New Member saying hello & thank you!!

Hello, my name is Mischa, my cat's name is Periwinkle (Peri for short), and she is 13, newly diagnosed with diabetes. I got her when I was 17, she is my first kitty, and I had no clue what I was doing. She's been an outdoor/indoor cat her whole life, and she was always very active, curious, and adventurous.

About 5 years ago she began over-grooming on her belly, but the vet dismissed it as stress or her pudgy belly rubbing up against stuff. Also around this time she had a pretty intense roundworm infection. She has always had a very healthy appetite, so it went unnoticed until far too late. It is shameful to mention, but due to barely scraping by financially, I was not able to consistently afford the monthly parasite medication, and her roundworm infection was largely due to my own neglect. We have been more consistent with this since! I mention this detail because I suspect, due to the severity of the infection, this may have had some impact on the development of her diabetes.

About 3 years ago, her activity level began to decline, and within the last year she has developed noticeable back leg and tail weakness, and her over-grooming increased. We had moved around this time and started living with 2 other cats, so I assumed her increase in over-grooming was just due to changes and stress, and the decline in activity and back leg weakness due to old age and arthritis. In October 2020 we went to the vet for a check-up, they did bloodwork, noted that her glucose was high but dismissed it as stress during the test. January 2020 her over-grooming had stretched from her belly to down her legs, and I felt something was wrong, so we went back to the vet.

They tested her urine, her blood, and her fructosamine, and she was given a diagnosis of diabetes about 1 week ago. We were started on 2iu caninsulin 2x daily. She has been very easy to shoot, plop her in front of some wet food and she doesn't notice a thing.

At the same time as getting the diagnosis, I discovered this site, and switched her from Orijen Cat & Kitten dry food to LC wet (various brands, less than 6%), and Tiki Cat Born Carnivore Deboned Chicken & Egg (~11% carb). She consumes mostly wet now, but will snack on the dry.

We went back to the vet yesterday for a glucose curve, and they found that the insulin was dropping her too low (3.5 nm/L) and they had to intervene with syrup. It upsets me to think that she may have been dropping into hypo this last week and despite me checking on her as much as I could I did not notice any significant distress! They reduced her dose to 1.5iu 2x daily, but I'm still concerned that is too high!! We go back for another glucose curve in a week.

I'm grateful that she is responding to the insulin, albeit too well, and there has been a noticeable drop in her glucose even over the last week. Last week when they tested her they said her PSAM was 26nm/L, and this week it was 17nm/L.

We just acquired Accu-Chek Guide meter yesterday, and I'm going to make a real effort to start home testing her this weekend. I suspect she will be a bit of a challenge to test but she has always been incredibly food motivated so we'll work it out.

***I'm soooooo grateful for all the information on the feline diabetes website, the message board, and the catinfo.org site. Without it I would be so hopelessly lost, getting the diagnosis was stressful and made for many tears, and having a place where I can find an answer to literally ANY question I might have has been SUCH A RELIEF. Thank you thank you thank you thank you!!!***

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Welcome. You are not alone. If you have questions please ask. Until you learn to test I would lower to 1 unit

 

Welcome Mischa and Peri, you couldn't have found a better group
of members . They have years of experience. I'm sure you will do well with testing.
Peri is adorable

 

I would strongly suggest you start home testing. Caninsulin hits hard and fast and it was developed for dogs or canines hence the name, who have slower metabolisms than cats. Did your vet explain that she needs food on board at least 30 minutes before the shot? This was all probably due to the bad combination of starting her on too high a dose. She should have been getting 1 unit not 2 to start off with. And the food switch that can drop their bg level pretty drastically. We recommend that you only change the food once you’re home testing so you can make sure your cat’s bg levels are safe. Lastly, most cats do a lot better on gentler longer lasting insulins like Lantus or prozync.

 

We have quite a few helpful tips for home testing.
Warming up the ear is key for me. I have an old sock I fill with rice (tip from this forum) and i nuke it for about 30 seconds or so (each microwave varies) to get it warm and i press it against Minnie’s ear for a few seconds till i feel it’s warm to the touch. That makes a huge difference in getting enough blood when you prick. If you get a tiny dot, you can “milk” the ear to get more blood out. As I’d you were gently squeezing a pimple.
You also want to aim for the sweet spot @Diane Tyler's Mom can you upload the pics I still get an error message every time?

 

Also get larger lancets to begin with like a 28 or even 26. The smaller the gauge, the larger the point and the hole it will make and since you don’t have a lot of experience yet, you’ll need a larger hole to get enough blood. With time the ears develop more capilares which makes it easier to get a good size droplet too. When you look at the lancet, you’ll see it has a bevel side. A lot like the syringes. You want the bevel side up going in because that’s the sharpest edge and again, it’s easier to make the little puncture you need to get the blood droplet. I use a couple of cotton ovals that I place behind the ear so I have a firm backing while I prick the front. Whatever works for you, a paper towel folder up, cotton balls. I just like the size of the ovals. Then after I got the blood and tested, I use the cotton oval to press the spot firmly for a few seconds and that keeps it from bruising. I do this by myself so the other thing I do is use a small flashlight that I hold in my mouth and aim at the spot to be able to really see the ear and what I’m doing. If I can’t see it well, it doesn’t work. If you have help, someone can do that while you test or I know some people use a lamp instead. It’s all a bit of what works for you and as you do it, you’ll figure it out. Last thing, I used to get super stressed out because sometimes I wouldn’t get enough blood and I’d have to prick her more than once, so I started singing to calm both of us down but mainly me lol. So now when I start to hum our “testing” lullaby Minnie gets one her bed and waits to get tested. She’s a very good patient. Also she knows she’ll get food or a treat immediately after. A treat immediately after the tests builds positive association and makes them more likely to put up with it. I know it may sound like a lot but it becomes second nature. It takes me less than 5 minutes to do it now. So try it out, see how it goes and how she reacts and be patient with yourself and her as you get the hang of it. The important thing is to try to test before the shots so you know he’s not too low to get the insulin. Ideally you want to test, feed then shoot. Testing should be on an empty stomach, no food for at least 2 hours before you test so the number you get is his true blood glucose and not influenced by food. As you get better at it, I’d also recommend a test at +3 or +4 since that’s typically when caninsulin peaks so you can see how low the dose is taking her at each 12-hour cycle

 

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear

 

Thank you for all the advice!! The warm sock is a game changer!!

I was able to successfully test her BG level twice today, 2 hours pre-shot (17nm/L) and 2 hours post-shot (12nm/L). Lowered her dose to 1iu, I don’t want to risk it, and I’m tired of waking up in the middle of the night worried about her. However, if I do wake up tonight I might try and test her again for my own peace of mind.

Been feeding her lots of treats to get her to tolerate me torturing her, her levels might be higher because all I’ve got are Temptations, will figure out a better option tomorrow.

I feel bad about pricking her ear, she acts like it’s painful, but maybe I’m hitting the marginal vein and not the sweet spot... flashlight might be useful. Additionally, is there some kind of antiseptic or something soothing I can put on her ears after? I’ve been wiping with cold wet paper towel. I don’t think she would let me squeeze on the ear post-prick to avoid bruises but I’m willing to try.

Worried about what the vet will say about me lowering her dose, but I need the peace of mind until I have a better handle on home testing.

Again, THANK YOU for all the advice and replies, feeling much less alone in this.

 

You need to do a pre-shot test before feeding, and then wait 20 minutes before giving her the insulin. And then I'd test at +3, +4 and perhaps more depending on the numbers you get.

Don't worry about infections in her ears. It's always a bad idea to use antibiotics to prevent infection, due to resistance. Wash your hands before poking and it'll go just fine

Now there's a difference between how we do things in different parts of the world, but where I am, we don't use parasite medicine to prevent fleas and worms, unless the specific cat is prone to get those, or live in a forrest area. We treat if there's signs of parasites, not otherwise. Because if we did, the parasite would become drug resistant. Like Frontline, its useless.. the fleas don't die

We have the same with antibiotics in any kind. I can't go to the pharmacy and buy a cream with antibiotics in. I would need a prescription and the doctor wouldn't prescribe one, unless tests shows that it is necessary.

My point is, don't feel guilty.

 

You don’t have to squeeze the ear post test. Just press it gently with the paper towel. Like you would to stop a small bleeding on your finger and only for a few seconds. Better treat options are any freeze dried variety like PureBites and VitalEssentials. Or even baby food if she likes that. Bonita flakes and cooked chicken.

 

And no need to test 2 hours preshot. What you really want is right before the shot. If you’re shooting at 7am, you want to test her 5-10 minutes before that. You just want to make sure she hasn’t eaten for 2 hours at least before that preshot test

 

Peri has been an outdoor/indoor cat most of her life, and we live in a relatively mild climate year-round, so it has been recommended to give parasite meds somewhat regularly if they are going outside.

I did not intend on doing a 2 hours pre-shot test, just every few hours I would go torture her with ear pokes trying to get blood, and those were the 2 times I happened to be successful. Just spent 40 minutes trying to get her ears to bleed for me before her AM shot and no luck. Very frustrated, and Peri doesn't wanna come near me now LOL. I used like 5 different lancets and even brought the lancet pen out to see if that would help. Warmed up her ears, too. Will keep trying but my success rate is not very high right now.

 

Just hang in there! It will get a lot easier, I promise!!!!
When I do my night tests I pee, eat, drink, refill my glass AND poke the cat all within 10 minutes before I'm back in bed. And I'm not fully awake
So it will get a lot better. You both need time to get used to this new thing

 

What size lancets are you using? And also make sure she gets a treat whether you fail or succeed with the testing. Consistency there is key

 

Misha, I just want you to know that I was terrified of the home testing when Susie was first diagnosed. I didn't think I was going to be able to stick her. As others may have mentioned there are two really helpful steps to take. Rub the outside of the ears with a small amount of vaseline. Also, try to apply a rice sock on the ear for a minute to bring the blood to the service. Make SURE it is not too hot. I microwave mine for only 12 seconds and then test it on my own ear. The other thing I did, which was really helpful to me, was I bought a cheap "head lamp". It is just a light that wraps around my forehead that I can click on (battery powered) to better see where my ear puncture is and if I have enough blood. Between the rice sock, the vaseline and the light from my forehead I feel I have everything I need to test. My cat has become used to the testing if I offer some low carb treats afterwards. The insulin injections have never been a problem for Susie. Good luck. You are on a great site for advise.

 

The lancets I got from a family member, as they had a spare glucose meter and supplies I could use, and the box doesn’t actually say the gauge. The brand is Bayer Microfilet. And yes, been giving treats through the whole process, during and after!

I’ve also decided, instead of poking her multiple times in a row unsuccessfully for like 30 minutes straight (like I did this morning), frustrating both of us, I will try once or twice in row and then let it go & try again later. I’m aiming for a pre-shot test and 1 or 2 post-shot tests. I want to make this as easy as possible for both of us to get used to.

I had one successful poke today but then the test strip wouldn’t read it, I didn’t get enough blood on it. Practice makes perfect though! Will keep at it.

 

Another tip that I found extremely helpful was to "scoop" up the blood droplet on the top of my thumbnail. Once I have the droplet, I can release the ear and use the test strip with the droplet on the top of my thumbnail - don't have to hold the ear and wait and wait this way.

You also my want to give 2 pricks very close to each other. Sometimes that's enough then to get a blood droplet.

Also, different meters require different size of blood droplets. Some require a large droplet. Here is some information regarding meters and droplet size that might help you.

It's 2017 - but it will give you some idea of the difference required by each meter. I think the Accu-Chek requires .6 - you can get meters that only require .3 (I use Freestyle Lite) . Cost of the strips is also a factor, but the ears will develop more capillaries as you do this more. You may want to switch meters to one that only requires .3 until Peri is a bit more use to this deal. http://main.diabetes.org/dforg/pdfs/2017/2017-cg-blood-glucose-meters.pdf