually that didn't take long, at least to begin with. I just made a list of all the brands of wet food the independent pet store has, and they have both Wellness and Tiki. Wellness is a little cheaper plus the Tiki cans are smaller. That's really good. I can probably find grocery delivery for Friskies (which will have a delivery charge), but for RIGHT NOW I know I can order a bunch of food from them and it's at least a step down in price from DM. That's a pretty good "win" for 8am.
     
  30. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    I'm glad you are composing a list. Most cats go off the DM quite quickly.
    Grocery time slots are hard to come by at the moment. The pet store should carry Friskies.
    While there is a grocery delivery charge (I use the $3/$5 curbside pick-up option), if the charge is not geared to the amount of the order, take the opportunity to stock up on your own essentials.
     
  31. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Oh yeah, I've also done some grocery deliveries just for myself - would certainly stock up.

    Local store carries (no Friskies though):
    Pet Mama
    Kippy
    Almo
    Royal Canine
    BFF
    Merrick
    Weruva
    Aujou
    Petcurean
    Boreal
    Little Bigpaw
    Natural Balance
    Tiki
    Wellness

    Anyway I'm going to drop by their store and arrange delivery - spoke to someone on the phone who didn't seem to get it.

    I've ordered some new kitchen scales so I can buy larger cans. In fact the one I ordered goes to 10kg so I should be able to weigh the cats if I cover it with a towel and adjust for it :)
     
    Critter Mom likes this.
  32. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Interesting that the images did not show up... I will attach 2 images right here and you can let me know if you see them:
    89de2d3ee90e37de809d904f7d41fe2c.jpg
    Body-Condition-Feline-Chart.jpg
    Yeah! They have a cat version but it just means that the chicken pieces are smaller (and more expensive usually). The freeze dried stuff is really easy to tear apart. If this is a new treat for Miles then maybe save them for only after BG test time (at least while he is learning) so that he is more likely to want the tests!

    Just take things one step at a time. Getting Miles regulated is a marathon... not a race! Even if you were doing everything "perfectly", his BG levels could still (and probably will be for a while) stay high! So don't beat yourself up about taking time to adjust to everything. I know it all seems urgent right now, but Miles has had diabetes for a while... yes it is hard on his body, but spending a few weeks adjusting to the news and getting everything in order will be minuscule in the long run. What is important is that you are taking the steps to get where you need to be!

    Try mini-steps with the ear testing. First, get that hot rice pack made (the large one you have will probably be too cumbersome!) and heat it up. I only need to heat mine up for 15-20 seconds... it depends on how much rice it in it. Then rub it between your hands to make sure there isn't a super hot part inside. Then, try out the thing I mentioned earlier with the flashlight. Look at his ear with the flashlight pointing from the inside out, and then try heating up his ear and do the same thing. Basically, just explore how his ear looks. Then give him a treat (these can be your old treats if that is all you have right now).

    Then, explore how the lancet device works. It has a pull-thing at the end to prime the device, and then a square button to release the device. Try it a few times. Then add it to your routine (without the lancet) after you heat up Miles' ear. Hold the device near him and click it and then reward him. Some cats really hate the noise of the device, so you will need to see if Miles will learn to tolerate it or not.

    Just try doing this a few times a day. Ideally, do it in the same spot of the house each time (maybe at one of his beds). Make sure to reward him each time! You don't need to rush to using the lancets and actually testing yet.

    Awesome! Glad you found some more economical food choices!
     
  33. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Just trying to figure out where Miles is on that chart. I am confused. Like, pelvic bones visible WHEN exactly? When they say "ribs visible" do they mean individual ribs or the rib cage? Because I would say his individual ribs don't seem to be visible but I can see his pelvic bones from the side.

    The other thing is that from above his rib cage appears to be wider than his pelvis.

    I think regardless of the feel of his ribs he is probably too thin, but I don't know if he's a 1 or a 3 :(

    It's hard to get a focused photo of him from above when he's walking, but I think you can see there his rib cage, waist, and legs.

    Part of the confusion is that I think he still has some residual belly fat. The vet said that might actually not be belly fat but long story short, right now, is that it's a confounding factor for me when I try to estimate things.

    CameraZOOM-20201223091744042.jpg
     
  34. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Wait wait, pelvic bones not leg bones. Hnm. Anyway here are more pics of Mr Miles

    CameraZOOM-20201223103121492.jpg
    CameraZOOM-20201223103004110.jpg
     
  35. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    He stood still long enough for me to take this. Pardon my bare toes!

    CameraZOOM-20201223111334236.jpg
     
  36. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I wouod say underweight with score of 2 or three.
    How does here head size compared with waist?
    My Nala is large chested and small head size. I consider that she is at her ideal weight even though she looks like #3 except she has a small head. compared to the chart in the previous replies.
     
    FarmKitty and Chris and Miles like this.
  37. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thank you Larry :) I would say his head is bigger than his waist. I wouldn't say he has a small head.

    So then the question is by what % should I increase his food per day? 10%? 20%?
     
  38. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    I couldn't say for sure because I don't have very much experience with cats in general (I've only had Dixie for 5 months). Maybe a good start would be to calculate how much food Miles should have if he was at his ideal weight? Then add some extra to account for the diabetes. Then you can weight him and see if he starts to gain his weight back or not and adjust the food that way.

    You want make sure he is not losing anymore weight! Diabetic cats that lose weight are at risk of getting ketones which would require an urgent emergency vet visit. Here is more info on ketones: https://www.felinediabetes.com/ketones.htm. You can quickly test Miles for ketones by buying some ketone urine test strips ($10/100strips), sticking a spoon under him while he pees, and dipping the test strip in the urine.

    If you make a new forum post on main feline health forum with a title that specifically mentions the weight thing, then I bet you will get more educated answers about how serious his condition is. Dixie lost quite a bit of weight while unregulated, but she was overweight before :facepalm:. Weight loss is a sign of diabetes, so I bet you will find a lot of others that have dealt with what you are going through. Yes, it may be more expensive at first to give Miles extra cans of food but as he gets regulated, he will gain weight and then need less food! :)
     
    Critter Mom and Chris and Miles like this.
  39. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi FarmKitty and others,

    Sorry for sort of vanishing - combination of Christmas (even if not going anywhere/seeing anyone) and my anxiety about trying to use the machine. I finally bit the bullet today and used it on myself and just now tried to use it on Miles. Possibly I didn't put the lancet in right as it was kind of crooked after firing, and I seem to have missed. I had the thing on 3 and maybe I didn't have it right up to Miles' ear. Anyway no blood, but I gave the cats a minnow treat anyway - hopefully to start to build an association.

    I have not had much luck getting him accustomed to the hot rice pack. How hot does it need to be, by the way? I was putting mine in the microwave for about 15 seconds and it was warm, not hot, but Miles seems to think it is a toy or in any case something odd - the first time he tried biting it! But I don't have any trouble handling his ears with my *hands* so for the attempt I made this afternoon I just handled his left ear a ton to try to warm it in the palm of my hand.

    Feeding has been a little all over the place but I think I'm still feeding him more than plenty (1.5 cans should be close to 300 calories) so I'm not too worried there. I am going to probably try Friskies next because I miscalculated the cost of the current food and it is not really any cheaper than the DM.

    I tried to order one set of scales, that came back as "sorry we're out of stock" after a couple of days, so I ordered another one from Canadian Tire.
     
    Critter Mom likes this.
  40. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Awesome that you could use it on yourself! It took me months to be able to work up the courage to use it on myself :p. I find it really hurts if I poke my finger and it will be sore the rest of the day, but cat ears have very few nerve endings so it won't be anywhere near the same pain as pricking your finger!

    I'm pretty sure I also used 3 when I first started out, and then I turned it back to 2 when I had more successful pricks. What I do is hold the lancet device device tight to the ear and I line up the hole so that it is about 1/3 of the way off of the ear and 2/3 of the way on the ear (so basically it is around the edge). I only press the 'go' button when the device is tight to the ear, because I have found that if it isn't and I trigger it too soon, then I don't get any blood either.

    It is interesting that your lancet was crooked after firing. Was it the needle that was crooked? Or was it the plastic part? I have found that the microlet lancets are a very snug fit in that lancing device so I haven't had any issues with the plastic part being crooked. The needle is also on the thicker side, so it will be harder to bend. I am using cheaper/thinner lancets right now, and they sometimes shoot out of the lancet device, they go in crooked, and if I am not careful about removing the cap then I will often bend the thin needle. Maybe double-check that when you take off the cap off the lancet that the needle is straight. If it is crooked, then reassess the method you use to remove the cap.

    My method for setting up the lancet device it to put a fresh lancet into the device and push it all the way to the bottom. Then, I twist off the top of the lancet and throw the cap away. Then put the cap onto the lancet device. When I started out I would always accidentally take the top off the lancet first and then it made it more difficult to get it into the device :rolleyes:.

    Also, are you holding anything behind his ears while doing this? I take a single toilet paper square and fold it up so that it is thicker and then wrap it around my index finger a couple of times. Then, I will hold that paper behind the ear and hold the lancet device on top of the ear. The paper is enough to prevent the lancet from going through the ear and pricking my finger (which I haaate ugh). I will see if I can get some pics later on for you.

    It took me a while to figure out this process. Originally I held a flashlight underneath the ear and tried to poke with that, but Dixie hated the light for some reason. Then I tried using a small plastic pill container. Then I tried using paper towel. Finally I realize that the toilet paper was enough and that using my finger gave me good flexibility when holding the ear.

    That is good! And every prick will count and make the future ones much easier to bleed :) Also, you can always reset the lancet device and give some more pokes if you are feeling up to it. That is a common occurrence for me!

    I try to heat it up so that I can touch it to the inside of my wrist and not feel any 'hot' pain. I used to just get it warm and then hold it for about 60 seconds, but I remember reading on here that someone said it should be hotter so I started microwaving it for a bit longer. I also eventually reduced the time I held it on her ear to maybe 20 seconds, but that was when her ears learned to bleed more!

    That is also a good method, but I feel like it is more advanced. I have only moved to the hand method after testing Dixie for 4 months, and even then it is still hard to get her to bleed sometimes. I feel like I might go back to the hot rice sack method sometimes (or maybe go back to the bigger lancets). So I think you should just try out different methods for a little while and see what works for you. I think some people fill up a little plastic film canister with warm water and use that on the ear to warm it.

    That sounds like a good idea. Food choices are expensive and aren't really the priority right now, so getting the Friskies that are low-carb would be the best bet while you get the testing/insulin under control!
     
    Critter Mom likes this.
  41. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    I use a cotton cosmetic pad. They are thick and thus no need to double/triple up. I then use the pad to compress the spot/absorb the blood.
     
    FarmKitty likes this.
  42. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    I used a 5ml plastic pipette filled with water heated in the microwave to a temperature where you could just about hold your finger in the water without saying, "Ow!" The filled pipette wasn't that hot to the touch due to the plastic's poor thermal conductivity. I'd touch the bulb of the pipette to my wrist to make sure it wasn't too hot before using it to warm Saoirse's ear.


    IMG_20160131_152925.jpg


    It worked really well for us because Saoirse hated anything going into her ear. She was happy with the pipette because I only needed to hold it in contact with the very edge of her ear to warm it.


    Mogs
    .
     
    Last edited: Dec 30, 2020
    Reason for edit: Clarification.
    FarmKitty likes this.
  43. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Here are some pics to help you out

    1. Put lancet into lancing device, take off lancet cap, and then replace lancing device cap. Set device to 2 or 3.
    1.JPG 2.JPG
    2. Put flashlight underneath ear. Notice how you can barely see any veins!
    3.JPG
    3. Hold hot rice pack (or whatever you got) to ear.
    4.JPG
    4. Now shine flashlight under the ear and notice all the veins and capillaries! The dark red spot is a bruise (probably from hitting the vein or missing too many pokes)
    5.JPG
    5. Get toilet paper square and fold it up and then wrap it around your finger. You can also use paper towel, cotton ball, or cosmetic cotton pad.
    6.JPG 7.JPG
    6. Before you do the next step, put the test strip into the Bravo meter. If it was already in it, then remove it and put it in again. The meter turns off after a few minutes and it is very annoying to have the perfect bead of blood and then the meter turns off midway through! Hold up pad behind ear and hold lancet device in front of ear. With the lancet device held firmly against the ear, you can trigger it and hopefully get some blood. In this pic, the lancet device could probably be held more more towards the edge of the ear (but it was hard to get a clear pic!). You want to avoid hitting that vein that goes around the outside of the ear.
    8.JPG

    Too many pictures so this post will be continued....
     
    Last edited: Dec 30, 2020
    Shelley & Jess and Critter Mom like this.
  44. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    7. If you get enough blood, then bring the meter up to the blood spot and let the test strip sip it up. Try to keep your cat very steady during this. In this case, the meter didn't get enough blood and I got the error message. I think this would have been enough blood but I was taking photos so it started to absorb into the fur
    9.JPG
    10.JPG
    11.JPG
    8. So I reset the lancet device (just by pulling the back end of it - you don't need a new lancet), get a new test strip and try again! If it has been a long time then you might want to reheat the ear a bit. This time, I got more than enough blood.
    12.JPG
    13.JPG
    9. A good result! I like to make sure that the blood is enough to fill up the little while square on the Bravo meter strips. You can now either enter the data into the spreadsheet right away, or do it later in a batch (because the meter stores data with the time and date). You can also take the toilet paper and hold it over the poke spot to stop the bleeding and to prevent bruising. Try to hold it for 20 seconds or however long your cat will stand it :)
    14.JPG
    10. Reward with treats and chin scratches :cat:
    15.JPG
     
    Last edited: Dec 30, 2020
  45. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    This way works best for me. When I finish up my big haul of EasyTouch 30G lancets then I think I will switch back to the Microlet 28G ones that you have because they fit the lancet device very nicely and I didn't have anywhere near the same bruising or testing issues that I am seeing now!

    If you find that the lancet device doesn't work for you then you can also try going free-hand by just holding the lancet in your hand. That is what we did for the first month because it seems like the common consensus around here is that it is easier. Personally, I had a very difficult time freehanding it (my partner did it all and if I tried then I would scratch her ear with it... it would also freak me out a bit!). The lancet device has been a game changer! You gotta figure out what works for you and your kitty :cat:. Let me know if you can't see the photos in the previous posts or if you want more explanation at a certain step. You got this!!

    EDIT: Also, if anyone sees anything wrong with my method then I am very open to criticism! I still find the process difficult sometimes and I'd love to know if there is anything I can change to make the process go smoother :)
     
    Last edited: Dec 30, 2020
    Critter Mom likes this.
  46. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @FarmKitty -

    I am so gonna bookmark this thread. Excellent pictorial tutorial! :cool:

    I used very similar techniques to your good self.


    Mogs
    .
     
    Shelley & Jess and FarmKitty like this.
  47. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Wow, that is some amazing information, thank you FarmKitty, I mean... just incredible. :)

    When I had something crooked in the lancet it was the plastic part. I think maybe I hadn't seated it right?

    I just tried to get a blood drop again just now but failed. I'm not even sure I'm loading the lancet properly. I'll try to take pictures here. Maybe to begin with I should try freehanding it, or just put the lancet into the device, cap off, as a holder, and try like that. Hm.

    Also I understand now that I'm not warming his ear long enough. If you just use your hand, how long do you hold it on the ear for?

    PS what about safe disposal of the lancets? I guess they are actually considered biohazardous material or something?
     
    Last edited: Dec 31, 2020
  48. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    So like this, I'm not even sure if the needle is going beyond the end of the cap or not!? But this does look like FarmKitty's picture.

    Before retraction:
    CameraZOOM-20201231114016684.jpg

    Retracted
    CameraZOOM-20201231114031454.jpg

    lol Miles is still sniffing around where I gave him his minnow treat :D
     
  49. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    That looks like it is seated correctly! You just press the lancet all the way back basically (it will just be plastic on plastic). I know what you mean about wondering if the needle actually goes beyond or not. When I first opened the packaging I had never seen a lancing device before and I thought I was shipped a faulty one hahaha. The needle moves out and back extremely fast so it is pretty much impossible to see it. You could maybe try holding a piece of paper over it and see that it will poke a hole in it. Also, if you tested yourself then you will know that it does poke! The dial will adjust how deep it pokes. I have found that 2 works for me, but when I first started out the 3 worked better (I think).

    If the ear isn't warmed up then I doubt you will get any blood. Even now, after testing for months I will poke Dixie and get no blood. It takes more than just 1 poke (especially in the early days). I mean, even when the ear IS warmed up you can still get no blood from a poke. Even so, every poke will contribute to more capillaries being formed and your cat's ears will "learn to bleed".

    I don't think you should just hold it, but also rub your fingers on the ear. I only started this after months of testing, so it takes maybe 20 seconds. Maybe you will want to do it for a minute or more? It also depends on how cold your cat is. Sometimes Dixie is by the vents and her ears are freezing and other times her ears are hot all by themselves. Maybe try to get Miles when he is laying in the sun?

    Have you tried the flashlight method? That will show you how the ear changes before/after heating. Then you will be able to see if your rubbing has made a difference or not. The flashlight should reveal something like this:

    ear.jpeg
    You want to hit that sweet spot. If you hit the vein (the larger red part), you will likely get blood, however it will then cause bruising which will show up as a darker red splotch on the ear. So you sort of sacrifice easier shots later on for some easy blood now. I was definitely hitting the vein (usually on accident) when I first started though :rolleyes:. It is a frustrating process in the beginning. Remember to hold his ear with the tissue for a little while after poking (I think it prevents bruising).

    I don't think you should give up on using another device to heat his ear just yet. Try the hot rice sack more, or see if you can get something to store warm water in to hold to his ear. I just find these methods work soo much better and faster (if Miles can stand it, that is!).

    I haven't quite figured this out myself yet. I have a small needle disposal bin that I got from the vet so I put the lancets in there (without their caps on - I used to recap them but they all fall off eventually and increase the waste). For now, you could find a thick plastic container to put them in (like a plastic milk jug, pop bottle, large yoghurt container, etc. Then you can research how to dispose of them safely in your city later on. Some plaes allow you to just throw them away in a thick plastic container, but others will want you to use the correct needle disposal container and take it to the vet/pharmacist.

    That is awesome that he is digging the treats :cat:. Another thing you could do to create a routine is try testing him right before breakfast and dinner. His reward will be to eat his normal meal. This will help because you will need to test at those times anyways when get gets on insulin, and also it reinforces the routine even more. Sometimes, if Dixie doesn't want to eat one of her meals then I will test her and then it will actually trigger her to eat right after :confused:.
     
    Critter Mom likes this.
  50. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    If you want to try free-hand, then there is some info about it here. It looks like you should do it at a 45 degree angle (as opposed to using the lancing device that you would hold at 90 degree angle).
     
  51. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Also one more thing... try to alternate his ears in the beginning. I started out only using Dixie's right ear and it worked for a while but then it got so bruised. When I switched to her left ear, it wasn't used to all the poking so it became the 'difficult' ear. I wish I had been using both from the beginning so that when the bruises inevitably come, you can at least have an alternative ear.
     
    Critter Mom likes this.
  52. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Oh, I'm just kicking myself because I went to the corner store and I could have bought batteries for my flashlight. I haven't tried it yet "because it doesn't have batteries!" Really clever eh? I'll get on that.

    Great idea to use a piece of paper to test if the lancing device is working properly. Thanks as always for all the fantastic tips and thoughts.

    Testing Miles before breakfast seems like it could be a PITA but we'll see. Right now somewhere between 15-30 minutes before his meal he starts really bothering me about food. (And breakfast, I'll note, is at 7:30) If he's in that state I don't think he'll be very amenable to being tested, but maybe if I do it 45 minutes earlier, like... right after I get up... *groan*
     
    Critter Mom likes this.
  53. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    If you have a smartphone with a flashlight (or a bright screen) then that will work as well! I keep a keychain flashlight with her test supplies so that I can check out her ears (she is prone to ear infections).

    Since the poking is probably the most intimidating part at the moment, maybe just try rubbing his ear, clicking the lancet device on his ear (but not using a lancet), and then rewarding him. He will learn soon enough that being tested is the secret to getting food :D.
     
  54. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    I think the flashlight app I had stopped working. Found my actual flashlight. Turns out it only takes AAs and I have rechargeable AAs but can I find a pair of rechargeable AAs? No. I'll sort it out.

    Great idea about "testing"! :)
     
  55. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi all,

    Just to give a bit of an update. Not any good news I'm afraid.

    I still haven't been able to successfully test Miles' blood. It may be something as basic and stupid as I don't have batteries for my flashlight still so I keep just missing the vein.

    I saw a youtube video by a vet where he took the sample with the lancet on the inside of the ear instead of the outside. That is what I've tried lately but no luck because Miles really does not like things going in his ear. @FarmKitty what has your experience been with inside vs outside?

    So because I still wasn't able to get a good reading I booked a visit to the vet last week and the time they had was today. They kept him for the day, sampled his blood and got a glucose curve from that. The results were
    - They rated him borderline for insulin. I guess the positive spin would be maybe he might be able to do without?
    - They want to do things by the book so (a) no treats at all, and (b) only food they have approved, for about a week and a half whereupon they want to retest. I'm ok with that.

    He's gone down from 5.4 to 4.9kg. :(

    I guess the good(!?!?) news is that the feeding amount of this new food they've given me is actually more than what I was feeding him - 1.75 cans instead of 1.5. Considering the DM feeding guide recommended, I swear, just 1 can, I feel more confident about this.

    Anyway he's home now, gobbled up his dinner (a whole can - I'll give him 0.75 at breakfast), and doesn't seem to bear me any ill will. He might have growled or hissed at Ella though... I'm not sure what happened because I was in the other room.
     
  56. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    How are the tests failing? Do you get a little bit of blood to appear but not enough to test? No blood at all? Or is it an issue with getting the blood to the test strip?

    When you test, are you making sure to heat up the ear? You will definitely want to use something to heat it up when you are just starting out (such as the hot rice pack). Try to get the ear hot! Of course don't go overboard, but I know that "warm" can be a bit subjective and it can be easy to not warm it up nearly enough. If the ear is cold then you definitely aren't going to get any blood.

    Also, make sure to hold the ear firmly (see step 7 of those pics I posted a while back) while you test. I curve the ear around my index finger (that is protected with some paper). Then press the lancing device firmly into the ear. Only then do you release it. Once you release the lancet device, then slowly bring it away and keep holding the ear. Sometimes you will not see any blood come out but then if you keep holding it for ~15 seconds then blood will start to form!

    Also, how often have you tried testing? Don't just give 1 poke and be done with it. Try poking 5 times each test. Really give it a good go and make sure the ear stays hot, which can be difficult to do because the whole process can take longer when you are beginning all this. I often had to make a few trips to the microwave to get a good test.

    Try testing several times a day (if you aren't already).

    I think I tried to 'inside ear' method once, but it was too tricky so I ditched it right away. Do whatever works for you!

    If the ear testing really doesn't work for you, then you could try an alternative such as testing the paw pad (more info at the bottom of this page).

    That is great that you were able to get a glucose curve at the vet. Have you asked the vet for the results of the glucose curve? You could create a new post with the results and ask for advice from others that went through your situation.

    I'm sorry to hear about the weight loss :( There used to be a spreadsheet for monitoring cat symptoms for people that aren't able to blood test. I think it tracked weight, hunger, water intake (or output!), and glucose levels in the urine. There might have been more. I tried to find it for you but I had no luck. Unregulated diabetic cats will often lose weight, be very hungry, and drink a ton. They won't always exhibit all of those issues (Dixie did though!). Do you have ways of tracking some of these things? It can be hard to track some of them (like urine output) with multiple cats.

    Also, you might want to look into getting some glucose urine test strips. They have them for $24.99/100 at diabetesexpress and probably most pharmacies. These test for both ketones and glucose. You just hold a spoon under your cat while they pee, and then dip the stick in the urine and it will tell you how much glucose is in their urine. Ideally, your cat should have no glucose in their urine. Looking at your lab results, it looks like Miles test 3+ in the urine section. That means that Miles went over the "renal threshold" (10 mmol/L on a Human meter). The chart here shows the different blood sugar levels. It would be interesting to see what levels Miles was at during the vet visit!
     
  57. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi FarmKitty,

    I have been heating up the ear with rice in a sock (I need a different sock - I'm losing a few grains). But as you say, "warm" is subjective and I may not be warming it up enough. but yeah, I've just been trying one poke. :( I can see how your method will make it more difficult for the cat to avoid the lancet. That's good. Thanks.

    But no my tests are failing because I don't get any blood at all. If I did get blood I was planning on picking up the glucometer with test strip attached and touching the end of the strip to the blood droplet.

    So a major problem here is me not sticking with it enough. I'll have to try more.

    I didn't get the glucose results but I will ask for them when I call today about a followup appointment. I was talking with the vet tech outside at 6:45pm and I just forgot.

    Good idea about a spreadsheet. I got new kitchen scales, which are fairly big, but it will still be a matter of getting the entire cat onto the scales :D

    A small qualitative positive thing is that Miles seems happier with this food and feeding schedule. He even let me sleep in until feeding time at 7:15 yesterday, though whether that was because he was at the vet the previous day, I don't know. Today he whined for only 15 minutes before.

    edited PS this is Miles! Long past time I introduced him. I think he may have rubbed some fur off of his nose while he was at the vet's.

    mugshot.jpg
     

    Attached Files:

    Last edited: Jan 15, 2021
    Critter Mom, Pookie and FarmKitty like this.
  58. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well I got the numbers and will post them but right this instant - Miles didn't finish his food this morning OR this evening. That cannot be good. I cannot honestly think of any time when he DIDN'T finish whatever I put in front of him. :arghh:

    edited PS: I did have to pick up the last part of his food so that his sister wouldn't eat it. I'm going to have to get a different flavor on... ugh... Monday, because the vet's is closed tomorrow. Or give him some of the food that he likes but they didn't provide. Ahh screw it, if I have to put back his appointment I put back his appointment.
     
    Last edited: Jan 16, 2021
  59. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Chris,

    I'd suggest asking them to put numbers round what they consider to be 'borderline'.

    Did they give you the BG readings they took for the curve?

    Like the pic! :cat:


    Mogs
    .
     
    Chris and Miles likes this.
  60. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi Critter Mom,

    These were the readings.

    Chris

    23.4 mmol/L
    20.3 mmol/L
    19.6 mmol/L
    19.1 mmol/L
    19.3 mmol/L
     
  61. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Gave Miles a quarter can of the food I had been giving him previously and he kind of gobbled that up. So I think he just does not like the Hills' Glucosupport liver flavor. :( So instead of his evening meal of a whole can of the Hills, he probably had 2/3 of a can of that a quarter can of whatever the other stuff is, I can't remember.
     
    Critter Mom likes this.
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Those aren't anywhere close to borderline readings. They're very much in 'kitty needs insulin' territory, even taking into consideration possible temporary stress hyperglycaemia due to the vet visit.


    Mogs
    .
     
    Chris and Miles likes this.
  63. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Oh FFS. Thank you, Critter Mom.
     
    Critter Mom likes this.
  64. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Last edited: Jan 16, 2021
    Critter Mom likes this.
  65. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Those are some high readings, so it is interesting that your vet isn't pushing insulin. Dixie was also in that range when she was diagnosed (22.6 mmol/L on Alphatrack) and the insulin and brought her numbers down a ton into a more reasonable range.

    One thing to note is that those readings from the vet are using a pet-specific glucometer (such as an Alphatrack). Most people on the forums here use a human glucometer calibrated for human blood (like your Bravo meter). So if you look at any of the posts about certain dosing protocols they will all reference the human glucometer values. The values between these two meters differ and there isn't a way to convert from one meter to the other. Just something to keep in mind when you are scrolling through all the posts and see people mentioning their BG numbers.

    Also, I looked at the Hills' Glucosupport in the food chart pdf. If it is the same as the "Hills m/d" then it looks like it is a little over what we recommend for carb content (13%). You will need to double-check if the nutrition value is the same or not though. It is better to have <10% carbs. I'm not sure how much that food costs, but it is just something to consider!

    How have the testing attempts been going? Any luck?
     
    Critter Mom likes this.
  66. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ok you seem more calm about the lack of pushing insulin than me. That is a little calming because I am kind of freaking out.

    I understand about the difference between human and feline calibration - I assume the vet used a feline one, and the site I linked to is also showing actual feline data, so I see how it's higher.

    The cans say both GlucoSupport and m/d so I assume it is that food. But if I don't feed Miles what the vet is selling it's not going "by the book" as far as they are concerned and I don't think they're going to proscribe insulin! :(:banghead:

    Honest to god I haven't tried testing again. I'll have to try tomorrow. And I'll have to email the vet with the numbers for the GlucoSupport food and what I was feeding him before and ask what's up, and try to be polite about it. They're CLOSED tomorrow though.
     
  67. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Are there any other vets in your area that you can go to? Maybe look at some reviews online? It is a very simple process to switch vets. You just show up to the new one and they will transfer any history over for you. Going to the vet should be a positive experience!

    You don't have to do everything that the vet says, like buying their "recommended" food and whatnot. They are giving you an educated opinion based on their experience. Same thing with people on this forum! We are all just speaking from experience with our own diabetic cats. You basically gotta question everything and do what you are comfortable with. My vet wanted me to feed Dixie dry food for her diabetes, and I did research into it and learned that it would work against her so I ditched that "prescription food" and got my own. It is hard to say no at first, but it gets easier as you go along.

    I was just confused about why those high numbers would not immediately make Miles a candidate for insulin, since that is what happened with Dixie! Also, I am very careful to not give medical advice out on the forum because I don't want to lead you into any trouble. I am just a diabetic cat owner and am not in any way a medical professional! So that is why I always say to question what you read on the forums and do your own research. And while you are at it, question your vet as well and do your own research! Treat your vet as another knowledge source. So you could go to a different vet to get a new perspective.

    You need to make testing a priority. Otherwise, you will end up shooting the insulin "blind" (so you won't know his BG levels). Then you will take him into glucose curves regularly at the vet. This forum does NOT recommend this method because diabetic cats on insulin can drop their BG values very quickly and there will be a higher chance of Miles experiencing a hypoglycemic episode. We home test so that we can see what our cats are doing and if their levels start to drop. Dixie has dropped below 2.7 mmol/L at least 4 times already! It is a good thing that I home tested because then I knew to lower her dose right away. I don't want to think what would have happened if I had waited a few weeks for a glucose curve at the vet.

    Try setting an alarm on your phone to test Miles.
     
    Critter Mom likes this.
  68. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    I think you should consider those ketone/glucose strips that I previously mentioned (or at least just get ketone-only urine strips... the glucose strips will always read positive when Miles' BG levels are that high). If a diabetic cat isn't getting enough insulin and isn't eating then it can develop diabetic ketoacidosis which can be very deadly! So please read up on that as well: https://www.felinediabetes.com/ketones.htm
     
    Critter Mom likes this.
  69. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thanks FK, very much appreciate your thoughts.

    I have a personal issue with not recovering from failure and trying again which has been how I have kept trying and failing and giving up on testing Miles.

    I just got up and I think I'm going to give Miles the previous food for this morning. I predict he will eat it all up. And gather some information and I will try to test in a couple of hours when I am more awake. The alarm is a good idea.

    edited PS no surprise to me, he ate all the Wellness Chicken Pate I put in front of him.

    However reviewing the food PDF I see that the latter food has a much higher caloric content -
    the m/d (if it's the same) gives 156/can and Wellness chicken pate is 218. Is too many calories any concern?

    Now to track down what they originally told me to feed him before Christmas... omg did I misread what they told me? I think I was under feeding him at one point :(
     
    Last edited: Jan 17, 2021
  70. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Chris,

    From your link above:

    upload_2021-1-17_13-30-25.png

    Now, the following graphic illustrates what a typical feline response to a dose of Vetsulin might look like (regular 12-hour cycle, not influenced by any bouncing):

    [​IMG]

    The curve on the Merck website looks more like what one might hope for in a dog given one dose of Vetsulin every 24 hours. (A cat's graph would show two dips, one for each dose. They metabolise insulin faster than dogs do.) In all the data for Vetsulin cats I've seen since joining this forum, I've never seen a cat respond to Vetsulin in the way that their graph shows.


    Mogs
    .
     
  71. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    The main concern when it comes to calories is weight management (although cats who do not maintain adequate daily calorie intake are at risk of developing hepatic lipidosis and, in the case of diabetics, ketosis/DKA). For the diabetes, the carb content is key.

    As long as the carb % is OK for a feline diabetic then it doesn't matter which food brand/variety you feed (wet food is very much preferable). To manage the cat's weight, you keep an eye on the kcals in the food. If their weight gets too high, feed fewer calories per day till they get to their ideal weight. (NB: Weight loss needs to be very, very gradual otherwise cat risks developing hepatic lipidosis.) If they need to gain weight, feed extra calories. There's good information on feline weight management at catinfo.org. You can get reasonably priced baby scales online to do weekly weight checks. Keeping a little diary of what you feed each day helps to keep track of calories consumed.


    Mogs
    .
     
    Last edited: Feb 23, 2021 at 11:35 AM
    Reason for edit: Clarification (blue text).
    Chris and Miles likes this.
  72. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    I only referred to the Merck link because it listed values for the ideal range for the glucose curve, but it is good that you point out some potentially suspect data.

    They said "the maximum and minimum levels of glycemia, which ideally should be between 120–300 mg/dL (5.6–16.7mmol/L) for cats for most of the day" - do you agree with this?

    It is possible that the vet tech I spoke to end of day Wednesday assumed I was not feeding Miles a low-carb food. :confused: :sigh:
     
  73. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ok small progress. I finally put a flashlight app on my phone (one with no ads! yes!) and wow it's like creating a road map for your cat's ear. And I did manage to get a small blood drop from Miles' ear on maybe the 3rd attempt but I misread the Bravo device and thought it was indicating an error instead of indicating that it was ready for a sample. Going to have some coffee and try again in a bit.
     
    Critter Mom and FarmKitty like this.
  74. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    It was a perfectly valid and sensible site to link to, Chris. :) I was only trying to point out that the Merck graph was just a tad misleading (and very naughty of them to include!).

    They'd be quoting numbers as measured on equipment calibrated for cat blood. I think the upper bound of 300 is too high. The online Merck Veterinary Manual puts the renal threshold as measured on pet-calibrated between c. 250-290 (varies from cat to cat). For a well-regulated cat, the idea is to keep it under the renal threshold the vast majority of the time. On a human meter, at a rough estimate that would be low 200s. (I've read one report here of a cat whose threshold was under 200, so we know that's possible).

    Per the normal feline BG reference range given to me by my vet for use with my Alphatrak (70-150), their target nadir of 120 as read on a pet meter is sound, IMO. It's in the normal range and there's a good safety buffer between the target and the lower bound of the normal reference range. For human meter users, the FDMB Vetsulin guide advises reducing dose if nadir BG drops below 90. Bearing in mind that human meters typically read lower than pet meters, the Merck target and the FDMB threshold are pretty much in the same ballpark.

    Having said all of the above, because of the typical mode of action of Vetsulin and depending on the individual cat's response, Merck's target range might be all that's safely achievable for many cats on this particular insulin, but should that prove to be the case there are other insulins to try. Many cats on Lantus and Levemir have a smoother response and flatter curves so tighter regulation is generally a better prospect for cats receiving them.

    Then you have the exceptions that prove the rule. One of the kitties currently on the board is doing very well on Vetsulin following a change to a low carb diet. For curiosity's sake, have a look at his spreadsheet:

    https://docs.google.com/spreadsheet...yC4LwQveNxBftGX5VrAT-8VUQSE--JxS8ojhF/pubhtml

    Every cat is different! :)


    Yay! You got a blood sample. :D

    Small victories, Chris! They all count, and you will get there. :) Try warming the ear a bit more next time.


    Mogs
    .
     
    Last edited: Jan 17, 2021
    Reason for edit: Typo.
    FarmKitty likes this.
  75. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thanks for the clarifications Mogs!

    I just managed to get blood from Miles' ear three times, so I guess I am getting the technique down, but the only results for my troubles were two "insufficient quantity" readings from the meter and two stripes used. I guess the solution there is more heat to increase blood flow.

    Gonna have to see if I can actually have a phone conversation with the vet tomorrow. I am guessing from the lengthy turnaround times to get appointments that they are slammed or they can't work as quickly as normal during COVID, so I don't know if that'll be possible or not.
     
    Critter Mom likes this.
  76. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Yay! That is a good start! Using the heat for longer will help. Also, make sure you keep the ear wrapped around your finger after the poke. When I tested Dixie today, no blood came out for the first 15 seconds and then it slowly started to bead up and there was enough blood another 15 seconds after that. Keeping the ear taught around your finger seems to encourage the blood to come out. You will want enough blood to cover up the little white square on the test strips.

    What questions are you planning to ask the vet? It might be a good idea to formulate a plan if the vet is super busy (and it will save you $$$!).

    BTW, in Canada there is no prescription for insulin (you can buy it in pharmacies or online). The vet will probably recommend an insulin that they are familiar with and they will try to sell it to you. I buy ProZinc insulin from my vet, but I could get it online if I wanted to.
     
  77. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Yeah, to be honest, I should ask if I can send an email because that will let me organize my thoughts and present the nutritional information about the Wellness food I've been giving Miles.
     
    Critter Mom likes this.
  78. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thank you for the info about the little white square as I was touching the end of the strip to the blood rather than that side of the end, if that makes any sense. Some of it may have gotten on the bottom of the strip and the end.

    Inserting a PS here - I'm only now really taking in what you said about insulin not needing a prescription. So I don't actually need to convince my vet that Miles needs insulin. Okay... I just need to get on with testing then.

    I guess I was thinking to write/say something like: The person I spoke with last week said told me a couple of things, and I didn't represent myself all that well, and I want to improve communication between us and ask some questions.

    First, I want to explain about the food I'd been giving to Miles. On Saturday he stopped finishing his meals of the GlucoSupport m/d liver flavoured food I was sold last week, so I have had to stop giving it to him.

    I had been (and am again currently) feeding him the Wellness Chicken Pate for which online resources give the following figures:
    Protein 32%, Fat 60%, Carbs 8%
    https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

    Would you agree that if I feed him this food and no treats, that he would be on an appropriate diet for his condition? If not, maybe we could try more of the food you sold me previously, or a different flavour of the GlucoSupport.

    Second, I would like to get your own opinion about whether Miles' readings from last week really were (only) borderline. I admit that yes, I gave him a few treats to get him into his carrier (listed as min 70% protein and 3% fat). But would those really be enough to increase his numbers by that much?

    (Thanks, etc etc)
     
    Last edited: Jan 17, 2021
  79. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Yeah the white side of the strip is just plastic. So hold it so that the black part faces up toward you and then that little white square will sip up the blood. If you get enough, the blood will go all the way up to the second white square. Sometimes it will only fill the square in half-way but still give a reading. I have been double-testing when this happens, and every time the meter has given the same result the second time (so it seems pretty consistent!). Let me know if you need pics of this part.

    Yup! Testing is the most important thing right now. You need to feel confident testing at minimum twice a day (breakfast and dinner) and then start Miles on an insulin. You don't need to 'convince' the vet of anything. You can just make a vet appointment in a couple weeks and get them to show you how to administer insulin. During that appointment you can show that you are feeding low-carb wet food and that you are testing his blood regularly (and you can have the data to back you up!).

    I don't know how close you are with your vet, but I don't think you need to send this in. I doubt the vet will want to do any research into the nutrition of a specific food (or looking at the pdf). From my experience, they just know the brands that their vet office sells (like Hill's or Purina DM). So if you send this in then don't expect any extra insight. Unless your cat has some other underlying condition (like kidney disease) then I think it will be fine for you to stick with the Wellness stuff that is 8% carbs (although that fat % is a bit high - there is more info at the start of that Cat Food pdf about that. They recommend 20-40% fat). Whatever you choose, make sure Miles is eating it!

    Are those the freeze-dried minnow treats? They wouldn't raise his levels like that and definitely wouldn't sustain them like that. Looking at the data, Miles' blood glucose was 25 mmol/L one month ago, and he was over the renal threshold because the urine test showed glucose. The curve you just had done put him at 19.1 - 23.4 mmol/L.

    My experience: Dixie's results were similar to yours in the beginning (22.6 mmol/L), and after 6 months of insulin she has been 3.5 - 8.6 mmol/L (with HUMAN meter - so a bit lower numbers) in the last week. I have aimed to keep her under the renal threshold (~10mmol/L), and now I aim to keep her even lower. I hope this gives you some general idea of what insulin can do and how effective it is! When Dixie has gone below 2.7 mmol/L (too low), I feed her half a can of medium carb food (14% carbs) and her numbers jumped from 2.3mmol to 7.7mmol at the most, and other times even less of a jump. So no, feeding a few treats to get Miles into his travel carrier isn't going to shoot him from normal levels into the 20's!

    Are you emailing this question to the same vet? The one who was saying that Miles was borderline for insulin before? Honestly I think the best thing you can do now is to test several times a day, get a spreadsheet of you results going, give him the low-carb Wellness food that he eats, and buy some ketone test strips. Then set a deadline (a couple weeks at most) to go to the vet and bring your data in with you so that you have something to actually discuss with the vet (and it'll boost your confidence!). Then you can safely start Miles on insulin (and maybe you can even research the different insulins beforehand so that you can be even more informed!).

    One thing to keep in mind is that it is common for diabetic cat owners to give up and basically not treat or abandon treatment of their diabetic cat (which is very cruel). Vets want to avoid this so they won't jump into saying "oh you need to test 4 times a day and feed these meals and read this stuff" because it can be very intimidating. My first vet was so happy that I had done any research at all and that I actually wanted to do treatment. They said that this diagnoses can often scare away patients. My current vet is genuinely excited with all the work I have done (tracking the BG levels and spreading out food into mini-meals), and this is all stuff that I learned on this forum and contradicted the earlier vet's advice (old schoold advice of feed 2 dry meals a day and only do glucose curves). I have very nice vets available to me, which I feel like is rare after reading the issue that people on this forum have with their vets.

    So yeah, don't try to convince your vets that a certain food is better or that BG testing is the better way (it won't work haha). Instead, spend your energy on taking care of Miles and use vets when necessary!
     
    Critter Mom likes this.
  80. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Another thing I’d like to mention… The only time I have really talked about diabetes with my vet is at Dixie’s diagnoses. They gave me a sheet with info about it (which linked to this forum funnily enough!) and the vet tech let me practice giving insulin (just saline solution) to Dixie so that I was prepared. They then send me home with ProZinc and told me to give 1 unit.

    Everything else I have done after that has all been due to this forum, which has different dosing protocols for each type of insulin and it tells you exactly what to do. The vet won’t tell you any of this stuff. I have made insulin dose changes all on my own and I don’t need to ask the vet about any of it. At one point, I tried to explain the dosing protocol I was using to the vet and they were like “yeah yeah you know what you are doing, it is all good”. So don’t expect the vets to know the way that we do things around here…

    I know that it can be scary/weird doing stuff that the vet doesn’t explicitly say to do. Dixie is the first pet I have had responsibility over and I have only had her for 7 months. At first I was anxious about doing something without checking in with the vet. But then I just thought about all the people that make daily decisions for their pets without their vets knowledge (like giving random supplements, or feeding super high carb dry food or whatever) and life just goes on… so that has chilled me out a lot.

    I hope this gives you some perspective on how things will go (if you follow this forum that is!).
     
    Critter Mom likes this.
  81. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    OMG, thank you always for your posts FK.

    I guess you may be right about there being no need or honestly no point in sending the email. Like all I am really hearing from them is "do it by the book, by the book". The actual vet who I talked to back in December wanted me to get the cat-rated glucometer. I kind of expect that if I go to them in two weeks with a chart of Miles' data they will say "well that data is invalid because it wasn't taken with the cat-rated meter". :(

    Is your first test of Dixie before or after feeding? Also, injection of insulin? (Sorry I should just look this up instead of prevailing upon you.) I'm afraid that right now my morning usually involves Miles starting to whine and whine about food about (or at least) 15 minutes prior to feeding, when I am probably still in bed. At least that's the case with the Wellness food which evidently he maybe still thinks of as a treat, but in any case it would be hard for me to get him to sit still long enough to even do a test when he's in that state.

    As far as talking to the vet in person or getting them to show me how to inject insulin... I feel like there's almost no chance of that, because of COVID. They are operating under a "deliver your cat at the door and we'll take it from there" procedure. If it was possible to actually see the vet I would have turned around and asked for a hands-on lesson about how to test Miles for BC right away when I was having failures.

    I managed to get a successful reading just now (about an hour after feeding). Gotta throw myself together for work now.

    edited PS: I share your concern about the fat level in the chicken Wellness. I think the profile of the fish looked better.
     
    Last edited: Jan 18, 2021
  82. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Great news, Chris! Really pleased for you. :cat:


    Mogs
    .
     
  83. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Yup, they will likely say that. Even my very forward-thinking vet still talks about the pet meter. They even offered to let me borrow one for glucose curves. When you bring in data for them, just summarize it (highest values are x, lowest values are x, he stays in x range), and when you get Miles on insulin you can just bring in a glucose curve chart. Don't try showing off the spreadsheets we use here... it doesn't work in my experience :rolleyes:.

    I just tell the vet that the AlphaTrak strips are $214 CAD /100 strips (on amazon) vs $40 CAD /100 Bravo strips. And I don't even know if you can still order the AlphaTrak meter in Canada! All you need to say is that you plan to test Miles several times a day to monitor him and that this is within your budget.

    The felinediabetes.com site also mainly uses the human glucometers, and there are countless cats getting regulated and going into remission (here is a thread that is all the cats who went into remission using ProZinc - you should read some stories!)

    Pet meters are more accurate, but the fact that you can home-test Miles when he is calm and at home will be even better. Going to the vet can stress out cats and their BG levels will raise (which may lead the vet to suggest a higher insulin dose than necessary!). So getting the home tests is preferable to taking him into the vet for a glucose curve.

    The standard method with ProZinc/Lantus is to do a BG test and see what you cat is at. If he is super low then you will need to refer to the dosing protocol for your insulin to see what to do next. Then, if your cat is in a safe range, you feed him. After he had eaten his meal, you give him the insulin.

    With an insulin like Lantus, I think this should all get done on-time (like within 15 minutes or so), although I could be wrong about that since I don't use it. With ProZinc, you get more leeway (so maybe an hour variance). I started with ProZinc and I was happy with that because I found the whole test/feed/shoot thing to be tricky in the beginning, and it was nice to know I had some leeway with the ProZinc timing.

    Getting Dixie to eat her whole meal before shooting was easy when she was unregulated. Diabetic cats don't process all their nutrients in the food they eat, and they basically feel hungry all the time (even though they lose weight :(). She would bug me for food allll the time. But as time has gone on, I can now give Dixie the ProZinc while she is eating since she won't finish her whole meal but I know from experience that she will go back to her food later. So the whole process doesn't take very long anymore!

    You will want to get that morning/night BG test without any food in him for 2 hours prior. The reason for this is that his BG levels will rise when he eats. Consider if you had fed him a meal before, he might have been low but then jumped to a higher BG level which you consider safe to shoot insulin. But that level is temporary and will start to come down AND the insulin will bring his levels down even further. So basically you need those BG tests at insulin shot time to not be food influenced at all. I hope this process isn't too difficult for you! If you do it every day then I bet Miles will adjust. When Dixie wants her meals then she basically begs to get tested hahaha.

    Ahh right, and you are in Ontario so that is definitely out of the picture! Well, the insulin shot demonstration was very short and simple. You basically just pull up the skin with your left hand and then insert the needle horizontal to their body with your right hand (is gets shot just right under the skin). There are lots of youtube videos on this and the forum can help you too, so don't worry about getting an in-person demonstration. I was nervous with needles and I did the shot with Dixie on the first try.

    You probably don't need another vet appointment then. Just keep testing Miles the next week and gather some data. Then research which insulin you want to use (Lantus or ProZinc) which you can find on this board, and buy those ketone test strips. Once you feel ok with testing, you should work to get Miles on an insulin (do this sooner than later). At this point, you can send your vet an email outlining what your plan is and maybe ask them if they have any concerns about it. Remember, it is not about convincing them what is the "right" way to do it, it is more about gathering extra info. If the vet is super concerned with your methods then you can listen to them. I don't think you will gain anything out of taking Miles back there right now since you can't get a demonstration.

    YES! That is excellent! :cat::cat::cat: When you have some time, get a spreadsheet set up so that you can track his BG levels and share them with the forum. Using that link, you will want to use the "World Spreadsheet Template" that that is at the very bottom (since we are in Canada and use mmol/L). The spreadsheet numbers at the top are how many hours after giving insulin. Since Miles isn't on insulin yet, you could just decide on the time that you would want to eventually give him insulin e.g. 9am/9pm and then enter in values like that. It can always be changed later. You can check out my spreadsheet in my post signature to see an example of how it will look (since I also use the World version).

    Yeah it is just something to look at. But isn't a big deal right now and should take a backseat to getting a start on regulating his BG levels!
     
  84. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    We can't be 100% certain (since there was only 1 BG test during his first lab test), but Miles was originally at 25 mmol/L one month ago, and now during that glucose curve he was a bit lower (19.1 - 23.4 mmol/L). So maybe your switch to low-carb food has made a difference :cat:. It will be great to see what his values are when he is at home.

    Here is an excerpt from the Lantus and ProZinc intro threads which you might find helpful. All the numbers are using human meters:

    'What is Regulation?':

    There are different definitions of regulation. As hometesting becomes more common, we've been getting a better understanding of what cats and their humans might be capable of. Janet & Fitzgerald propose the following "regulation continuum":

    • Not treated - blood glucose typically above 300 mg/dl (16.7 mmol/L), poor clinical signs
    • Treated, but not regulated - often above 300 (16.7) and rarely near 100 (5.6), poor clinical signs
    • Regulated - generally below 300 (16.7) with glucose nadir near 100 (5.6), good clinical signs, no hypoglycemia
    • Well regulated - generally below 200-250 (11.1-13.9) and often near 100 (5.6), no hypoglycemia
    • Tightly regulated - generally below 150 (8.3) and usually in the 60-120 (3.3-6.7) range, no hypoglycemia, still receiving insulin
    • Normalized - 60-120 (3.3-6.7) except perhaps directly after meals -- usually not receiving insulin
    There may also be an extra category of "mostly above 300 (16.7) but with good clinical signs" which occurs with some cats who are getting insulin. We don't know why it happens, but such a cat probably should not be considered to be regulated. On the other end of the spectrum, it is possible for a cat who is not getting insulin to have blood glucose as low as 40 mg/dl (2.2 mmol/L) on a glucometer calibrated for humans. If you have a non-diabetic cat, try testing her with the same meter to get a safe comparison figure.
     
    Chris and Miles likes this.
  85. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Right, well, I've cloned the spreadsheet but since my only data is from after meals I haven't started to record there.

    I tried to get a sample from Miles this evening and failed to get a good one, wasting several strips in the process. On the positive side Miles was a VERY GOOD BOY. I know we mostly say that about dogs but he is so sweet and gentle. He didn't complain at all about the testing even if he didn't like me sticking a wrapped finger in his ear, and he tolerated being picked up and brought back to the couch when he left. So that was confidence building at least.

    I've also started pushing back the cats' mealtime. Honestly I'm not sure if I can go "cold turkey" from 7:15 to like 9:00 or anything, but I fed them at 7:30 tonight and I'll go for 8:00 tomorrow night. Hopefully that will be late enough that Miles won't be off his rocker about food and will let me test him. But do I need to test him IMMEDIATELY before his meal, regardless of when I feed him? I'll to try to test him before his breakfast tomorrow morning regardless.

    Also, is there a page that EXPLAINS the spreadsheets because omg I have no idea what is going on in yours, although I recognize your feeding schedule.
     
  86. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    It is fine to record food-influenced values in the spreadsheet. You only need to worry about food influencing your tests when you start insulin and are testing at insulin shot time. So go ahead and add your data into the spreadsheet! You can see the data history on the Bravo meter if you press the up-arrow when it is off. Then you can navigate the values with the up and down arrows.

    Failed samples are fine! Just keep at it. I'm glad that Miles is adjusting so nicely :)

    You can test him 30 minutes before he gets fed. As long as he hasn't eaten 2 hours prior to that test. When you get used to testing him then you will probably find that you can test a minute or so before feeding him! But in the beginning, it is good to give yourself extra time to make sure that you can get a test and not go too far off the insulin schedule.

    The Spreadsheets, Tech Support & Testing Area forum has a stickied post How to use the Spreadsheet that should help you out!
     
    Chris and Miles and Critter Mom like this.
  87. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Awesome, thank you very much! :) Got some reading to do, clearly.

    I tried testing Miles this morning around 7 but that was the time he started "pester mode" for food (I fed them at 7:30) and I couldn't get him to sit on the couch with me for any length of time. Testing him 30 mins before feeding time may be a challenge. I need to make sure I'm fed so I have the energy to really give it a go!!
     
    FarmKitty and Critter Mom like this.
  88. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Better late than never with a good idea, right?

    I was able to test Miles just now at 9:30. He does generally love attention so he purrs when I put the heat pack on his ear (and thankfully he has stopped trying to bite it). After getting a successful reading I zipped into the kitchen, cut off a fingernail-sized lump of wet food, and gave that to him to eat, to at least start the association between testing and food :)
     
    FarmKitty, Critter Mom and Pookie like this.
  89. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Nice one, Chris. All the small victories will mount up. :)


    Mogs
    .
     
    Chris and Miles likes this.
  90. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thanks Mogs :)

    I just ordered some more food and litter for delivery and I'm going to have to do research again about food that's available. I think I misquoted the numbers for the food I was feeding Miles - it's:

    Wellness' Complete Health pate, Chicken: 30% protein, 66% fat, 4% carbs

    Purina DM is 43%, 52%, 6%

    Friskies pates also have high % fats.

    For the next food I picked the Wellness Turkey and Salmon which is at least sliiightly better: 37%, 58%, 5%...
     
    Critter Mom likes this.
  91. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, I think that changing Miles' food made him possibly even more excited about food than the chicken, maybe because it was just different. I'm feeding the cats at 7:45 now but in the morning Miles comes up onto the bed a bit after 6 (not that surprising) but maybe starts whining about food at 6:20 or 6:30. I feel very short on sleep and am still unable to get a blood sample from Miles before breakfast. So just to review, it's been about a month since I changed him to wet food and he is still going crazy for it. When it's actually feeding time he will do a lot of twirling around in the kitchen, he will kind of paw at the food bowls when I pick them up, and similar/worse when I am putting them down with the food in them.

    Outside of the mornings and a couple of hours before dinner (in the evening he might start pleading for food around 5 or 5:30) he is possibly even more sweet than ever but... I don't know whether this behavior is actually ever going to change and I am doubting my ability to mentally cope or to figure out a way to properly take care of him.

    To be more specific if I get him up on the sofa to try to heat his ear prior to getting a sample, he doesn't want to stay there, and will try to get off.

    Of course I could try to just cope. Maybe go to bed bang on at 10 o'clock instead of what I've been doing lately and dragging things out until 11. Just keep feeding him - maybe increase the amount a little to 2 cans/day and stick with that for some months to see if he calms down. I just don't know. :(

    It seems like a vicious cycle. If part of the reason for his activity is his diabetes, it is by the same token stopping me from being able to sample his blood which would let me possibly administer insulin. Maybe if I was able to give him insulin he wouldn't be feeling so very hungry and would be calmer. smh.

    Thanks for 'listening'.
     
    Last edited: Jan 24, 2021
  92. Beanie071

    Beanie071 New Member

    Joined:
    Jan 23, 2021
    I have a kitty that is smaller nature and he just has sinus issues because of it he sneezed and snores, but there is nothing wrong with him. Our vet suggested as weird as it sounds to set up a few dehumidifiers up especially one where Mile's sleeps. Also another thing that helps is when you take a hot shower bring him in there with you and let the steam work its magic. I started doing this and no sneezing and less snoring. Hope that helps. As for the diabetes stay positive and patient it gets easier and there is plentiful useful information out there.
     
    Chris and Miles likes this.
  93. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    You may need to restrain him for the time being. I used to get behind Dixie and straddle her with my legs. This would work for both blood testing and insulin shot time. I also found it helpful to try and gently cover her head with my palm that holds the lancing device. Now she is used to the routine and I don't need to do this stuff anymore.

    I have heard that others wrap their cats up in a blanket, so you could try that as well.

    Since Miles sometimes sits patiently, I think there is a good chance that you won't need to do this for long. You just need get the routine started and then eventually he will associate the test with the food. It is great that you are testing on the couch every time!

    You are probably correct in that his excessive hunger behavior is due to the diabetes. Increased appetite is one of the big symptoms in diabetic cats. Dixie was also this way, but after starting on the insulin it calmed her down A LOT!

    Another thing that helps is using an automatic feeder. I am not sure how this will work for you with your other cats, but it is something to look into. Dixie gets 6 of her meals from the feeder and only the 2 main ones at shot time from me (since I need to test her BG before feeding). This means that she no longer associates me with food as much. She used to go wild when I would open the can of food, and now she doesn't care as much. However, she will camp out at her automatic feeder!

    So please don't expect him to get bored of his food and settle down by himself. If you leave him untreated then he can develop more severe symptoms.

    Could you start filling in the BG test data that you have into your spreadsheet? You would use the "World mmol/L" tab. Don't worry about any test being food influenced. Just enter in all the data. It is ok if you leave a lot of days blank.
     
    Critter Mom likes this.
  94. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    No, it's not great that I've been testing him on the couch; it's a futon thing and it's deep enough for me to straddle him there. I've put what pitiful data I have in the spreadsheet but since I haven't given him any shots I don't know how to record it proerply.

    Maybe I'll be able to straddle him but since I wasn't even able to get a BG level from him when he was being reasonably cooperative just now I doubt it is going to matter.
     
  95. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    I just mean that it is good to keep testing in the same location each time. I use a cardboard scratcher thing that Dixie lays on and now that has become the "test" spot. I prefer doing the testing and shots on the floor, but that is because Dixie is older and doesn't jump much anymore.

    For the spreadsheet, just make up a time that you would give him a shot. You can always change this later when you start on insulin. For example, I give insulin at 10am and 10pm.
    So for me,
    AMPS = 10am
    +1 = 11am
    +2 = 12pm
    +3 = 1pm
    ....
    and
    PMPS = 10pm
    +1 = 11pm
    +2 = 12am
    ....

    AMPS and PMPS will line up with the insulin times, and this will be at the same time that you give the bigger meals of the day.

    I actually write the times directly into my column headers so that I don't need to do the math in my head.

    Can you move your test results to those columns? Then it will colour code them for you. Looks like you figured out the "U" column already :)

    You were able to get 3 successful BG tests from him! That is good! So please don't feel down about that. That is a big accomplishment.

    If you don't get a good reading from him, then just reward him with a treat and try again a couple hours later, okay? It will all be good :)
     
  96. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    The Bravo meter does need a large drop of blood (0.6). There are meters that need less blood. The FreeStyle Lite is one (0.3). Though the strips are twice the price, you might waste less strips.
     
    Critter Mom likes this.
  97. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Actually, the Bravo strips require 0.5 microlitres (according to the test strip box). But yeah, if you are finding that you frequently get blood from the ear but not enough for the bravo strips then you can look into alternative meters.
     
    Critter Mom likes this.
  98. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi all,

    I was really at low ebb yesterday. I don't know why I tried to push myself to get results when I was really tired - I know that makes dealing with my anxiety worse. But I am not, by the same token, fundamentally secure in feeling that Miles' diabetes is actually something I can manage.

    I've moved the results, and I've added three successful tests from today. Are things formatted correctly? I figure I should if nothing else take a bunch of samples a day to really try to get Miles to associate being tested with a treat.
     
    Critter Mom likes this.
  99. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Wow, looking good! Great that you got so many tests today as well.

    You might as well give it a good try though, right? This ear testing business is the hardest part. I'd say the second hardest part will be that you will need to occasionally stay awake with Miles if his BG levels drop too low, but you won't be dealing with that for a while and you can find a dosing protocol that works with your schedule. So please remember that things will get easier from here!

    You can remove the @ +... number after each test. It is totally fine for it not to be exactly on the hour. What I do is just round to the nearest hour. So 2:20pm would be 2pm and 2:30pm would be 3pm, etc.

    If you do that and only keep the number in each section, then the spreadsheet will automatically take the numbers from the World mmol/L spreadsheet and convert them to the US measurements (which is the tab that most people here will look at).

    Sometimes it is useful to add the "@ +..." like if Miles' BG levels were dropping very low and you had to do a lot of tests. Or, maybe you are trying to find his nadir (lowest BG level on insulin) so you will test a couple times an hour. Then you can manually colour-format these values and add them to the US tab. But for now I recommend you just keep the number in each cell.

    Yes! I agree 100% :D This will also help new capillaries form in his ear and it will bleed a lot easier for you.
     
    Critter Mom likes this.
  100. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, I can certainly round things off like you say. Thanks for explaining why.

    I am absolutely sure that the hardest thing is going to be testing Miles when he is hungry. It's one thing when he mildly wants to get away (normal times) vs when he really wants to get away (the time when I most need to know his BG level).
     

Share This Page