Hello! Food and insulin questions

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

  1. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Has he been this way his whole life at feeding times? Or is this a relatively new symptom?

    I think you just need to be consistent with your routine, which was what I read when I first got Dixie and it has been the most helpful advice during all this. Cats really like routines. So give him test before breakfast and dinner meals. Even if you just have to pretend to test him because you are so tired. Just get him on the couch (or wherever you want the permanent test location to be), rub his ear for 2 seconds and click lancing device. Then go feed him. Do you think this is doable?

    I do the tests in a place where Dixie can have her eye on her feeding location (and automatic feeder). I have noticed that she only wants to lay down one way so that she can stare at it. If your couch is far away from the feeding area, then you could try a location that is closer so that he associates the test with the food.

    If you do this, then he will know that he has a better chance of getting the food he wants if he goes to your special location and sits still for a couple of minutes. I know it sounds crazy, but even when Dixie is meowing for food in the morning and running around, all I need to do is take a few steps towards her cardboard scratcher and then she runs to sit on it because she knows that she only gets food if she does this test.
     
    Critter Mom likes this.
  2. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi FK,

    No, he hasn't always been this way. I mean, wanting food, yes, not like this. Aside from sort of slapping at the food bowls when I pick them up, he also lifts himself off of his forelegs to get at the food as I bring the bowls down. And he starts whining about food when I finish work at or before 5pm, maybe because that's when I finish work, it didn't seem to matter whether I fed them at 7 or 7:45. If the forum allows uploads I could probably take some video. (Guess not)

    I think I could pretend to test him before each meal, even if I have to lift him up there. I mean, despite having to straddle him, I was actually able to get blood from his ear yesterday before a meal, before he got away from me :-/

    These do sound like helpful steps, thank you!
     
  3. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    That sounds like a new symptom then, so there is a higher chance that this is excessive hunger due to the diabetes and not just a personality trait (such as liking a specific food). That means that it should subside once you start treatment!

    That is great if you can get that testing routine down. Definitely just pick him up and put him on the couch. If he goes back to the food then you just pick him up again. If the couch is an issue then consider testing on the floor.

    You got this!!
     
  4. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Once you have fixed the values in your spreadsheet then could you update your signature? This gives members a good snapshot of what is going on with Miles.

    Also, instead of linking directly to your google spreadsheet, you can link to the "published link" which will hide personal account information. To get this link on your spreadsheet, go to "File" in the top left, then click "Publish to the web" in the drop down box. You can leave the settings as is (e.g. entire document), and just click the green "Publish" button. It will ask you to confirm so you just click "Ok". There should now be a link there that you can use. The link will automatically update every 5 minutes! So then replace the link that you currently have in your signature with this link.

    While you are doing that, you can add extra info to your signature. Refer to mine for an example of this.


    • 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 (date of diabetes diagnoses)
      • 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.
     
  5. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Sorry I've been gone - it's been longer than I thought!

    I understand setting up the signature and so on... it's just that right now nothing seems to matter other than getting Miles used to testing. As you can see I've done comparatively a lot more testing and a couple of times - particularly just now - he has been willing to sit and be tested before being fed a meal. So I feel like we are making some progress.

    I think the next step might be to try to test him 30 minutes before every meal. What do you think, FarmKitty?

    PS I don't think this is just me, but setting up a link in one's signature is more complicated than it should be here because it doesn't prompt me for the text of the link as well as the URL. I forget how to modify it, and I'm not enthralled with having to look up how to do this again. Not that this is anyone's fault!
     
  6. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Hey Chris,

    Looks like you are proficient at testing! You are ready to move onto treating Miles' high BG levels now. You can see that he is staying over the renal threshold all day. Can you make a vet appointment and say you want insulin?

    We want to bring those yellows and pinks down to the blues and greens! The sooner the better for Miles :cat::cat:

    I agree that the link-making process isn't the most intuitive. What you need to do is, first, highlight the text that you want to link, and THEN you will click the link tool and enter the URL. Then it will turn your highlighted text into your link!

    Just copy-paste this so that others can see where you are at (I think it will carryover the link as well!):

    DX: Dec 17, 2020 | No Insulin Yet | Bravo Meter | <insert food brand here> | <insert any extra health issues here>
    Miles' Spreadsheet
     
    Critter Mom likes this.
  7. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, at least much more experienced. Is there something I should be entering for when I try to test but fail? Those times aren't listed!

    Thanks for explaining the link thing. That's actually pretty easy, I just didn't think of it.

    Miles woke me up and started whining for food 15 minutes ago, so a full hour before mealtime. This might be a tough morning.

    I need to familiarize myself better with interpreting the values from the Bravo meter so I can back up my readings. And yes... I think what I have to do is set up a phone call with the actual vet I spoke to in December and not any less experienced member of the clinic.
     
  8. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    If you want, you could record some notes in the "remarks" column, but that would just be for you and wouldn't be useful for other members checking out your sheet.

    The four main symptoms of diabetes are increased thirst, increased urination, and increased appetite (along with weight loss). It's also known as the 3 P's (polydipsia, polyuria, and polyphagia). Very similar to humans! Looks like Miles is displaying increased appetite. Perhaps you have noticed him hanging out at the water bowl more or urinating more? Please use this as motivation to get Miles on a treatment! Otherwise the symptoms are likely to get worse and worse :(

    Sure, but please don't put off treating Miles because you think you need to know everything about his BG values. The vet should be able to interpret them for you.

    How about you update your forum signature and then create a new forum post right now (since we like to keep threads under 1 page) so that it will attract some fresh eyes. The title could be "I need help convincing my vet that my cat needs insulin". Be sure to make it clear that insulin is not prescription in your country.

    Then make a vet appointment ASAP.

    And please get those ketone strips that I mentioned earlier!

    There is not much else I can say...
     
    Critter Mom likes this.
  9. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Yeah, that all seems good. What I feel I need is information backing up the use of the Bravo meter, if someone has put together a summary related to reliability or how the numbers shown on the Bravo relate to what the actual numbers for a cat would be.

    However really I think this is about my own fear of disappointment. I am going to make the appointment today and see what the vet says (and yes order ketone strips and use them).
     
  10. Hercule's mum

    Hercule's mum Member

    Joined:
    Jul 27, 2020
    Hi Chris, I tried to read all the messages but may have missed whether you are using a lancet device, or just going free hand? If you haven't tried free hand, I reccomend it. The device was a disaster for me, but by hand I can approach the ear with much more precision and stealth! Also, perhaps you can have the treats already with you when you are going to test, perhaps in a plate covered with a tupperware? that way you can uncover immediatly after testing to help with the association?


    I don't know brazo meters, but I always like to point out that glucose is glucose in human or feline blood. It is the exact same substance being measured. Now I ask, do you think there are more regulations to sell human or pet meters?
    The advantage of pet meters is that is calibrated for the part of the curve that is most appropriate for pets, but the whole thing is a relative meassurement anyway. So the important thing is to know when Miles is too low, or too high, or whether there is a constant movement up or down. The exact value out of context means very little, and there is always error on the measurement anyway (in pet or human meters)
     
    Last edited: Feb 12, 2021
    Chris and Miles and FarmKitty like this.
  11. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    The reliability of glucometer readings are regulated in Canada. I did a quick google and found some info about it for you (https://www.ascensiadiabetes.ca/our-accuracy/):

    Current regulation based on Health Canada recognized ISO 15197:2013 standard requires results within ±15% range, specifically: ≥95% of results must fall within ±0.83 mmol/L for blood glucose concentrations < 5.55 mmol/L and within ±15% for blood glucose concentrations ≥5.55 mmol/L.1

    So the Bravo meter would adhere to giving these ranges. There is a Bravo meter control solution so that you can check that your meter is calibrated correctly, but it looks like it is sold out on diabetesexpress so I am not sure where you could get one. I never got one and instead tested myself (since I am not diabetic) to make sure that it was within an accepted range.

    If you want extra reassurance, you could get an extra meter as backup. I got the Nova Max Plus from diabetes express since it also has an ability to use ketone blood strips. The strips are a lot more expensive than the Bravo meter, but it gave me more confidence that both meters were working since their values were within the same ranges.

    You won't be able to find anything that can convert the BG readings from the Bravo (or any human meter) to pet readings, although some people have tried tracking the difference. Instead, we pretty much mainly refer to the human readings on this forum since the human glucometers are more popular.

    Please don't get caught up in the small details of Mile's recovery right now, because they will overshadow the bigger changes that needs to be done. Miles needs his BG levels to be brought down to normal range. Once you start treating his diabetes, and checking for ketones, then you can start looking into all the extra little details like using a pet meter, supplements, or better food sources.
     
    Chris and Miles and Critter Mom like this.
  12. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thank you for your thoughts! I think the association is pretty good, I have the bag of treats on the coffee table next to the sofa and Miles even gave some indication of expectation after I just measured him now.

    I have managed pretty well with the lancet device. I think the key was wrapping my finger with a piece of toilet paper and putting it up against the back of the inside of his ear.

    Hmm, ok, this still confuses me, as to how it is a relative measurement rather than absolute? Good point about error, thank you.
     
    Critter Mom likes this.
  13. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    I remember seeing mention of the control solution ... hm, it must have been in the manual.

    My worry is the vet is going to say "I don't recognize your observations since you aren't using a meter calibrated for cats". But that's anxiety talking.
     
  14. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Maybe bring your meter and strips with you to the consult and ask the vet to spot check Miles' BG with both their pet meter and your Bravo meter?

    Also, if you ask the vet to run a fructosamine test, it would provide meter-independent evidence of Miles' average BG for the last 1-3 weeks. If the result of that test shows Miles average BG to be in diabetic numbers that is the main diagnostic info the vet needs to confirm that Miles' glucose regulation is abnormal. In addition, you'd need to provide information to the vet on Miles' clinical signs, in particular:

    * Is he drinking and peeing a great deal?
    * Is he unusually hungry a lot of the time/all the time? Is he being fed additional grub and still looking for more?
    * Has he lost weight (especially significant if he has been eating extra)?
    * What are his energy levels like? Does he get tired/lethargic?
    * What is his mood like? Does he ever seem in any way subdued/depressed. Does he ever withdraw somewhere out of the way?
    * What is the condition of the hair coat? Unkempt/greasy/dander-ridden?


    Mogs
    .
     
  15. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well I doubt I'd be let into the clinic, still. But the fructosamine test might be useful, then again, when I brought him in and they did a glucose curve a few weeks ago? a month ago?... the attitude of the person I spoke to (not the actual vet) wasn't that helpful. I'm hoping to talk to the actual vet on the phone.

    But thank you for the questions, that's helpful Mogs :)
     
    Critter Mom likes this.
  16. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ok, so I spoke to a vet tech who checked with the vet on a couple of points. Maybe last time I didn't get my message across - she said that last time they thought I might be feeding him something with rice or otherwise basically a high carb food. Sigh.

    Anyway I have him scheduled to go in next Thursday morning. They said that they have to check his blood again because insulin is prescribed!? :helpless shrug: However it sounded like a 20 minute appointment which get things going. A demonstration of injection is involved which I can only imagine will be done from the inside of the window to the clinic since, due to COVID restrictions, I can't enter!
     
  17. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Maybe the regulations for selling insulin are different for where you live? But in most of Canada you can buy it over the counter. Here is an article comparing the prices of Lantus at different vets and pharmacies https://www.cbc.ca/news/canada/brit...per-from-pharmacies-and-wholesalers-1.1304362

    However, if you want a pet-specific insulin, like ProZinc, then I'd take a guess that going to the vet to get it is your best bet. I doubt you will find a pharmacy that carries it. Although it looks like there are a lot of online pharmacies that sell it over the counter, so no prescription needed.

    But if you put Miles on Lantus (which you can see by the Lantus/Levemir forum is very popular here!) then that is a human insulin and can be purchased at any pharmacy without a prescription.

    That is great that you have an appointment lined up! But your vet clinic kinda sounds like a pain... are there no alternative vets around you? You don't need to stick with the same one if they don't make you feel good.

    Can you email you vet and ask which insulin types they carry? You can say that you just want to research it beforehand.

    Ideally you will want a long-acting insulin that works well with cats, and not something like Caninsulin/Vetsulin which lots of people here find don't last long enough in cats. Most people here use human insulin, like Lantus, because they seem to get cats regulated the best. A few use ProZinc (like me), which is a pet-specific one, but it isn't as popular on the forums.
     
    Chris and Miles likes this.
  18. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi FarmKitty,

    I can't sleep right now so thought I'd check in. Great idea to ask about what insulin they carry. I might have to call them to find out but whatever.

    Other vets. Yes there is another one in the neighbourhood but it's (two or three times?) further away and I'm on foot with the cat carrier. If I have to deal with the same vet tech as in January I might just ask if for someone else. I was lying awake chewing that over just now.

    Maybe I'd better find out how much they charge for insulin as well.

    Chris
     
    Last edited: Feb 13, 2021
    FarmKitty likes this.
  19. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    PS from what I've read, insulin is behind-the-counter but does not actually require a prescription in Ontario. smh.

    PPS on a more positive note, Miles didn't raise too much fuss when I tested him this morning 30 mins before breakfast. One thing that I think helped was that the treat bag was on a side table, and I moved it to the coffee table, and he saw it and got excited. Still. What a good boy <3
     
    Last edited: Feb 13, 2021
    FarmKitty and Critter Mom like this.
  20. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    I should have posted sooner, sorry. Today's the vet visit day but I'm also kind of scatterbrained/tired.

    The insulin they have on hand is Caninsulin :( and they could get one other, only now I can't find my note where I recorded the other. I think it started with an L but I am not sure if it was Lantus or not. Maybe the best thing is to take him to the vet then, get whatever approval/help I can from them, get a limited supply of Caninsulin as a bridge? Or I could just not buy anything and connect with you folks and figure out next steps.

    I should note that Miles' numbers seem to be going up which worries me. :(

    And on a dietary note, when I switched him from the chicken food to the salmon/turkey I kept the quantity the same despite it being a lower calorie count listed. That was stupid, right? I should calculate an amount that would give him the same number of calories? :(
     
    Last edited: Feb 18, 2021
  21. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Chris,

    The insulin you're trying to remember the name of is indeed Lantus. Which country are you in? (Asking so that I can get a better understanding of what steps are needed to get Lantus for a cat where you are.)


    Mogs
    .
     
  22. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Hi Mogs,

    I'm in Canada - Ontario.

    Cheers,
    Chris
     
  23. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    So - the vets agree that he should be on insulin, starting him on 1 unit, they do have Lantus in stock. Owing to a lack of needles they are ordering those and will have them for me tomorrow... I could go to the pharmacy to get them but I'm feeling overstressed today. So I should be starting him on Lantus tomorrow evening.

    Critter Mom, FarmKitty is also in Ontario so I trust that what they say about their experiences will hold true for myself. I'm just saying that because I don't want wasting time. MUCH appreciated though.

    Trying to think of anything else to mention. I ordered more glucose strips & lancets as well as strips for ketones.

    I am a bit worried that maybe the stats for the particular food I am giving Miles are no longer accurate and that might be why Miles' numbers have been going up. The vet said to just keep him on the same food right now, though.
     
    Critter Mom likes this.
  24. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Chris, that is awesome you are getting Miles on insulin! Lantus is very highly regarded here and I think you will have a good support system. Check out the stickied posts in the top of the Lantus forum and you will find a lot of good information!

    You are right that when you switch Miles to a new food, you will need to adjust the amount depending on how many calories he needs. I have made this mistake in the past! It is a good idea to record any food changes in his spreadsheet because some foods can raise BG levels and it is good to be able to track the changes. If you notice that his levels were lower on the chicken flavour, then maybe it's a good idea to go back to that one and see if it makes a difference.
     
    Critter Mom likes this.
  25. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thank you FarmKitty, much appreciated :)

    I dunno if it would be a good idea to change his food back to the chicken right away at the same time as putting him on insulin. I have to order more food today - I think I will get the chicken.
     
  26. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    I changed my mind in the middle of making my last post, in cas that confused things :D
     
  27. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    I'm sure whichever flavour you pick will be fine for now. You are right in saying that it is a good idea to keep things consistent when introducing new food or medication.

    However, we also need to balance those decisions with the fact that we want to keep our kitties healthy and pursue their treatment in a timely manner! If I look back on my past, I think I was sometimes a bit slow to change Dixie to lower carb foods, change to different ingredients, get a dental, or to start her on medications because I wanted her values to stabilize first so that I could see the actual effect that these new things had on her BG values. But in doing that, I just put off her treatment longer than it needed to be.

    So yeah... we gotta choose between being "scientific" in introducing new things slowly and one at a time, vs treating our kitties with things that seem to just work (such as how certain foods will seem to agree/disagree with our cats). There isn't any true 'right' answer either, although we do need to consider the safety of introducing new things... such as not switching to a lower carb food at the same time as starting insulin!

    And please remember to enjoy your time with Miles! I won't lie when I say that the diabetes treatment can take a bit of a toll on your life... Knowing that you need him to get insulin every 12 hours and that sometimes you will need to stay up with him and worry can definitely become a source of stress. Things were finally getting easy for me with Dixie, but then she just got diagnosed with some more diseases and now I am back at square one with researching food, medications, and monitoring her BG levels... It can be hard to remember that she is my lovely cat and not just a source of data!

    I am very happy that you are now able to consistently test Miles' BG levels. The two next hurdles will be the insulin shots and learning how to adjust his dose. If he gives you trouble at shot time, just remember how you have already trained him to associate ear tests with food. The same thing will happen with the insulin shots! You just gotta give it time.

    Good luck :)
     
    Chris and Miles and Critter Mom like this.
  28. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Why have you had to stay up with your kitty? :(

    The way Miles has been, his crying is 99 times more of a toll on me than measuring his BC. I have been losing probably 30-45 minutes of sleep in the morning for a long time, and adds to my stress at other times (like 2 hours of it before dinner). At other times he is a perfect dear and wanting lots of attention and purring madly. So I'm just hoping that on insulin he will be happier and I will be happier.
     
  29. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    He will definitely be happier on the insulin! Dixie has had sooo many positive changes since starting treatment for her diabetes. Even at the 7 month mark, I am still noticing changes! Recently, her whiskers have been looking a lot thicker. It is amazing how diabetes can take such a toll on the body. I bet you will start to notice changes in Miles very shortly after starting the Lantus.

    I have had to stay up some nights when Dixie's BG levels dropped lower than normal (which could lead to a hypoglycemic event, which can be deadly!). It wasn't an issue when she was up in the yellow/pink numbers, but when she started to come down to the blue/green ones, then I had to monitor her a lot more to see what she would do. Some nights she would be in the greens at preshot time, so I would decide to give her the typical dose of insulin and stay up to make sure she doesn't drop too low.

    It is not always like this though. Once I got an idea of how low she goes throughout the night, then it was much easier for me to go to sleep knowing that she would be okay.

    Another thing you can do is try to schedule your shot times in a way that you can get a PMPS+2 test in each night before bed since that +2 value will often signal if you are going to have an "active" night or not, where "active" means that they might drop low.

    Sometimes Dixie's +2 was 9.3, othertimes it was 3.0! So that signals to me that I need to stay up and monitor her, and make sure she has the food she needs.
     
    Critter Mom and Chris and Miles like this.
  30. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Wow, 3? I can understand why you'd stay up then.

    I will start a new thread about insulin questions (I'm sure I'll have them) but I'll have to figure out how much to feed Miles once I start the insulin. I guess I would go back to the amount for a healthy cat.

    I am wondering about how much to feed him that would allow him to healthily put on more weight. I feel like he has lost muscle mass as well as fat, unless it's just a lack of energy he is feeling. Part of that is looking at him, like his back legs are kind of... Gangly? The other is for instance at one point he wasn't able to step up to my computer and then onto the desk. He is managing since then , though.
     
  31. FarmKitty

    FarmKitty Member

    Joined:
    Aug 19, 2020
    Yup! Although that number will be different depending on what stage you are at. For instance, if Miles is usually around 16 throughout the day, then suddenly he is 11 at +2, then that would be a sign that you should test him more that cycle and then see what he does. Basically, be on the lookout for any lower numbers. Eventually his numbers will come down more and more until you can keep him safely in a normal range :)

    Webmd says 24 to 35 calories per pound, so you can start with that calculation and then add some extra since Miles' diabetes isn't regulated. That will help him get all the nutrients he needs.

    Not sure about this one because I haven't dealt with it, so maybe do some forum searching and make a post if you can't find your answers.

    Arthritis is almost a given for older cats, so you should mention this to the vet. Another thing we see on the forum is that diabetc cats get neuropathy, where usually their hind legs will be very weak and they won't walk very tall. If you treat the diabetes with insulin then it can actually completely recover. There are also some vitamin supplements that people recommend (I have Dixie on methyl-B12 and folate) that can help with neuropathy.

    In my experience, Dixie has done a complete 180 with her back leg progress. When I got her, she would only take a few steps before sitting down, would lay down at the water bowl, and wouldn't jump. She is now very wild and can pounce, chase, and even jump. I started the B12 supplements late in the game, and when I talked to the vet we were both in agreement that if I had started early, it would be hard to tell if it was the vitamins working or just the result of getting the diabetes regulated. Insulin is a miracle!
     
    Chris and Miles and Critter Mom like this.
  32. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ok so from what you're saying, I understand that I don't need to change the amount I feed him until some time in the future. Got it!

    Thanks for your thoughts on arthritis and neuropathy. Your story of Dixie's recovery is SO SWEET :) :)
     
  33. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, according to the cat food chart the chicken food is 220 calories/tin. I am feeding Miles 1 3/4 tins per day, so that's 385 calories. At one point he was 10 pounds so that's 38.5 per pound. I guess that should be fine.

    It isn't stopping him from whining of course and it seems like that has increased since I put him back on the chicken flavour.

    I just wasn't ready mentally to start insulin tomorrow. I have to do more reading/watching today... hm... maybe just starting a thread would help calm my nerves.
     
  34. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    No need to worry about calories or how much to feed. As long as your cat isn't regulated, he can't use the food, that's why he's hungry all the time. If he's still loosing weight, feed more.

    You'll never feel ready. It's going to be overwhelming no matter how long you wait.
    He needs you. Only you can make him feel better.
     
  35. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Paradoxically, even though that may well be the truth... Those are good words to make me anxious and to dissuade me from trying.
     
  36. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Chris,

    I am a walking monument to anxiety disorders: I have chronic PTSD, my sleep has been completely disordered for the last decade and a half, I am completely housebound by agoraphobia/panic disorder, and I have howling obsessive compulsive disorder. I regularly become paralysed by fear and fatigue. You have no idea of the level of terror I had to work through when treating Saoirse.

    One thing that might help you get past the block you're dealing with is to rank your fears. What frightens you the most? If you get scared enough of that, it might help you feel less anxious about the lesser fears and take the steps you need to make sure the worst one doesn't happen.

    I hope you appreciate from the above that what I say next comes from a position of great empathy. Sometimes you just need to put on those big pants, take a deep breath and do, not think. You're not alone with this. You've got a 24/7/365 support system here. Please use it.

    :bighug:


    Mogs
    .
     
    FarmKitty likes this.
  37. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    I'm sorry, but it's the truth.
    I have anxiety too, panic attacks and OCD.
    It is hard, the only way it gets easier is to get going. Miles needs you, you're the only one he has. We've ALL been exactly where you are right now, scared to $hit, afraid of doing something wrong. But we're still here, helping each others, supporting, giving advice, hugs when needed.. you have support 24 hours a day. There is always someone here you can ask, even in the middle of the night. You won't be alone.
    Hugs to you, Chris. :bighug:
    We all just want to help.
     
    Critter Mom likes this.
  38. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    So sorry to hear about how hard it was for you. Vibes!!! And you're right about the pants. Thank you for your support. You and FarmKitty have given me a ton of support which has really helped.

    Fears sometimes stem a lack of information. I hadn't read the Insulin 101 document and I'm doing that now. One thing I didn't know was "how long do I have after feeding to give the injection?" The vet said "right away" but that is in a bit of a conflict with my habits in the morning. (Cook oatmeal, right about when it's ready, feed cats, then eat my oatmeal.) The 101 document indicates up to an hour. Obviously I don't want to push it but I want to know if I need to change my routines or not. There is talk in one document about "don't loom over your cat" but another about injecting during feeding which is I think what I am going to try first, albeit that Miles devours his food pretty quickly. If that somehow does not work though, now I know how much "fallback" time I have available. That helps relieve my stress a little.
     
    Critter Mom likes this.
  39. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    When you've got the technique down, it really doesn't take more than 2 minutes.

    I take the cats food out of the fridge, in their bowl, and feed my non diabetic. Go back to the kitchen when he is eating, getting a syringe, insulin from the fridge, then I take food bowl, phone, syringe and insulin to the bedroom window where I test and feed.
    She jumps the windowsill, I poke her ear, she eats while I draw the insulin up and record her BG in her spreadsheet. When she's done eating she jumps to the bed, where she lies down and then I shoot. Back to the fridge with the insulin, dump the bowl in the sink, syringe in the container, and all done.
    Literally it only takes a few minutes.

    Once the routine is there, it doesn't take much time. Neither does taking the BG during the cycles.

    During the night, I get up, pee, eat, poke the cat, chek Facebook (totally bad habit by the way!), record her BG in her spreadsheet and back to bed within five minutes, and back to sleep. Or, just back to bed, cause I'm not really awake :woot:
    It's all routine!

    I'll bet that when you've done this for a month, you can't make a cup of coffee faster than feeding, taking BG and giving Miles his insulin :cool::bighug:
     
    Critter Mom likes this.
  40. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, maybe in a month. Right now Miles' routine is "Start whining 1-2 hours before dinner. Squirm if the human tries to measure my BG half an hour before dinner. Get excited any time the human goes into the kitchen. Paw at the bowls when he picks them up. When he starts opening the cans start rushing around that end of the kitchen. As he puts them down start jumping up in excitement. Wolf down my food and try to eat some of my sister's. Keep licking the bowls for everything they're worth." So I wouldn't even get to your second sentence there.

    But I'll cross my fingers for the future. Thank you Sasha :)
     
    Critter Mom likes this.
  41. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well that didn't work right. I managed to poke myself with the needle through the tent of skin I'd made - doing it wrong because I know my finger should not have been in line with the needle at all - and I was so startled I don't remember if I pressed the button or not. I am pretty sure I didn't but I imagine I should wait until tomorrow am.
     
  42. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Good attempt! Every step along the way helps. :)

    Definitely wait till tomorrow, Chris. Any time you've attempted to give insulin and something goes awry, you work on the principle that *some* of it might have gone in and you always wait the 12 hours till the next dose is due before giving insulin again.

    Tip: when forming the tent, put your thumb on the mid-line and your middle and index fingers either side of the thumb on the other side of the tent. The hollow where you insert the needle should be directly under the thumb (which you can see) and the two fingers should be well out of the way of the needle.

    One thing that helps when learning is to take a spare syringe, fill it with water and practise giving the injection on an orange. Granted you'd have a job trying to tent the skin of an orange, but it does build confidence by helping you to get the right 'feel' for the act of injecting.

    Another helpful tip is to make sure that the bevelled edge of the syringe needle is facing upwards (makes the injection smoother).

    Last tip for tonight is if ever you suspect you might have given a fur shot (needle comes out other side of tent and at least some of the dose may not have gone in) in addition to feeling the fur to see whether there's any wetness, give the injection area a good sniff. Lantus is rather pungent (has a really 'medical' odour) and it's easy to smell even a small amount. Even if you can smell insulin on the fur, the same rule still applies: some of the insulin may have gone in so you wait till the next dose is due before giving any more insulin.


    Mogs
    .
     
  43. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    PS...

    If it's any bit of comfort, Chris, you're far from the first person to do this - and many more after you will do it as well. :)

    Night.


    Mogs
    .
     
    Chris and Miles likes this.
  44. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Good luck with giving the insulin tomorrow, it'll be the best thing you ever did for Miles. If you want to practice before hand, I've heard you can try on a loose skinned orange - just water of course. ;) Yet another video on how to give insulin here:


    I too am in Canada, and I don't think anyone linked this Canadian brand list for you: Food Chart
     
    Chris and Miles likes this.
  45. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thank you both. What a great forum. :) And yes Mogs I was very conscious of the idea that if I had injected him with any of it, plus another dose, which be more than the standard dose, and that could be dangerous.

    What I have right now is one of the Lantus pens but I suppose I could get an ordinary syringe for testing. This seems to be the best YouTube video I've seen for that device. In some of the others, the owners don't hold for 10 seconds which is part of the instructions.



    I'm not sure what you mean by the hollow. Don't you inject into the folded up skin that you've lifted into the "tent"?
     
    Critter Mom likes this.
  46. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    We don't use the pen needles. The mechanism doesn't work well if you keep the pens in the fridge. The manufacturer does not recommend keeping the in use pens in the fridge if using pen needles. Outside the fridge they last 28 days. In the fridge you can use to the last drop. Plus you can only change dose by 1 unit increments with pens needles. If you still need insulin again, ask for cartridges. And we use syringes to give insulin. The BD Ultrafine II syringes, purple and yellow box, available at any pharmacy.

    Another post you might want to read.
    Insulin Care & Syringe Info: Proper Handling, Drawing, Fine Dosing
     
    Chris and Miles likes this.
  47. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Augh I put it back in the fridge. *SIGH*
     
  48. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    You need to store it in the fridge until you get some syringes, so it won't go bad. So no worries :D
     
  49. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, I gave Miles his breakfast and had my own, and then sat on the couch with him where I've also done his BG tests. Ella (the other cat) joined me on the other side and lots of purring from both. It's pretty much their favourite place to hang out. I was able to get the pen there before Miles and keep it on my left where he couldn't see it, but I also tried rubbing Miles' face with the pen a bit because I saw that mentioned. Anyway I was able to turn away from Miles and prep the pen on the other side of my body, and... bottom line is I think I injected him but I'm not sure if it was a proper injection or it just went into the fur - not through his skin and the other side, but did the needle actually go in? I guess I will see in two hours from now what his levels are at and if what I did had any effect. :-/
     
    Critter Mom likes this.
  50. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    Was he wet? If not, it went in. :D
     
  51. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Good work, Chris! :bighug:


    Mogs
    .
     
    SashaV likes this.
  52. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Suggestion:

    Set the insulin pen to dispense a very small dose and discharge it onto some kitchen paper. Give it a sniff so that you'll become familiar with how Lantus smells (it is quite distinctive). After that, any time you're not sure whether the dose was delivered OK you can check for dampness around the tent area and also give his fur a sniff. If there is any Lantus on the fur you should be able to smell it.


    Mogs
    .
     
    Wendy&Neko likes this.
  53. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    This might help:


    [​IMG]


    As you can see from the above, you lift up the skin to form a tent, which looks like an upside-down V-shape, a little hollow forms - the 'tent door' - and that's where you need to aim the tip of the syringe needle, going in at an angle as illustrated.


    Mogs
    .
     
  54. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ahhh I see, thank you Mogs!

    I have gotten an idea of the smell, from yesterday - I think I got a little on my finger. I didn't smell any this morning, possibly a good sign. Miles' BG at +2 this morning was a little lower than normal but I don't know if that's indicative of anything or not. I'm going to increase testing (in retrospect I should have started that a couple of days ago).
     
    Critter Mom likes this.
  55. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Lantus dose onset is typically round the +2 mark so it's still early doors.

    I want to wish yourself and Miles every success with his insulin treatment. Well done, Chris! :)


    Mogs
    .
     
    Chris and Miles likes this.
  56. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well ****, I think I just gave him 2 units because I didn't understand that the pen resets to 0 after injection. FML. I guess I'll be taking lots of care tonight.
     
  57. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Get your first test no later than +2, Chris.

    If you need help during the cycle, please start a new thread (this one's too long and won't get proper attention). If you don't get a timely reply, post a thread on the Lantus board saying you need help ASAP.


    Mogs
    .
     
  58. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    @Bron and Sheba (GA) -

    Hi Bron,

    I'm about to sign off and I spotted you on the board. If you're around could you please keep an eye out for Chris and Miles this evening? Chris has just started giving Lantus today and he's quite nervous. He's just getting used to using the pen and giving injections and there may have been a couple of hiccups today:

    AM cycle: Not sure whether dose delivered OK (no insulin smell, but unsure). Starting dose is 1.0IU Lantus.

    PM cycle: Not sure about Lantus pen operation and may have administered 2.0IU insulin instead of 1.0IU. [See post #156 above, time stamp 01:04 GMT.]

    I have asked Chris to get a +2 test.


    Mogs
    .
     
  59. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    @Critter Mom i will be here for about an hour then have to do the school run then a hospital visit but I will certainly look in on Chris and Miles when I can.
    @Bandit's Mom may be around soon as well.
    Sleep well.
     
    Critter Mom likes this.
  60. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
  61. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thanks, sorry, I know I should create a new thread but I think I need to learn how to convert the numbers I get to the more commonly used units, for the title?

    Anyway Miles' number just now is 18.0 so I am even second-guessing whether or not I did an injection. @Bron and Sheba (GA) I don't think Miles is in any danger whatsover.
     
  62. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Suggested thread title:

    <switch on question mark prefix> PLEASE HELP: First day Lantus - may have given 2 units instead of 1 unit. How long to test?

    It very much looks like you did, and that you may have quite an active cycle (+2 lower than preshot often signals that BG may go lower as the cycle proceeds).

    Hope the above makes sense. The meds have blurred my vision and the brain's rather woolly.


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

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Ok, thanks Mogs!!
     
    Critter Mom likes this.
  64. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
  65. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well, that was a bit of a scare and I'm a bit groggy this morning (stayed up an hour later for the +2 test, and waking up in the middle of the night). But while I would not have asked for that trial by fire, I feel more confident about injecting - ironically. I am going to stick with the pen for the remainder of this week but will look into syringes and maybe buying more Lantus from the pharamacy.

    On a more immediate note, maybe I should put this in another thread, but ... I don't remember if I put my sock with rice in the middle of the microwave or what exactly but one of the knots got very hot and actually there must have been a cinder because it created a lot of smoke. I currently have the windows open (it is about -1C/31F here) and a fan running to blow smoke out of my living room window.

    I'm wondering if any person or company makes small, safer heat packs? Or maybe it's just my microwave...

    PS on a positive note: I didn't have much trouble injecting into the front flank this morning, and Miles didn't really squawk about it either. :) It is actually more trouble getting him up on the couch - I think I had to pick him up, put him on the couch, and then fussed over him a great deal before giving the injection.
     
    Critter Mom likes this.
  66. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    Darn Chris! You be careful!! :bighug:
    How long did you give the sock in the microwave?
     
  67. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Thanks!!

    How long in the microwave - 50 seconds.

    From doing a little searching, I would guess the sock was not 100% cotton. I would guess it had some polyester in it, which is not microwave safe.
     
    Critter Mom likes this.
  68. SashaV

    SashaV Well-Known Member

    Joined:
    Apr 25, 2020
    Yeah, that's probably the problem.
    Try 100% cotton and give it a little less time. You can always give more, of it isn't enough. You can't really do it the other way!

    I think a new thread is due.
     
    Chris and Miles likes this.
  69. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Well done last night, Chris. :)

    Re warming the ear, have you got a small plastic receptacle like a pill bottle around? If yes, then maybe try the following:

    - Just before testing, half fill a mug or a small bowl with water and heat that in the microwave till it's just finger hot (or use a kettle to heat the water before pouring it into the mug/bowl).

    - Fill the pill bottle with the heated water, put the cap back on and then place the filled bottle into the remaining hot water in the bowl/mug to keep it warm till you're ready to use it.

    - When ready, dry off the pill bottle and test it against your wrist to make sure it's at the right temperature.

    - Curl the edge of Miles' ear around the pill bottle and hold it gently in place till it's warm enough for the poke.


    Mogs
    .
     
    Chris and Miles likes this.
  70. Chris and Miles

    Chris and Miles Member

    Joined:
    Dec 16, 2020
    Well now I'm regretting changing the cats' food last Thursday, because now I don't know why Miles' PMPS numbers are going up. There is the complicating factor that at lunch time Miles managed to lick a chocolate cookie that was on a saucer before I could get it away from him. I guess I just need to not freak out and see how the rest of this week plays out.
     
    Critter Mom likes this.
  71. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Early days, Chris. Marathon, not sprint. ;)

    Exactly! It'll take several days for the depot to establish before you'll get a proper view of what this dose can do.


    Mogs
    .
     

Share This Page