Please help. What blood glucose is too low to give insulin?

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Giovanna1127, Sep 19, 2020.

  1. Giovanna1127

    Giovanna1127 Member

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    Hello - My cat has been on insulin for a little over a week. We are on day 2.5 of his implanted freestyle libre monitor. The doctor implanted this thing and told me how to record blood glucose but said NOTHING about what to do when it gets too low, what is too low, or when it is too low for insulin.

    his glucose has gone below 50 multiple times today and last night. After multiple calls to the vet a nurse told me to give him kero syrup if it goes under 50 but didn’t say what # is too low to give him insulin.

    He just ate and his glucose is 85 which is in the low range (70-180) of good, but still good. Intuitively, I don’t want to give him insulin because I am afraid his glucose will crash but the doctor didn’t give me ANY scenarios in which not to give him insulin.

    does anyone have a number where if below that # you don’t give insulin?

    thanks!

    gia
     
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    What type of insulin and what dose?

    Do NOT give insulin if your cat is under 200 until we know a lot more details
     
  3. Giovanna1127

    Giovanna1127 Member

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    Thank you so much for your reply!!! Ok. No insulin give. Just checked again and he is at 90. He gets 2 units of lantus solostar. It is a 100 unit/ml pen.
     
  4. Giovanna1127

    Giovanna1127 Member

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    Thank you so much for your reply!!! Ok. No insulin give. Just checked again and he is at 90. He gets 2 units of lantis (the pen - not sure if this matters) 2x/day, 12 hrs apart, which I think is standard. Ladt insulin was 8:30 am.
     
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  5. Giovanna1127

    Giovanna1127 Member

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    Thank you so much for your reply!!! Ok. No insulin give. Just checked again and he is at 90. He gets 2 units of lantis (the pen - not sure if this matters) 2x/day, 12 hrs apart, which I think is standard. Last insulin was 8:30 am.
     
  6. Giovanna1127

    Giovanna1127 Member

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    Apologies. Please ignore the multiple posts.
     
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  7. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    OK...2 units is a high starting dose and it's obviously too high for him right now. Most cats should be started at .5 to 1U and then that starting dose is held for 5-7 days to see what it can do.

    It also sounds like you're using the pen with the special pen needles? We don't recommend that here because you can only give whole unit doses which is fine for humans, but our cats need much smaller dose changes! You can use regular insulin syringes that have half unit markings and pull the insulin out of the pen (under the cap is a rubber stopper just like a vial has...you just use the pen as a "mini-vial")

    There are lots of other good reasons not to use the pens "as intended" too...besides being stuck with whole unit dose changes, you're also supposed to "prime" it each time you use it by wasting 2 units....that's a lot of insulin to shoot into the sink or the trash! Also you're supposed to hold the needle in for 10 seconds....a lot of cats aren't real cooperative about that.

    The fact that you've already had some numbers that were too low (under 50) and now you're getting Pre-shot numbers too low to shoot is a very good indication that the dose is too high. If this were my cat, I'd probably drop down to 1.5 and see how it goes for several days.....but if he drops below 50 again, I'd drop down to 1U and start over.

    It will really help us to help you if you'll start keeping track of your test results on our special spreadsheet. Here are the Instructions on getting the FDMB spreadsheet. If you have any problems getting it set up, feel free to send me a private message by clicking on my name and choosing "start a conversation".

    Here's How to understand the spreadsheet once you have it set up.

    Also, if you'll fill out your "Signature" it will save everybody time because we won't have to keep asking the same questions. (you'll see signatures under our comments). Things like:

    Your name/Cat's name, age, sex, date of diagnosis, type of insulin, type of meter, type of food, any other health conditions or meds?.....and then the link to your spreadsheet goes in last.

    To do the Signature just go to the top right and click on your sign on name...there's a drop down list ....just choose "Signature" and a new box will pop up. Enter the information and "save" and that's it!

    P.S....what are you feeding?
     
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  8. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    It happened to me too but I was able to delete it. Don't worry about it...the board sometimes has it's little nervous breakdowns too....LOL
     
  9. Giovanna1127

    Giovanna1127 Member

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    Hi Chris,

    thanks for all of the info. He’s over 15 lbs, so perhaps that is why the initial dose was so high, but agreed, it seems too high for him right now. He was also at 330-480 pre-insulin, so that may have been a factor. The needles I have do not have 1/2 markers on them, only full dose. I was also not instructed to prime or hold the needle in for 10seconds, so don’t do either!

    I can try to hit 1.5, but it’s not an exact marker. Also, I am using the freestyle libre app, that auto uploads all of my data (while the “14 day” monitor is implanted anyway) To my vet (not that they have seemed to look at it yet). I’d rather post pics of the past 2.5 day graphs from the app, if that is ok, at least until he kicks the monitor off!
    I have uploaded print screens of the past 2.5 days data. No pressure to review, just there if anyone wants it.

    Re: food, that has been a changing variable as I was still weaning him off dry food (due to a fiasco I posted about 2weeks ago where my vet switched him overnight to 100% wet from 100% dry and he had diarrhea and vomiting for multiple days so we went back to the dry and started introducing the wet slower). Today was actually the first day of 100% wet food Today was actually the first day of 100% wet food. It has been a mix of Tiki cat after dark and meow mix pate toppers it has been a mix of Tiki cat after dark and meow mix pate toppers. The meow mix is a short term solution he handled it much better than the Tiki cat and Dave’s that I had given him which are better quality The meow mix is a short term solution he handled it much better than the Tiki cat and Dave’s that I had given him which are better quality.
     

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  10. Panic

    Panic Well-Known Member

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    A diet change from high to low carb requires close monitoring as it greatly reduces insulin needs ... looks like this is the case for your kitty. Did you drop insulin dose any during this time?

    Are you in the US? You can go to Walmart or Walgreens and pick up needles with half-units, 0.3 mL (not 0.5 mL). You'll have to eyeball it until then. :p
     
  11. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    The "priming" and holding for 10 seconds ONLY applies if you're using the special pen needles that are used with the pens. If you're using regular insulin syringes, you don't have to do anything special. Just insert into the pen, withdraw the correct dose and shoot the cat.

    The important thing is feeding something the cat will eat! Most of us feed our own diabetic cats Fancy Feast Classics, Friskies pates or 9-Lives ground which aren't exactly "premium quality".

    Starting dose has nothing to do with how high they were at diagnosis but can have something to do with the starting weight. On Tight Regulation, the starting dose is weight (in kgs) x .25 so would be 1.7U but we always start a little lower for safety (so 1.5 since you can't get syringes with .7 unit marks)

    On SLGS, the starting dose is .5 if eating only low carb food and 1U if kitty is not on a wet/canned low carb diet

    You can read more about TR and SLGS here

    You can get syringes at WalMart that have half unit marks for $12.58/100. Their 3/10ml, 30 or 31 gauge insulin syringes all have half unit marks (no matter what they might tell you)
    Relion syringes.jpg OR relion insulin syringes1.jpg
     
  12. Giovanna1127

    Giovanna1127 Member

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    Thank you panic. I did not drop the insulin dose because my vet didn’t tel me to. I did remind her about the feeding when she implanted the monitor 2.5 days ago and asked if changes were needed. She said no. I wasn’t testing sugar for 6 days between when he started insulin and getting the monitor 2.5 days ago. My vet said this was ok, but I’m concerned that his glucose may have been low during that period as well!!!! I have a lot to learn. Trying my best, tired, and frustrated. Also so appreciative and grateful for everyone’s kindness on this forum.

    Yes, I will go to walmart tomorrow and get those needles. Didn’t know you can get without a prescription?! I needed a prescription for mine and my vet is closed tomorrow.
    Regardless, will drop insulin to 1.5 tomorrow am. Monitoring him closely tonight.
     
  13. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Depends on what state you live in. Laws vary from state to state
     
  14. Panic

    Panic Well-Known Member

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    I believe Walmart's pharmacy is closed on Sundays. Prescription depends on your state, a quick google search should tell you. I think you can still get up to 10 without a prescription if the law does require them.
     
  15. Giovanna1127

    Giovanna1127 Member

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    Chris - thanks again. Good to know on priming and food. I paid $12 for 30 siringes So good to know I can get 100 for $12 from walmart!!!!! I’m teuly starting to question my vet.
    What is SLGS?
     
  16. Giovanna1127

    Giovanna1127 Member

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    Yes I am in the US - Florida.
     
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  17. Giovanna1127

    Giovanna1127 Member

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    Looks like syringes can be purchased in FL w/o a script but many pharmacies have policies thAt don’t allow this. Apparently, my area (Tampa Bay) is notorious for this policy. Will give it a shot.
     
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  18. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Start Low, Go Slow is a dosing method....the other one is TR protocol (Tight Regulation) which has been published in a veterinary journal.

    I put the link that explains both in above. As long as there's dry food in the picture, you can only do SLGS though
     
  19. Giovanna1127

    Giovanna1127 Member

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    Thanks again. I missed that bit. It’s been a LONG and stressful day. Will read now. Thank you !!
     
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  20. JL and Chip

    JL and Chip Member

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    Last I knew, the recommended starting dose of Lantus was 0.25U per kg of the cat’s ideal weight, or 0.25U per kg if a cat is underweight.

    The Internal Medicine vet and I discussed this specifically, including how often vets miss the “ideal” weight detail for cats who are overweight.

    Some vets prefer to just start at a dose of 0.5u to 1u and work from there, regardless of weight.
     
  21. Bandit's Mom

    Bandit's Mom Well-Known Member

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    If you are not able to buy syringes from Walmart of the local pharmacy without a script, you can order them online from here:
    https://www.adwdiabetes.com/search....ch_return=all&sort_by_field=Price Low to High

    They are based in Florida and you should have them in 2-3 days. If you order before 3pm, they ship it the same day.
     
  22. Giovanna1127

    Giovanna1127 Member

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    Thanks for the info on ordering syringes.

    I’ve been sleeping for no more than an hr, at a time so I can keep testing, currently ranging from 60-100. Gave some food about 45 mins ago, which seemed to help.

    i was planning on reducing dose from 2 to 1.5 units in the am but Chris suggested earlier than I not give insulin if under 200. Does the same apply in the am? Even at the reduced dose?

    I will probably continue to use that 200 as a benchmark, unless someone says otherwise.
    Thanks!
     
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  23. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    Until you get a little more data, if you get a Pre-shot test that's under 200, try stalling, DON'T feed and test again in 20-30 minutes to see if the number goes up without food.

    As you gain more experience and data, the Pre-shot you shoot starts to come down from that 200...down to 150....then slowly down to where you shoot anything over 90 (on SLGS)

    I understand you're using the Libre, but we still need for you to convert your results to our spreadsheet. We're very data oriented here and people will need to see what's been going on using the format that we are used to using before they can give you much in the way of helpful advice.
     
  24. Bandit's Mom

    Bandit's Mom Well-Known Member

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    I have sent you a PM and if you will send me those details, I can set-up your spreadsheet for you.
     
  25. Giovanna1127

    Giovanna1127 Member

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    Thank you again!!!!! OMG his monitor is gone. He must have finally gotten it off. Now I have no way to test his blood. It has been less than 3 days, was supposed to last up to 14, and cost me $100 to implant.

    how do all of you test glucose without one?!

    My vet said the other way was to keep him in the vets office for a full day and test every 2 hrs but there was no test from home option.
     
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  26. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Good morning (least it is here in Ca) We test with a regular old human meter, ALL diabetics use. Walmart ReliOn is the choice of many here. That meter takes the cheapest strips of which many will be used at first. We can teach you how to use it. ;)

    WELCOME TO OUR FAMILY:bighug:
    jeanne
     
  27. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    What Jeanne said. As fantastic as the libres are (well, until they fall off or stop working), round here, most of us are testing the old fashioned way!

    The meters require you to get a drop of blood for each reading. Where humans prick a finger, we use the edge of the cat's ear, which has very few nerve endings (they usually don't notice the poke at all, at least once they're used to the routine of sitting still and having the human mess with their ears).

    The main things you want in a meter are: cheap and easily available strips, and taking a relatively small droplet of blood. If you have a Walmart near you, a favorite meter is the Relion Prime. You also will need some lancets to do the poke, and at least at first, you'll want them to be a larger size (26 or 28 gauge; smaller gauge = larger lancet size).

    If you are able to get those supplies together quickly, we can help get you started!

    I am guessing that you are not shooting insulin this morning, given that he went low and you can't take a reading this morning?
     
  28. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    I think I put the most important thing at the bottom of the last message: please don't shoot insulin this morning without any data!
     
  29. Giovanna1127

    Giovanna1127 Member

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    Agreed. I don’t have enough info to give him insulin. When I tested a little over an hr ago he was at about 120, so may be too low anyway.
     
  30. Giovanna1127

    Giovanna1127 Member

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    Thanks for offering to hep. Where do I get the lancets? Can I get without a prescription? I am in FL - Tampa Bay and may be difficult to get syringes w/o prescription, so may be same for “lancets”?

    Its 8:45 now and I usually do insulin at 8:15.
    It may be too late by the time I go out and get all the stuff I need and come back to test him I might have to wait until tonight?
    I was also trying to research a new vet I’m just lost the trust in my current vet because she didn’t tell me really critical information about what to do when blood glucose was low if I followed her instructions I would’ve continued to give insulin twice a day regardless of what the blood” was and I don’t think I can get past that I was also trying to research a new vet I’m just lost the trust in my current vet because she didn’t tell me really critical information about what to do when blood glucose was low if I followed her instructions I would’ve continued to give insulin twice a day regardless of what the blood“ was and I don’t think I can get past that. Also dealing with my own medical issues and side effects from a new prescription so I am just a mess right now.
     
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  31. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Its going to be ok. Sadly we hear the "mistrust" speech a lot.:(
    You have landed in a safe place.
    Everyone here is dedicated to helping and teaching everything you need to know to keep your cat safe.
    You are part of this global community now.
    :bighug:WELCOME TO OUR FAMILY
    jeanne
     
  32. Giovanna1127

    Giovanna1127 Member

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    Thank you so much. I am so grateful for everyone’s kindness.
     
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  33. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Ah, that is frustrating. I will say, if you like your vet otherwise, a lot of us just quietly do our own thing with FD, and use the vet for other stuff.

    Lancets are over the counter everywhere-- should be with the rest of the human diabetic supplies. While you're there, it's also a good idea to pick up some ketone testing strips, especially if you're skipping shots. That's a different test than blood glucose, it uses urine (which presents its own challenges with a cat-- we have tips for that, too!).
     
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  34. Giovanna1127

    Giovanna1127 Member

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    Thanks. I am going to walmart in about 10 minutes. Perhaps I can give 1/2 dose once I get back, if blood glucose is ok and I get info on how to test using the lancets and relion prime. Realistically, I won’t be back w/ the tools u til 10am est - 50 mins from now.

    if someone could provide instructions in the meantime, it would be appreciated.
     
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  35. Bandit's Mom

    Bandit's Mom Well-Known Member

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  36. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Some keys when starting out:

    --- make sure her ear is warm. You can gently warm it by using a little sock with rice in it that you microwave briefly, or an empty pill bottle that you fill with warm water, or just by gently rubbing her ears a little.

    -- treats are KEY for getting the cat to buy in to the testing process. Pretty soon, most of our cats go running to the testing spot just because they want the treats!

    --- some cats are fine with all of it right from the start, but if you have a nervous or skittish cat, you may need to slowly build up to the testing process in stages, with treats at every stage. Bring her over to the testing spot, give a treat, let go. Bring her over, play with her ears a little, give a treat, let go, and so on.

    --- if you're nervous, she'll be nervous. One way to make everything calm is to sing! Especially silly songs, it's really hard to be nervous while singing!

    The whole process:

    1) gather all your supplies (meter, strips, lancets, rice sock if you're using it, cotton round or piece of tissue to blot the blood afterwards, and treats) in the testing spot
    2) bring your cat over, have her sitting on your lap or in front of you
    3) get the meter ready with a new strip
    4) poke on the outer edge of the ear (see pic below), avoiding the vein, and poking at a slight angle (we all have poked all the way through the ear, so don't worry if that happens!). A lot of us find that freehanding with the lancet is easier than the device, but do whatever works for you
    5) get the test
    6) hold the tissue or cotton round against the poke site to stop bleeding and minimize bruising
    7) treat time!!!

    Diagram of where you're aiming for (the "sweet spot"):

    [​IMG]
     
  37. Giovanna1127

    Giovanna1127 Member

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    Thanks again. I am now home with the lancets, meter, and keytone strips and have been watching Recommended videos etc. and then realized that I didn’t get test strips. I misunderstood and thought they came with the meter so need to go back out and get strips.
     
  38. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Did you find the syringes at Walmart too?
     
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  39. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Ooof!!!!

    I thought they usually included a small number (25 or so) with most meters, too (I don't have the Relion myself, though).
     
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  40. Giovanna1127

    Giovanna1127 Member

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    Thank u so much for reminding me. I forgot about those too. I’m not myself today. I will look for those and the test strip. Just got to walmart!
     
  41. Giovanna1127

    Giovanna1127 Member

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    Got strips but the pharmacy only has the same syringes i have. Only full units.
     
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  42. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Are you still at the store? Ask to look at the box-- sometimes they don't know that the syringes have the half-unit markings and assume they don't.
     
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  43. Giovanna1127

    Giovanna1127 Member

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    I left but we looked at the syringes through the bag (in the box) and confirmed that no half marker.
     
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  44. Giovanna1127

    Giovanna1127 Member

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    I’m failing miserably. Have been trying to get blood from the ear and it doesnt seem to be enough to register with the monitor. He’s being so patient but very visibly annoyed. I am almost in tears. I see the blood on his ear but its not beading so not registering.

    ear is probBly not warm enough, I am trying my best and really pushing his limits. The pill bottle doesnt work. Am trying to warm up his ears w massage, that is “easiest” but hes not used to it so he only lets me do so much.
     
  45. Giovanna1127

    Giovanna1127 Member

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    I tried to edit the above to add that He will not tolerate any in adamant object like a pill bottle by his ear he will let me touch him barely so I’m trying to little by little get him used to me touching his ears but also he never lays with his face anywhere near me he’s always got his back to me so it’s strange to be touching his ears and trying to get his face near me all at the same time these are things that he’s not used to and I’m doing it all at once. Typically I would take time to do this to get him used to it overtime so he trust me but this is all very sudden and I can’t just pin him down because that would be miserable twice a day I want to get him used to it gradually but I just don’t know what to do anymore Typically I would take time to do this to get him used to it overtime so he trust me but this is all very sudden and I can’t just pin him down because that would be miserable twice a day I want to get him used to it gradually but I just don’t know what to do.
     
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  46. JL and Chip

    JL and Chip Member

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    Do you have any Vaseline? Just dab a small amount on the ear and then gently smooth off the excess. Sometimes that helps the blood bead up.

    You can also scrape the blood off onto your fingernail and have the strip suck it off your fingernail. Not ideal, but worth a try in a pinch.
     
  47. Bandit's Mom

    Bandit's Mom Well-Known Member

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    I read here that Relion syringes all have half unit marks even though it may not say so on the box and Walmart staff are usually unaware of that.
     

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  48. Giovanna1127

    Giovanna1127 Member

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    Ok will try. Have poked the same ear like 4-5 times. I feel so bad. May move on to the other ear but need to warm that 1. I was soooo close w the blood on the strip but its just not enough. How long can I add to the same strip, before starting a new one? Ive been trying to get blood onto this one for a good 8-10 minutes now.
     
  49. Giovanna1127

    Giovanna1127 Member

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    I don’t know. The pharmacist and I looked at an actual syringe together through the plastic and saw no half marks. He said those were the only ones he had, not sure of the brand.
     
  50. Giovanna1127

    Giovanna1127 Member

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    I also don’t own vasaline so would need to go buy some of that to try that
    Method.
     
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  51. Giovanna1127

    Giovanna1127 Member

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    I am also doing this with one hand. Have to be petting him with the other, otherwise he won’t stay. He’s purring, so thats good but I live alone so don’t have anyone that I can tag team with!
     
  52. Bandit's Mom

    Bandit's Mom Well-Known Member

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    Take a break and try a little later. You will get the hang of it. :bighug:
     
  53. JL and Chip

    JL and Chip Member

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    If you don’t get enough blood on the strip on the first try, you have to toss that strip and start over with a new one. You can’t add more blood to a strip later. Are you getting an error message?
     
  54. Giovanna1127

    Giovanna1127 Member

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    Ok. Thanks. No error. I am going to wait until later to try again.
     
  55. Giovanna1127

    Giovanna1127 Member

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    Will watch some more videos in the interim.
     
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  56. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Giovanna...BREATHE step away and breathe. Its so easy to get all wound up when you think you are failing. I know been there done that. You really arent failing. Its a set back but NOT a fail. The first drop you get you will feel relief like youve never felt before. AND YOU WILL GET THAT DROP. ;)
    Always remember to give a little treat each time you think its a fail...give one to yourself as welll ...well ... maybe not kitties treats try some chocolate. :p

    You CAN do this. We are here to hold you up. :bighug:
    jeanne
     
  57. Giovanna1127

    Giovanna1127 Member

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    Thanks so much. I’m doing much better now, haha. I also continue to read more comments and feedback from other people and it seems like I’m not the only one that has this trouble so that gives me comfort and all of your comments give me comfort as well I also continue to read more comments and feedback from other people and it seems like I’m not the only one that has this trouble so that gives me comfort and all of your comments give me comfort as well. I will look at this as a win George is letting me play with his ears and has stayed in the same position he was in when I was testing his ears so that’s a good sign because he’s been very comfortably letting me touch his ears while I pet him, And purring happily. I included a picture. You can also see the little red marks on his left ear. Next time, I think I will try a slightly different angle I think will work better using a cotton ball on the underside of the ear.
     

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  58. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Awwwwwwwwwwwwwwwwwwww hes so CUTE! He has love in his eyes:bighug:

    The red marks will heal and BELIEVE ME. they hurt YOU wayyy more than they hurt him.:bighug::kiss::bighug:
     
  59. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    Thank you so much. He is truly such a gentle and loving soul.
     
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  60. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    Oh, he is just adorable! And such a good boy!

    It does sometimes take a while to get the ears to cooperate. Just checking, what size (gauge) lancets are you using?

    There's also an alternative testing site that some folks use, the paw pad. I've never tried it, but there have been a few cats who are much more tolerant of the human messing with their paws than with their ears. Who knows, maybe George will be one of them!

    By the way, I'm getting an "access denied" message on your spreadsheet-- not sure if you have to change the permissions, or just aren't linking using the "shared" link (we shouldn't be able to access or edit your Google Drive copy directly).
     
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  61. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    I'm getting the same
     
  62. Chris & China (GA)

    Chris & China (GA) Well-Known Member

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    May 10, 2013
    You know what you call the person who graduated last in pharmacy school? A WalMart pharmacist!

    Take a picture of the box or syringes you ended up with so we know for sure which ones you have.
     
  63. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Me too. I'm guessing Bandit's mom forgot to change the permissions when she set it up.

    @Giovanna1127 ...go to the top right corner of your spreadsheet and click on "share". A new box will come up. At the bottom you can change the access to "anyone on the internet with the link"
     
  64. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019

    So sorry. I've just done this. Please check?
     
  65. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
  66. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    works for meeee
     
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  67. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Hi. Ok. This is my first time editing a google doc so forgive me. I think I changed the setting that anyone with the link can edit the doc. Previously, it was just boomah.

    spreadsheet is now up to date.

    Gauge is 26, would have gotten 28 but there weren’t any.

    will give ears another shot before trying paw, I think he may tolerate paw even less!
     
  68. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    Hi Giovanna, you want anyone with the link to be able to VIEW the SS and not EDIT it. I have changed the permissions accordingly. Leave it as it is now. :)
     
  69. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    Haven’t gotten new syringes because no 1/2 units were available. Have included a pic of the bags I have, didn’t buy a whole box, just bags of 10 - wishful thinking on my end.

    syringes say capacity for 1/2 ml.... but there is no marker for half, was just going to aim for 1/2 way bet 1-2
     

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  70. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Ok thanks. So much to learn on my end!!!!!!!!!
     
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  71. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Oh.... those syringes will work for his present dose, but I'm glad you didn't get a whole box because they won't be good for smaller doses.

    You want the ones with 0.3ml total volume, not 0.5ml. Next time you're out you can look for those. Even if you can't get the half-unit markings, I think you'll find that it's much easier to eyeball half-doses on the smaller size syringe.
     
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  72. Bandit's Mom

    Bandit's Mom Well-Known Member

    Joined:
    Oct 18, 2019
    These are BD (a brand) syringes. You want the Relion ones from Walmart. And you want 0.3ml syringes with half unit marks. The ones you have are 0.5ml ones.
    If Walmart didn't have those just order from ADWdiabetes.com. These are some options:

    https://www.adwdiabetes.com/product/16367/carepoint-vet-u-100-pet-syringe-31g-half-unit
    https://www.adwdiabetes.com/product/1316/surecomfort-u100-syringes-half-unit-31g-3-10cc-5-16in-100ct

    If you order tomorrow morning, you should have them by Wed-Thu.
     
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  73. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    yeah those are the wrong size...they'll work but they'll never have the half unit marks because the 1/2ml syringe holds up to 50 units and there's not enough space for that many lines on the barrel of the syringe.

    You needed the 3/10ml ReLion syringes.

    You certainly aren't the first person to be swayed the wrong way by a WalMart pharmacist...Grrrrrr

    Call around and specifically ask if they have the Relion 3/10ml insulin syringes in 30 or 31 gauge before you buy more
     
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  74. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    Ok. I got my syringes at CVS per prescription and the ones at Walmart were the same. I will call another walmart and the CV where I got to syringes to see if either have thee .3ml ones before ordering from that site, to hopefully get sooner.
     
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  75. Sandi & Whisper

    Sandi & Whisper Well-Known Member

    Joined:
    Oct 2, 2015
    Hi Gio, I haven't read your whole thread, but browsed it quickly. Just so you know, it IS legal to buy syringes over the counter in Florida without a prescrption (I checked the current FL statutes), however, I think that the heroin addicts are messing it up for you. Per https://www.wtsp.com/article/news/d...-syringes-a-problem-in-tampa-bay/67-433661319 : "While state law permits over-the-counter sale of clean syringes to people over the age of 18, many pharmacies in the Tampa Bay area have store policies preventing the sale of syringes without a prescription."

    I use the Walgreens brand, and though it doesn't say so, they do have half unit markings. I've included a picture of the bag, the back of which has an item number. You may want to call a Walgreens and see what their store policy is. If the pharmacist says that you can't have any, ask specifically what the actual store policy is. I had to push up to a district manager at a Walgreens in North Carolina because one particular pharmacist wouldn't let me have any because of her own personal hangups, while the policy was that it was permitted. It got her in trouble, and I am glad. NC law is the same as FL -- no Rx required.

    Best of luck to you!
    Sandi.
     

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  76. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Another mistake your vet made if he wrote for the bigger syringes.

    Here's something I wrote up for others for testing...maybe it'll help you too!

    It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

    Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat.
    Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

    You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

    It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) or even just a warm washcloth (inserted into a baggie so you don't get the ear wet) works well

    For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

    Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!
     
  77. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    Cvs says they have them and I don’t need a prescription! They are also across the st. Vs. a 15 min drive to walmart, So will pick some up later. They said 31 gauge, 6mm in length, and 1/2 unit markings. Fingers crossed!
     
  78. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Just to be clear...not ALL 3/10ml syringes have half unit marks (and a lot of pharmacists don't know that there's even such a thing as syringes with half unit marks! I've heard from lots of people here who went in with the picture of the box and knew exactly what to ask for and the pharmacist still told them there wasn't any such thing as a syringe with half unit marks)

    It's really sad that they don't even know their own products. Relion is a WalMart brand. You can't get them anywhere else. You'd think that the WalMart pharmacist would know their own brand of syringes:(
     
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  79. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Thanks so much. If CVS doesn’t pan out for some reason, will try that. Thanks!
     
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  80. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    Perfect!! But still open the box and look for the half unit marks. (it really is a shame that we, as consumers, have to do so much of the "work" just to get the right thing)
     
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  81. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Let’s hope the pharmacist knew what he was saying when I asked him multiple times to confirm that the syringes have half unit marks! Can see how they might screw that up though. Fingers crossed!
     
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  82. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Thanks. I was using temptations Today bec I know he likes those. Need to find another solution. He does like these tubes of inaba churo things but harder to administer. Will think of something as he doesn’t like chicken.
     
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  83. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Try setting the lancing device on a deeper setting.
    You are not hurting your cat. Cats are used to having their ears bashed in cat fights.

    If you sit on the floor while testing, you can somewhat box a cat in with your legs. Place the cat between your thighs facing away from you. Wrap your non-dominant arm around the cat's chest with the hand near the ear. This allows you to hold the cat, pet and also hold the ear with one hand while testing with the other.

    Give a small treat after. A bit of tuna works. A cat will begin to associate testing with treats.
     
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  84. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    Hi - I don’t know if I got the wrong things but there is no “deeper setting” for my lancing device. It is a tiny little needle. I included a pic.

    i also tried to test again, using my finger behind the ear as the corton ball freaked him out. Got 0 blood from him and a whole lot from me. So, I tried to use my blood on the strip. It was a huge bead and still not enough!!!!! Also, it’s not really suctioning, so I keep moving it around trying to catch the blood and it’s not working! If I can’t get it to work with the huge bead of blood on my finger I don’t know how I am going to get it work on a much smaller bead of blood from my cat. Pic of my meter/finger attached.
     

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  85. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

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  86. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    I did and went right through to my finger. My concern now is the monitor. I had a huge bead of blood and it still didn’t read.
     
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  87. THH

    THH Member

    Joined:
    Aug 28, 2020
    The Carepoint ones from ADWDiabetes are the ones I used for my diabetic cat for over a year, as well as at the rescue where we generally had 4-6 diabetic cats at a time. They're great syringes and very cheap as well.
     
  88. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Are you putting the strip all the way into the meter?
    What you do is put the strip partially into the meter. Take the test. When you have what you think is a large enough drop of blood, either on the ear or scraped onto your clean fingernail, insert the strip fully into the meter and then touch the strip to the blood.



     
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  89. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    I don't have the same meter, so I'm not certain, but it looks like the strip isn't pushed into the meter all the way???

    Can someone who uses the Relion confirm?
     
  90. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    (((((Gia))))) we'll help you get this sorted. My head is spinning just reading about syringes :p
     
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  91. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    I see why now. In the picture in the instructions it lookz like you are scooping up the blood, in the video, he is hovering and then suctioning up the blood. That is where I went wrong. Written instructions in box are very misleading. Thanks.
     
  92. JL and Chip

    JL and Chip Member

    Joined:
    Dec 28, 2009
    In the photo you posted of your finger next to the meter, the arrow on the meter is telling you to remove the strip. The meter considers it a “used” strip so you’d need to remove that strip and insert a fresh one, then try again and it should sip the blood.
     
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  93. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Really?! That is the screen thAt appears when I turn it on, even if there isn’t a strip inserted. It is also the screen in the video to say that it is ready to take blood .....
     
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  94. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    Ok I see it now.
     
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  95. JL and Chip

    JL and Chip Member

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    Dec 28, 2009
    You should see a “blood drop” icon at the bottom if the screen when it’s ready to accept blood. The arrow means the strip is used and needs to be replaced.

    At least that’s what I recall (I use the Relion as a backup meter).
     
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  96. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    You are tota
    you are totally right!!! I did it! FINALLY! I emptied out a liquor mini and filled w warm water, used that in his ear, much more tolerable than a pill bottle, which is larger.

    his reading was 111. Will update the spreadsheet, but still quite good considering that he hasn’t had insulin since 8:30am yesterday morning!

    as far as next steps, I am guessing that I will have to embark on this lovey journey before his dinner and attempting insulin tn. Will take glucose right before he eats. Should I still not give him insulin if under 200 when I test right before he eats?
     
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  97. JL and Chip

    JL and Chip Member

    Joined:
    Dec 28, 2009
    Correct. Get a blood glucose (BG) reading at tonight’s shot time then check back here for advice before giving insulin. 111 is a great number, by the way!

    oh, and welcome to the vampire club. :)
     
  98. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    What we usually suggest for new people when they get a number under 200 is that they stall, don't feed, and test again in 30mins. We would want to see if he might be going up, so that he might be at a "safe" number by the time the Lantus starts to take effect in a couple hours, and we don't want that decision to be influenced by food.

    Similarly, we try to keep the two hours prior to shot time free of food, so that we know the pre-shot number doesn't have a food influence.

    All that said-- wow! That is a fantastic number for not being on insulin for so long! Not sure he's going to be high enough to shoot by shot time, whether you stall or not!
     
  99. Giovanna1127

    Giovanna1127 Member

    Joined:
    Sep 5, 2020
    Haha. This made me laugh :) and will do.
     
  100. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Giovanna --

    If I may make a suggestion. Would you start a new thread tomorrow? This thread is quite long. You've been accumulating a lot of information and trying to find a particular suggestion will be difficult in a thread with almost 100 posts. Frankly, I wanted to make sure your question was answered but I couldn't wade through all of what's here. Please feel free to tag me if you do need your initial question answered.
     
  101. Red & Rover (GA)

    Red & Rover (GA) Well-Known Member

    Joined:
    May 18, 2016
    Congratulations!
    I agree with @JL and Chip – do not give insulin if under 200.
     
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  102. Giovanna1127

    Giovanna1127 Member

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    Sep 5, 2020
    I just checked blood and it was 115. Can wait to feed and test again in 30 but not sure how he will tolerate a 3rd test, he was much fiestier with the 2nd test, and he’s hungry!
     

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