Does the worrying ever stop?

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oscem

oscem

Member Since 2015
We've been at this for just about 3 weeks now and things are going okay. Malcolm has been switched to a diet of about 85% canned food and 15% Hill's Prescription (he doesn't seem to be into an all wet diet, so I'm waiting on samples of the Young Again Zero Carb before I order a full bag - I know the Hill's isn't the greatest, but it's better than nothing right now). He went in for his first glucose curve at the vet's on Monday and his numbers were still in the 300s, so we upped his ProZinc to 2 units 2x/day. We are seeing a positive change, though, as he's grown less lethargic and is regaining his old personality (he's even fighting back with our other cat, Neal, instead of just taking the beatings). I know we're moving in the right direction.

However, I'm a wreck. Usually, he's got my husband home with him in the mornings and there are only about 4 hours between the time that he's left for work and I get home (or if I'm working from home, there's no time where he's alone). My husband is working regular 9-5 hours today (which isn't going to happen again anytime soon), and I'm in the office, which means Malcolm is home without monitoring until about 5:30 today. He ate well this morning, he got his insulin, and he has been doing very well on the new dosage, so why am I such a nervous wreck about him being home alone today?

We've rearranged our schedules around his feedings and insulin. Even my 8 year old son knows that we need to be home by 7:30/8 PM every night to feed Malcolm and give him his shot. I feel like I worry more about Malcolm than I do about my son because my child can tell me what's going on or if he feels bad, but Malcolm can't do that. We're still getting used to all of this, but does the anxiety ever subside? (I already deal with a severe anxiety disorder to begin with, so maybe it's just getting exacerbated.)
 
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No, it doesn't. Even if you get your baby in remission as my sluggo was for a couple years, you relax some, but you are always on guard for relapse. And I find myself worrying right now having given him his insulin and having fed him with everything looking all right. I wish I could be there watching over him, but I can't.

And when your vet abandons you because he/she doesn't agree with what you're doing, it's even worse. But you soldier on. You do the best you can, and hope for another remission.
 
Does the anxiety ever subside? Yes and No. Yes, as you collect more data and can make more confident decisions about adjusting his dose so you know you are shooting a safe dose of insulin. No, in that diabetic cats love you throw you lower numbers every now and then to keep you on your toes! I'm actually just heading home during my lunch break to test Bandit because his pre-shot blood test this morning was 100 points lower than it usually is. I'm sure he's fine, but I just want to test him mid-day to make sure he's safe and that his insulin dose doesn't need to be lowered. Normally, if his morning number is nothing unusual, I set the auto-feeder to release his food at 1pm (half way through his cycle) while we are at work just in case his blood sugar dips a little.

Are you monitoring his blood glucose levels at home? That is definitely the key to not worrying nearly as much because with home monitoring you know exactly how the insulin is working in your cat. Dose adjustments cannot be accurately done based of curves in vet offices. First, the determined dose is usually too high because cats show inflated blood glucose values at the vet's office because their blood sugar levels get higher when they are stressed out. Second, you really need to test before each shot to make sure it is safe to give your cat insulin. Your cat's blood sugar can suddenly drop suddenly for many reasons--you switched to an all-canned, low-carb diet, his pancreas suddenly starts producing insulin again because of the treatment, he starts to feel better, or maybe just because it is Tuesday. Most cats don't present any symptoms of mild-moderate hypoglycemia (they may seem a little more restless or hungry, but that's it). You never want to get to the point where the hypoglycemia is severe enough to present itself physically--that's when it becomes life threatening. Daily home-testing isn't just better for your cat--it's also better for your peace of mind! :cat:

Just a note on the food--you mentioned that he's eating canned food, but he's not into an all-canned diet? What are the problems you're having feeding only canned? There are some great tips for transitioning to an all canned diet here: http://catinfo.org/docs/TipsForTransitioning1-14-11.pdf. Even lower carb dry foods can sometimes present problems with regulating cats--they all must have some high glycemic starch that binds the food together because of the way dry food is manufactured. Also, diabetic cats need all the extra moisture in their diet that they can get, and dry food is dehydrating. And dealing with diabetes is hard enough--you don't want to also have to deal with the other diseases caused by dry food down the road, like Urinary Tract or Kidney Disease.

One thing to watch out for--cats on a wholly canned, low-carb diet tend to see drops of 100-200 points in their blood glucose levels, which usually means they need less insulin. So that makes home monitoring even more important if you're in the process of changing his diet! Some cats even no longer need insulin at all once the diet has been changed, and become diet-controlled diabetics.

I hope I haven't ovewhelmed you with my answer--these forums are a wonder resource with fantastic people ready to answer any concerns about Malcom's treatment you may have. :)
 
THANK YOU! Seriously, I live with worrying every day about normal things, so when it's one of my babies (human or furry), I tend to worry even more and my anxiety level gets way higher (probably like Malcolm's BG level :)).

Julia, I am not testing at home yet - I'll be honest, I am terrified to do it (I don't know why the home testing scares me more than giving shots, but it does), but we've decided that we're going to use the weekend to learn. I don't want to rely on the curves at the vet (every 2 weeks is going to add up and add up fast, cost-wise), but I've really just been scared of it - I think I worry that we're already sticking him twice a day and sticking him even more will just be harder on him (and he'll run from us). But this weekend is it - I've got some YouTube videos ready to go so I can see how to do it.

As far as the food, he doesn't have a problem with the wet food in theory :D, but I think he's so used to free-feeding dry food that we're working on getting him out of that habit - he will literally stop eating the wet food and wait for a little bit of dry food before going back to the wet food. We've tried separating him from our other cat, Neal, but he doesn't like being separated, so now we let them eat together, but keep an eye on them while eating to make sure Malcolm is actually eating. He's gone from a few bites of wet food to half a can at feeding times, so he's making progress. (Neal, on the other hand, is ALL about the wet food...which is fine with us because we'd like him to drop a few pounds - at the moment, because of his coloring, he kind of looks like a potato when he sits down.) Malcolm is very much a creature of habit. I don't like having him on the dry food at all, but if it's a choice between that and not eating, we'll keep a little in his diet for now. I figure the YA food (if he likes the sample) will at least be the best option for his diabetes if he absolutely won't transition to 100% wet food.
 
It does get better (not really) but even in remission I always worry about Dusty falling off the wagon. I notice his every move now; did he just drink some water, why and was it too much? Did he pee too much to little? Did he eat too little too much? Did he poop, was it soft or hard is he constipated? Is he playing? Is he sleeping? Is he gaining weight or loosing weight? Arggggggg. Yes I stress too much too but I'm realizing there's only so much I can do and control. We eventually learn to live on the edge all the time. These little monkeys really do control us!
Regarding Young Again, I tried it with Dusty and my civie Beni, they liked it and it didn't affect Dusty's BG reading in a bad way, it actually went down. My only concern was with Beni, he started acting strange, rather lethargic and confused so I took it away from them. I might start it up again slowly and better monitor what's going on with Beni but I think you can safely use it with you diabetic with no negative impact on his BG readings.
 
oscem said:
Julia, I am not testing at home yet - I'll be honest, I am terrified to do it (I don't know why the home testing scares me more than giving shots, but it does), but we've decided that we're going to use the weekend to learn. I don't want to rely on the curves at the vet (every 2 weeks is going to add up and add up fast, cost-wise), but I've really just been scared of it - I think I worry that we're already sticking him twice a day and sticking him even more will just be harder on him (and he'll run from us). But this weekend is it - I've got some YouTube videos ready to go so I can see how to do it.
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Oh my gosh, I was a total WRECK when I first started testing Bandit. I was nervous, had no idea what I was doing, and I was in tears half the time because he fought me tooth and claw through each test. It was HARD. After few days of that, I thought, you're getting these tests, cat, whether you like it or not because we have to do it to keep you safe! And when my attitude changed and I was no-nonsense with him and more confident, his changed, too.

Cats have very few nerve endings in their ears, so the pokes don't hurt them at all. They just don't like being restrained and something new and strange happening to them. Rather than let him continue to struggle and try and bite and scratch me, I got a basket and lined it with fleece blankets. I put him in the basket for every test, and wrapped him in the blanket so just his head was sticking out. You want to get that drop of blood as quickly as possible, and there are tricks that help! Warming the ear with a rice sock or pill bottle gets the blood flowing better. I use a lancet device, but people here like free-handing the lancet if the device is too hard to use on him. Back the ear with a piece of tissue or a cotton ball so you have something to poke against (and to put pressure on the bleeding spot after). And try not to be scared (easier said than done, right?)! Cats can sense if you're nervous and they respond accordingly. Most importantly, give him a diabetic safe treat after every test! At my house, we use freeze dried chicken or salmon, and Origen cat treats. After a while he'll start to accept the tests, no problem. Now when Bandit hears the glucometer beep on, he'll come jump in his testing basket, lie down and start purring. :) Many cats don't even react as badly as Bandit did at first--they like their ears rubbed and don't seem to mind the poke at all.

Here's some tips to help you out: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/. This picture was invaluble to me in showingme where I should be aiming (you want to aim for the "sweet spot":http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html.

I would also emphatically stress getting larger gauge lancets--26g or 28g to start. The small 30-33g lancets that come with the meters and lancing devices are very difficult to get a decent sized drop of blood with. Also, make sure whatever meter you choose has affordable test strips! I use the Aviva Accuchek and buy my test strips on ebay or amazon (where they are half the price of what you'll pay for them in the store). Many people also like the Relion meters from Walmart because they also have affordable strips.

Fortunately, I give Bandit his injections while his face is in his food, and he doesn't even notice me sticking him. :cat:

oscem said:
As far as the food, he doesn't have a problem with the wet food in theory :D, but I think he's so used to free-feeding dry food that we're working on getting him out of that habit - he will literally stop eating the wet food and wait for a little bit of dry food before going back to the wet food. We've tried separating him from our other cat, Neal, but he doesn't like being separated, so now we let them eat together, but keep an eye on them while eating to make sure Malcolm is actually eating. He's gone from a few bites of wet food to half a can at feeding times, so he's making progress. (Neal, on the other hand, is ALL about the wet food...which is fine with us because we'd like him to drop a few pounds - at the moment, because of his coloring, he kind of looks like a potato when he sits down.) Malcolm is very much a creature of habit. I don't like having him on the dry food at all, but if it's a choice between that and not eating, we'll keep a little in his diet for now. I figure the YA food (if he likes the sample) will at least be the best option for his diabetes if he absolutely won't transition to 100% wet food.
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Transitioning can be a slow, gradual process, so if you need something like the Young Again to help you out temporarily, that's fine! Check out those tips I linked earlier--some really work well (like the parmesan cheese trick). How many times a day are you feeding him? Breaking up his meals into smaller, more frequent meals may help you with the transitioning process, and help keep his BG more level. I feed Bandit 4 times a day--7am and pm at shot time, and 1pm and am, mid-cycle. I freeze food for the cats and put it autofeeders when I'm not there to feed the cats lunch on weekdays.

Some diabetic cats can tolerate the low carb dry food, and some can't (Bandit is one who can't--his blood sugar will jump 100 points on dry food that's 8% carbs, but stay normal on canned foods at 9 & 10% carbs). But if you can get him off it in the long term, you'll only see benefits from that. :)

You're doing great so far! Taking the initiative and going through with treatment and insulin therapy shows how much you care for your cat, because many people aren't willing to do that much. And ask away here if you have any questions or problems with managing his diabetes! There's a ton of very experienced folks who were in your shoes at some point. Treatment works! After a year on insulin, Bandit went into remission and was healthier than most other cats his age, and he was diet-controlled for five years. The only reason he's back on insulin now is because he had to start steroids for an immune condition unrelated to his diabetes, and steroids usually cause diabetic cats to need insulin again. If we're lucky, we'll be able to start weaning him off the steroids next month and get him back into remission. :D
 
While you work up to blood glucose testing, take a look at my signature link Secondary Monitoring Tools for some assessments you can make to evaluate how he is doing. Doing those on a regular basis will help you notice small improvements.
 
Thank you - this board has been an enormous help and also very, very comforting :). I got home yesterday and Malcolm was GREAT - it is so nice to see my boy returning to us. We've lost two cats to illness in the last six years (Oscar was 10 and Emmy was 13) - I don't want these guys to leave us any earlier than old, old age - our cats are part of our family.

It's obvious Malcolm is feeling better - I tried to give him his shot last night and the goofball wouldn't sit still for me - every time I tried to tent his skin, he flipped his butt over so I couldn't get hold of it. I ended up turning the faucet on for him so he could drink (even before he started showing symptoms, this cat is my water cat) and he still turned himself around so it was hard to get a good tent on him. I finally managed to pet him into a spot where he could get his injection, but it was nice to see him with some fight back in him. Tomorrow, we start the home testing. Thanks so much again for the reassurance!
 
Hi Amanda. I suffer from anxiety issues too so I understand what you are saying. But even people who don't suffer from anxiety get anxious when leaving their cats home alone after giving insulin or about home glucose testing and injections too. So you certainly aren't alone in all of that. I found my anxiety level decreased once I was able to do home glucose testing. My Lucy is very feisty and I remember how anxious I was in the beginning when trying to do glucose tests at home. Eventually I decided that I had to be confident as I needed to keep my Lucy safe and I think my change in attitude helped as well as Lucy getting used to the tests. Once I was able to do home glucose testing I started to be able to see when Lucy's glucose levels might be going to drop when I was out or when her glucose was bouncing high after a low too. I always do a test before leaving the house except for when I won't be gone long and I have already tested that day because I am learning Lucy's reactions to insulin now. Having said that it is always possible for a low glucose level to happen so I never completely relax if I am going to be out all day so this is where my icams come in. I have set up cameras at home that work via my internet and I can look at the icams on my phone to see how my Lucy is doing while I am out and the icams have enabled me to worry less while I am out. My main advice is to learn to test Malcolm's glucose levels at home. My Lucy has had some low pre-dose glucose levels and without home testing I would have given her insulin without knowing that I shouldn't have done so. All the very best to you and your Malcolm too.
 
I have substantial anxiety issues. I take prescription meds for it and when Charlie was sick, it was BAD. I still watch him constantly for some hint that he's relapsing because it just seemed to be too good to be true that he went into remission so fast.
 
Julia & Bandit said:
Oh my gosh, I was a total WRECK when I first started testing Bandit. I was nervous, had no idea what I was doing, and I was in tears half the time because he fought me tooth and claw through each test. It was HARD. After few days of that, I thought, you're getting these tests, cat, whether you like it or not because we have to do it to keep you safe! And when my attitude changed and I was no-nonsense with him and more confident, his changed, too.

Cats have very few nerve endings in their ears, so the pokes don't hurt them at all. They just don't like being restrained and something new and strange happening to them. Rather than let him continue to struggle and try and bite and scratch me, I got a basket and lined it with fleece blankets. I put him in the basket for every test, and wrapped him in the blanket so just his head was sticking out. You want to get that drop of blood as quickly as possible, and there are tricks that help! Warming the ear with a rice sock or pill bottle gets the blood flowing better. I use a lancet device, but people here like free-handing the lancet if the device is too hard to use on him. Back the ear with a piece of tissue or a cotton ball so you have something to poke against (and to put pressure on the bleeding spot after). And try not to be scared (easier said than done, right?)! Cats can sense if you're nervous and they respond accordingly. Most importantly, give him a diabetic safe treat after every test! At my house, we use freeze dried chicken or salmon, and Origen cat treats. After a while he'll start to accept the tests, no problem. Now when Bandit hears the glucometer beep on, he'll come jump in his testing basket, lie down and start purring. :) Many cats don't even react as badly as Bandit did at first--they like their ears rubbed and don't seem to mind the poke at all.

Here's some tips to help you out: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/. This picture was invaluble to me in showingme where I should be aiming (you want to aim for the "sweet spot":http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html.

I would also emphatically stress getting larger gauge lancets--26g or 28g to start. The small 30-33g lancets that come with the meters and lancing devices are very difficult to get a decent sized drop of blood with. Also, make sure whatever meter you choose has affordable test strips! I use the Aviva Accuchek and buy my test strips on ebay or amazon (where they are half the price of what you'll pay for them in the store). Many people also like the Relion meters from Walmart because they also have affordable strips.

Fortunately, I give Bandit his injections while his face is in his food, and he doesn't even notice me sticking him. :cat:



Transitioning can be a slow, gradual process, so if you need something like the Young Again to help you out temporarily, that's fine! Check out those tips I linked earlier--some really work well (like the parmesan cheese trick). How many times a day are you feeding him? Breaking up his meals into smaller, more frequent meals may help you with the transitioning process, and help keep his BG more level. I feed Bandit 4 times a day--7am and pm at shot time, and 1pm and am, mid-cycle. I freeze food for the cats and put it autofeeders when I'm not there to feed the cats lunch on weekdays.

Some diabetic cats can tolerate the low carb dry food, and some can't (Bandit is one who can't--his blood sugar will jump 100 points on dry food that's 8% carbs, but stay normal on canned foods at 9 & 10% carbs). But if you can get him off it in the long term, you'll only see benefits from that. :)

You're doing great so far! Taking the initiative and going through with treatment and insulin therapy shows how much you care for your cat, because many people aren't willing to do that much. And ask away here if you have any questions or problems with managing his diabetes! There's a ton of very experienced folks who were in your shoes at some point. Treatment works! After a year on insulin, Bandit went into remission and was healthier than most other cats his age, and he was diet-controlled for five years. The only reason he's back on insulin now is because he had to start steroids for an immune condition unrelated to his diabetes, and steroids usually cause diabetic cats to need insulin again. If we're lucky, we'll be able to start weaning him off the steroids next month and get him back into remission. :D
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Bandit is a beautiful kitty !
 
I understand the worry. It's normal. Every day when I come home, I'm so happy to see Fred meet me at the door ! If He doesn't, my heart stops a little ( he's just slower getting to the door sometimes) but I really felt more relaxed when I started home testing. For me it was easier than giving the shots. Now I can test him in his sleep ! I do curves at home as well. The vet is just for emergencies and check ups. Fred was diagnosed 3 months ago. Good luck to you and Malcolm. He's so handsome!
 
Ps. Dry food has completely gone bye bye in our house. Even the diabetic Royal Canine for cats is higher in carbs and depletes kitty's water. Fred was a Purina One Indoor Advantage dry food junkie but he's nowadays Fancy a Feast classics junky. And I've been counter conditioning Fred as you see in this video and shot time has been easier.
 
I made myself a nervous wreck for five months. But things are going better. The more control I have, the more research I do, the less afraid I am. But I can't lie. Every single time I wake up or come home from work, the first thing I do is still look immediately for Benny and feel relief when he's still waiting for me. I don't know if that will ever stop. I hope it does.
 
Hi oscem,

I have multiple severe anxiety disorders (PTSD, OCD, social anxiety, panic disorder with agoraphobia). Home testing is the only thing that has helped me maintain any modicum of sanity since Saoirse was diagnosed. Even nearly a year after my little one was diagnosed I still wish from the bottom of my heart that the poking and prodding wasn't necessary. To help myself get over the intense distress I felt about it, I focused on what would happen if I didn't do it. I used my fear of losing my baby to overcome my fear of testing/injecting her.

I can't recommend setting up a spreadsheet with BG data highly enough. The ability to refer back to historical data was invaluable to managing both Saoirse's treatment and my anxiety. A bit like girlboheme above, when Saoirse was on insulin I always held my breath until she was safely past nadir but the anxiety was manageable with the home testing. (When Saoirse was first diagnosed her vet at the time didn't support home testing and I had to dose her blind. My anxiety then was stratospheric.)

I am keeping my fingers crossed that you get to grips with the home testing: it will help keep Malcolm safe and you sane. Hopefully Malcolm will be a good patient. (Saoirse purrs when she's tested, as do very many kitties.) Freeze-dried protein treats and fuss-fests make testing time much better for both kitty and kitty parent. :)
 
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