New Member I'm overwhelmed - food-testing-failing to give the shoot!!

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Tatiwen, Jun 30, 2020.

  1. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Hi Community,

    Sorry in advance for the long post!!

    Today is one of those horrible days, not that the past 2 weeks since my Kitten Luna was diagnosed were great because since then I have been battle myself about what would be the best for her.

    Luna is around 11 years old, a completely white beautiful cat who I rescued when she was already an adult cat. A couple of years ago, she was diagnosed with Hypothyroidism and since then she has been on methimazole. Since she was diagnosed with this illness she became a quiet kitten who basically only sleeps all day, except when she wants to eat and use the litter box. More than 2 years since I see her play and run around the house for the last time.

    Now she is diagnosed with Feline Diabetes and she develops a neuropathy of her back legs, this breaks my heart, at first I think it is time to let her go, but I couldn't, especially because I lost my kitten Lucas on June 1st due to FIP so I wasn't prepared to lose another kitten. So I decided to give her a chance.

    But after this 2 weeks I feel as I'm making her suffer every single day, she is not happy with me when pricking her ear to get the blood, especially because it takes for me up to 4 to 6 prick until I manage to get the damn blood drop and she is now also reacting with the shoot. For the blood test, I'm now warming her ear as suggested by some of you, but sometimes the blood only smears in the ear and it is impossible for me to get the right amount in the strip.

    I joined this group because it offers better resources about Feline Diabetes than what I'm getting from my Vet.

    I have read a lot of the information from here, I learned about food and how kibbles/dry food is the worst for a diabetic kitten. So I have already started to do a transition to wet food with the options available in Costa Rica, by the way, they are just a few options. I also found a place that sells raw food and I trying this with Luna. I'm feeding her with Nature´s Logic chicken and I gave up and also bought some Friskies ( I was reluctant due to the quality) and guess what seems as she likes the Friskies more than Nature´s Logic. During the weekend I tried the raw food and she accepts it without complaints. Don't know if doing this mix of wet food and the raw food at the same time is counterproductive.

    When starting to shoot her, I have to dilute the insulin because in Costa Rica there is no place that sells pet syringes with small capacity that makes it easier to get the right amount. But because of this group, I learned that insulin should not be diluted. So, I have ordered the syringes via Amazon and I'm doing the same with the strips because if I buy them here it will cost me the double. Another think about the shoot is the bubble, it is like the bubble hates me and wants to be in the syringe doesn't matter what I do. So I am afraid that if I inject a bubble inadvertently I can kill her. Her insulin dose is 0.76 UI of Lantus, but I read some posts that say 0.25 UI per kg and she is weighing 3.8 kg. If I follow this logic she should be receiving 0.95 UI instead of 0.76 UI.

    The point is that I have been doing whatever it is in my hands to try to fight for Luna, but when you see her laying on her bed, looking fearful at me because she thinks is time for the massacre, I asked myself if she deserves this.

    Today she has a follow-up appointment with her Vet to review the BG curve I did on Sunday and a checkup of her current condition.

    To be honest I don't know for how long I will be able to do this without falling apart. At least for now and due to the pandemic, I'm working from home, but when the time to go back to the office comes, I don't know how I'm going to manage all this.

    The option I have considered since day one of the diagnosis is giving her 2 months to see if she improves, if not, It will be time to let her cross the bridge. But when I think about this I feel like a serial killer. Having put my cat Lucas to sleep despite knowing that his illness was going to kill him as well, it is something that I cannot overcome, so it makes it more difficult to take any decision for Luna.
     
    jt and trouble (GA) likes this.
  2. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Welcome! You've come to the right place. My cat had been diabetic for four years and was diagnosed with hyperthyroidism in December. (She gets liquid Meth). what was her t4 at the last checkup?

    So you have a copy of the lab reports from two weeks ago? If not call up and all them to email them to you. We may have other suggestions for you.

    Neuropathy doesn't cause pain in cats in the same way as people. It sometimes takes weeks to months to resolve, and will resolve quicker with better bg numbers (we can help with that) and adding b12 methylcobalamin supplements. Many use the brand zobaline which can be found on Amazon, but not sure they have it in Costa Rica. Check stores and online for human b 12 methylcobalamin.

    Testing will get easier as new capillaries start to form. If you are using lancets that are 30-33 gauge, try switching to 26-28 gauge as they are bigger.

    Good job switching to lower carb food.
    What do you mean you deluted it??? You didn't shoot water into the insulin did you? If you did, throw it away immediately and get another vial as it is contaminated.

    A bubble won't hurt her under the skin.

    Lantus is not dosed according to weight. The recommended starting dose is 1 unit twice a day. It can later be adjusted by how she reacts to the dose. There is info on how lantus works at the top of the lantus forum.
    http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

    It's a marathon. Don't expect results to be so quick.
     
    Last edited: Jun 30, 2020
  3. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    You are using syringes with 1/2 unit markings, right?
    Even with those syringes, it is hard to get consistent, small doses because of air in the syringe and because the zero mark on the syringes is not consistent.
    Since you are inject subQ, a little air injected under the skin is not a problem.
    How lonk since the diagnosis of diabetes and how long since you noticed the neuropathy? With the BGs in your spreadsheet diabetic neuropathy should be clearing up.
     
  4. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Wait, I just looked and noticed a few things. 1st I only see numbers for the morning. What are you giving in the evening? Are you only shooting once a day? Insulin is ment to be shot twice a day. No insulins last 24 hours in a cat. The numbers you are recording really aren't that high. Much lower than numbers then are typical for a newly diagnosed cat.
     
  5. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    No the ones I bought don't have 1/2 unit markings. it is in 1 unit steps, but I have already ordered the one with 1/2 unit markings, should be here in about 2 weeks.
     
    Last edited: Jun 30, 2020
  6. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Yes, only one shoot per day, this is what the Vet recommends to start, but after reading a lot of your post I know it should be twice per day and it is something I will discuss with the Vet today.
     
  7. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    She was diagnosed 2 and 1/2 weeks ago. I noticed the neuropathy at the beginning of the week she was diagnosed, indeed it was because of how she was walking that I took her to the VET, and from there the exams come and the results confirmed diabetes.


    Yes, I have the results, they did uroanalysis, potassium in the blood, Geriatric blood test panel & fructosamine. Here the relevant number she got:

    Fructosamine 364 umoL/L
    Glucose 4 mmoL/L
    potassium 5.5 mmoL/L
    T4 1.7 ug/dL
    Creatinine 78.3 umol/L
    Proteins 84 g/L
    WBC 20.5
    Neutrophils 13.1
    Eosinophils 1.02

    No I did not put water or anything inside the insulin, but since I was using the human insulin syringes I have to do a mix between the insulin and saline solution. I have to use a syringe of 100 UI, charge it with 2 UI and then add saline solution up to 50 UI, do a kind of the mix by slowly rotating the syringe, and later discard the liquid until I have only 19 UI and then do the shot on my kitten. But since I bought the pet syringes with 1UI steps I'm filling it a little below the 1 UI mark in order to get the approx 0.76 IU.

    I have already done it and it is in my signature.
     
    jt and trouble (GA) likes this.
  8. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Do you think she was misdiagnosed? Or should I only interpret your comment as a good thing!!!
     
    jt and trouble (GA) likes this.
  9. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    WELCOME TO FDMB! First let me give you a big :bighug: for the loss of Lucas. :(

    You are a good momcat! I think your Vet has a lot to learn about diabetes maybe after a while here you can teach him! ;)

    We are a community of dedicated cat owners and lovers. You have landed in a safe place! Your post makes you a member of this family.

    I will let the experts address your concerns and please know that WE ALL CARE!:bighug:
     
    Tatiwen likes this.
  10. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hi--

    I'm very concerned about the dose you are shooting, the dilution, and the measurement.

    Lantus is a human insulin. The concentration is U-100, 100 units per 1ml (cc). Were you using 50-unit (1/2 cc, or 1/2 mL) syringes for the dilution procedure you describe?

    I'm glad you are getting some more appropriate syringes. Most of us use 0.3 ml U-100 syringes with half-unit markings-- sounds like maybe you have them now or are getting them soon? Would it be possible to attach a picture of what you are using and show where you are drawing to now?
     
    Tatiwen and jt and trouble (GA) like this.
  11. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Lantus is a human insulin, meant to be used with U100 syringes, NOT U 40 PET SYRINGES. THe U40 pet syringes are meant to be used with prozinc and vetsulin/caninsulin. I'm so so confused what you are doing with the saline. I have never ever heard of anyone putting saline in with the insulin ever. Can you post a picture of the syringes you are using? How in the world would you measure .76? do you mean .75U? If your dose is .75 U, you would pull the insulin up to ALMOST the 1 on your syringe. It is just a few drops.
     
  12. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Also: I agree with Janet, those numbers are great for a newly-diagnosed cat! She may need insulin for a while, but it's a great place to start from.

    Wanted to add a couple things to my questions about the insulin measurement issue: if I understand your dilution procedure above, it should result in the right dose, it's just really non-standard. Did your vet tell you to do the dilution with saline? I just have never heard of anyone doing that.

    In general, my suspicion is that your vet might be more familiar with diabetic dogs than cats. Both once-a-day-dosing and dosing-by-weight are standard procedures for diabetic dogs, but not cats. Cats, with only vanishingly rare exceptions, need 12-hr dosing of insulin, and while weight is often used to get the starting dose, after that all bets are off. Big cats can require only tiny doses, and small cats with certain conditions can require absolutely enormous doses (we've seen 20, 30, even 50U!).

    Looking at Luna's spreadsheet, I'd be inclined to recommend going to a smaller dose, 0.5U or even 0.25U, twice a day, but let's be sure to verify the dose measurement on your new syringes first!
     
    Tatiwen and jt and trouble (GA) like this.
  13. NoahFL

    NoahFL Member

    Joined:
    Jun 12, 2020
    Welcome, you’re in great hands here. One piece of advice I’d recommend is using a small bit of Vaseline on the ear prior to BG checking. The Vaseline helps to pool the blood into a droplet which makes testing easier.
     
  14. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    If you ordered u40 pet syringes, cancel the order, it's the wrong kind of syringe for your insulin.
     
    jt and trouble (GA) likes this.
  15. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020

    Since 6 days ago I'm not using the syringes that require the dilution. I'm using the Ulticare VetRx U-100 3/10CC. the one in the picture. Those syringes don't have half unit, but it is a little bit easier to guess/estimate the 0.76 UI.

    In about 1 week I will get the syringes with half Unit I order via Amazon, they are expensive, but I wasn't able to buy it via Chewy & ADW, both asked me for a prescription that I don't have because I live in Costa Rica. Seems as the issue is the PO BOX I have in USA, it is located in Florida and in that state a prescription is needed when buying syringes.
     

    Attached Files:

  16. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    yes, these are the syringes you should be using. :) Other then not having half unit markings they are perfect.
     
    jt and trouble (GA) likes this.
  17. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Janet, that was my nightmare the first week with the dilution, again I just follow what the Vet told me, but good thing I found the Feline Diabetes group on FB and I start reading a lot of the info and even doing some question in there. As soon as people told me that dilute the insulin is a crazy thing I order the syringes, because in Costa Rica the smaller one is 50 U per 1/2ML. I was using the 100 U per 1ML syringes when doing the dilution. :(

    I know but that was the number my Vet gave me, I did not invent it. With the Ulticare syringes, I'm doing exactly what you say...pull insulin up to almost the 1 in my new syringe.
     

    Attached Files:

  18. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Thank for the suggestion!!!
     
    NoahFL likes this.
  19. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Maybe Saline is not the right word, sorry I not good in English as I wish, but I'm attaching a photo of what I'm calling saline.
     

    Attached Files:

    jt and trouble (GA) likes this.
  20. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    yes, that is saline, but I still don't understand why it was necessary at all.
     
    jt and trouble (GA) likes this.
  21. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    My Crazy Vet use a rule of three to estimate the amount of saline I need to put to a 1U of insulin to get a solution containing the equivalent of 0.76 U. The maths was very simple, but seems as the Vet was wrong by suggesting this.
     
    jt and trouble (GA) likes this.
  22. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    That may be your problem. oye!:confused:o_O:confused:o_O
     
    Tatiwen likes this.
  23. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Please know you and Luna have landed in a safe place. We'll do everything we can to get you both on the right path!;)
     
    Tatiwen and pomflora like this.
  24. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    [​IMG]
     
    Tatiwen and jt and trouble (GA) like this.
  25. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Were these the blood test results BEFORE starting insulin? The glucose is 4 mmoL/L which is 72 mg/dL for our friends in the US. That's a normal blood sugar number - really good actually. According to this website, her Fructosamine was also in normal level, although the high end.

    Here is a food chart from Mexico and Argentina, maybe some of them are available in Costa Rica.
     
    Tatiwen and jt and trouble (GA) like this.
  26. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    these are the results before she start with the insuline. About the ranges and according to the laboratory and the Vet the fructosamine and glocuse were out of the normal ranges. That's why Luna got diabetes as diagnosis. For me all this is confusing.
     
    jt and trouble (GA) likes this.
  27. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    Your labs tab on the spreadsheet shows blood glucose 20.28 mmol/l but urine glucose is 4. Can you confirm? 20.28 mmol/L (365) does sound high.
     
    jt and trouble (GA) and Tatiwen like this.
  28. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
    Yes, that the number, see the photos of the exams attached. I mark in pink the one for glucose.
     

    Attached Files:

    • e1.jpg
      e1.jpg
      File size:
      30.4 KB
      Views:
      5
    jt and trouble (GA) likes this.
  29. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
     

    Attached Files:

    • e2.jpg
      e2.jpg
      File size:
      29.1 KB
      Views:
      2
  30. Tatiwen

    Tatiwen Member

    Joined:
    Jun 16, 2020
     

    Attached Files:

    • e3.jpg
      e3.jpg
      File size:
      27.8 KB
      Views:
      3
  31. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    That clears thing up, thanks. It’s the urine glucose that is 4, not blood glucose.
     
    jt and trouble (GA) likes this.

Share This Page