? [Help] Jai Jai - The Vet has suggested 1 unit of Lantus

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heyhollis

heyhollis

Member Since 2015
Note:

This thread was previously titled "I think I have missed the shot, should I do it again?"
The title is now changed to "The Vet has suggested 1 unit of Lantus" after our vet visit on 2/8 morning.

I should have given my diabetic cat 1 unit of Lantus for the afternoon shot. However, when I pulled the needle out from his skin, I did not feel right. It looked like as if I did not inject the needle into his skin, though he struggled a bit when I thought my needle was in.........

I can smell the odor of Lantus on his skin, I think I missed the shot and I wonder if I should to it again...

Can you guys give me some advice? Heartfelt thanks for your help.
 
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NOOOOOOOO!!! Don't give another injection. :eek:

Just skip this dose, chalk it down to experience, and start over at the next injection. Fur shots are a common thing.

:)
 
OK - now that the immediate safety side of things is covered, here's why you MUST skip. Any time you think you may have mucked up an injection (and we all do!) you never know whether some or all of the dose may have actually gone into the cat's body.
To give a second dose - either at the time of the screwed-up injection or at any later time in the same 12-hour cycle - can result in an insulin overdose and significantly increase the risk of a hypo.

Are you OK now?
 
Aine is right. You've no idea how much insulin went in, so you could risk overdosing if you repeat the shot.
Most of us have done this at some time or other. ;)
Be kind to yourself. :bighug:

Edited to add: Oops, cross-posted with Aine :rolleyes:
 
Thank you for your reply. His PMPS was 371 (20.6 mmol), he is still very unstable since his diagnosis.

I almost burst into tears when I messed up his injection. I was testing all day for a glucose curve for tomorrow's vet visit. I feel so much sorry right now.
 
Please can you post to confirm you have not given a second injection. I'll be worrying until I hear back from you.

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No, I did not. Sorry for making you worried.

I was planning to test him again at +0.5 then decide. But when I read your advice, I understand that it will not be a good thing to give another shot.
 
Cross-post! Thanks for letting us know things are OK. And have a :bighug:. I feel for you, and went through similar emotional turmoil after Saoirse was diagnosed. It's so scary and overwhelming during the early days after diagnosis. We want to do everything to help our little ones as fast as possible and then we end up berating ourselves when something goes awry. :( Regulation is a marathon, not a sprint. Your little one didn't become diabetic overnight, and one missed injection isn't a big setback (although I know only too well how big a setback it can feel, especially when they're in higher numbers).

If you still want to run a 12-hour curve you could start one at this evening's PMPS and do it through the night time cycle? Maybe have a nap this afternoon so that you're rested properly.
 
Here's a link to the instructions on how to set up one of our spreadsheets so that you can store your kitty's BG results and keep track of how he's responding to his treatment.

How to Set Up a Spreadsheet and Link it in your Signature

If your meter measures in mmol/L you'll need to follow the link for the international version of the spreadsheet.

When you've set up your spreadsheet, you can add the link to your FDMB signature, along with your meter type and insulin type. That way, any time you post members here will straight away know your setup and be able to review your spreadsheet data with you. :)
 
:bighug:I need the big hug, thanks.

I have done his curve:
AMPS 374 (20.8)
+4 189 (10.5)
+6 155 (8.6)
+9 268 (14.9)
PMPS 371 (20.6)

We are going to take him to the vet tomorrow morning for a routine checkup (we did it almost every two weeks, but our last visit was the last week as requested by the vet). Every visit makes him very nervous, so do me and my hubby. We are unable to take him to visit the vet every week, because it is really exhausting (for both of us and Jai Jai).

Hoping that his BG does not drag up too much for my mishandling.
 
Critter Mom said:
Here's a link to the instructions on how to set up one of our spreadsheets so that you can store your kitty's BG results and keep track of how he's responding to his treatment.

How to Set Up a Spreadsheet and Link it in your Signature

If your meter measures in mmol/L you'll need to follow the link for the international version of the spreadsheet.

When you've set up your spreadsheet, you can add the link to your FDMB signature, along with your meter type and insulin type. That way, any time you post members here will straight away know your setup and be able to review your spreadsheet data with you. :)
Click to expand...

I started using the template, but I was mistakenly placed the information under "About Me". I think you read fine now.
 
Thanks for the meter info. :)

I've had a look at your spreadsheet and I'm a bit concerned that some of the doses have taken Jai Jai's blood glucose levels far too low. I think that it is possible that some of the higher readings may be due to Jai Jai bouncing after going too low. If he were my cat I'd be looking to give a smaller dose than 1.0IU at next injection time. I'm going to ask some more experienced members to have a look at your spreadsheet for you. They may be able to give you better advice on dosing. I'd also strongly recommend that you show your vet all of Jai Jai's data and asking him about a lower dose than 1.0 unit and also agree with him a "no shot" number (for example: do not give insulin if preshot test is below 200mg/dL /11 mmol/L).

Too much insulin can produce BG levels that look like too little insulin - hence the benefit of recording data in the spreadsheet since it helps you to easily compare how different doses affect your boy.

Working with a depot insulin takes time to learn - changes in a dose may not affect blood glucose for several cycles, unlike the Caninsulin you used before which is an in-out insulin whose effects usually wear off within the 12 hours following the injection.

If we can help you home in on a dose that suits Jai Jai's insulin needs better, then all going well his numbers should be a little less higgledy-piggledy. And safer.

--------

@BJM, @Chris & China, @Wendy&Neko - Please can one of you look at Jai Jai's spreadsheet ASAP and advise on dosing (some nadirs are very, very low).


Mogs
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That is a great help, Aine. Thank you. If I did not mess up with the injection, I probably did not create this post.

We are frustrated for his BG going up and down. We are on full time jobs and we are unable to test him so frequent to figure how Lantus is working on him. Jai Jai also hates pricking his ears very much and I got bite every time when I am doing that.

We have tried giving 0.5 units a few days (8 cycles) but his PSs were upped to 300s. That were astonishing when the time we read the meter.

He is now given saline solution daily (50ml) as the vet wants to keep him hydrated. I will show my vet all the numbers. Last time she told me that I tested Jai Jai too frequent even though I tested for PS figures only.
 
The really important thing to understand about Lantus is that it can take 3-5 DAYS to see a dose stabliize in its effects.

Also, the dose adjustments are based on how low the glucose goes between shots, not by the pre-shot levels.

I'm not home, so I may not be able to see the spreadsheet on my phone (its quirky). I'll see if it will after I post this.

Nope. Phone wasn't having any of it. I'll come back when I'm at home.
 
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heyhollis said:
I should have given my diabetic cat 0.1 unit of Lantus for the afternoon shot. However, when I pulled the needle out from his skin, I did not feel right. It looked like as if I did not inject the needle into his skin, though he struggled a bit when I thought my needle was in.........

I can smell the odor of Lantus on his skin, I think I missed the shot and I wonder if I should to it again...

Can you guys give me some advice? Heartfelt thanks for your help.
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I fairly new to the FDMB and two days ago in the PM I thought I fur shot too. He jerked from me and I could smell the prozinc. I was so upset. I did NOT reshoot and the next morning he was lower than he had been in a while. I might have gotten a drop on him but obviously enough in him to do it's job. Lesson learned.
 
heyhollis said:
We have tried giving 0.5 units a few days (8 cycles) but his PSs were upped to 300s. That were astonishing when the time we read the meter.
Click to expand...

You've done great to get the test data already in the spreadsheet. :)

Some of those higher numbers could be what we call 'bouncing' - if a cat's BG goes too low (or even lower than its body has been used to recently) the body's self-protective mechanisms will trigger the cat's liver to start releasing glucose into the bloodstream and this can produce much higher numbers. Depending on the cat, it can take several days for a bounce to clear, during which time the trick is to 'ride out' the bounce and wait for the cat's body to settle down again before considering whether an increase is justified. It may very well be that a dose of, say, 0.25 IU (for example) may be too low for your cat but it really does look like the 1.0 IU may be too high. You end up with very, very low preshot numbers and where you have given insulin on those occasions it has taken Jai Jai very low - dangerously low, to be truthful - hence my recommendation above to agree a 'no shoot' preshot BG value. (Any time a BG value is lower than the 'no shoot' value, you either stall for a little while and retest to see if you get a safe number, or else you skip the dose and wait for the next preshot test.)

If you look at your spreadsheet, you will see that you are getting preshot numbers in the greens and then you've given 1.0 iu which has taken Jai Jai way too low and then his BG soars when the cat's body's safety mechanisms kick in to put extra sugar into his blood. If you can get to the right dose for Jai Jai, you should end up with two preshot numbers a day that are at a level safe enough to give insulin, and the nadir should be above the hypo threshold, not dangerously below it.

Another thing to mention: since Jai has experienced a number of asymptomatic hypos, there is a strong possibility that his body may have become much more sensitive to insulin as a result. That is another factor that could point to the 1.0 IU dose of Lantus being too high - Jai's insulin needs may have decreased.

@BJM is going to have a look at your spreadsheet later (thank you, BJ!) and will provide you with further feedback.

In the meantime, I wonder whether you could answer the following questions for us:

1. Dehydration / Fluid Therapy - Does Jai Jai have any underlying health conditions that are causing the dehydration? Could you let us know more about this, please? (Are they sub-q fluids?)

2. What type of food does Jai Jai eat? Does he drink any water himself.

3. VERY IMPORTANT - How confident are you about the diabetes management advice and instructions for giving insulin that you have received from your vet? For the record, you are not testing Jai Jai too frequently. Your testing has provided us with data that will help us to help you keep him safe on insulin.

MOST IMPORTANT OF ALL -

I recommend that for the next several days you ask for help here with Jai Jai's dosing: it could help a lot to bring all those wild swings under control. Take the preshot test and then post asking for help with Lantus dosing (include the preshot number in the thread title). You can post on this board at first, and hopefully one of the Lantus & Levemir Insulin Support Group members will be able to guide you toward posting in their group. (It's very busy, hence my suggestion to post for advice on Feline Health first - less overwhelming when getting started! :) )


Mogs
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Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Here's what I see:
1 unit is too much - on 7/25 Jai Jai went hypo and then bounced up into the 400s.
Any time the glucose goes below 50 mg/dL on a human glucometer, the cat has earned a reduction of 0.25 units. So, do not give 1 or more units ever again.
On 7/18, after several shots at 0.5 units, Jai Jai got down to 67, a beautiful and safe number. And then you raised it after only 3 shots. Ooops. Too soon to raise it. You must be patient!

Go back to 0.5 units. Stick with it for a minimum of 3 full days (6 shot cycles) and up to 5 full days (10 shot cycles) unless he drops below 50 mg/dL again.

 
Here are some very useful forum resources to help you:

1. How to treat hypos - read this straight away and read again and again till you have the drill memorised (helps when there's a panic on!) and make sure you have all your hypo toolkit supplies ready to hand. Print out a copy of the document and keep it somewhere easy to grab should an emergency arise.

ON A HUMAN METER, if your cat's blood glucose ever reads below 50 mg/dL / 2.8 mmol/L - INTERVENE IMMEDIATELY TO RAISE YOUR CAT'S BLOOD GLUCOSE LEVELS. Also - reduce the dose at next shot time.

2. Management of Diabetic Cats with Long-acting Insulin - the published Roomp/Rand Tight Regulation Protocol. Read yourself, and print out a copy to give to your vet tomorrow. This published, peer-reviewed article contains a table with detailed guidelines on safe dosing for Lantus. It would help for you and your vet to agree to following the dosing guidelines (but possibly holding doses longer than 6 cycles if you are not able to get sufficient evening tests in). The TR protocol recommends a minimum of 3 tests a day: AMPS, PMPS and a mid-cycle spot check during morning or evening cycle. The underlying study upon which the TR protocol is based (cats on the German feline diabetes forum) showed that on average cats were tested on average 5 times a day. Here we encourage people to test at least 4 times a day: AMPS, AM mid-cycle, PMPS, PM mid-cycle (for example: a 'before bed' test); reason being that some cats tend to run at higher BG levels in one cycle or the other (the majority tending to run lower at night).

3. What is the Insulin Depot? - it will help you to understand better how Lantus works by building up a chemical store of insulin under the skin which is then released over time to provide longer periods of insulin effect.

Always, always come here and ask for help if you're not sure about anything. We're only too happy to do all we can to support you. :)



Mogs
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I am truly moved by your kindest help. I was not expecting such a sincere and faithful discussion from you on Jai Jai's case.

Regarding your questions, my replies are in-lines:

1. Dehydration / Fluid Therapy - Does Jai Jai have any underlying health conditions that are causing the dehydration? Could you let us know more about this, please? (Are they sub-q fluids?)

His blood test these few times (on 28/6, 12/7 and 26/7) showed that his UREA readings were high. His ALT readings were high too, so he was prescribed Samylin Small Breed, a multivitamin for the liver health. I have no idea whether it is a sub-q fluids. On the package, it reads "Compound Sodium Chloride Injection".

He had urinary tract infection for two times when about 7 to 8 years ago. We gave him Royal Canin prescription dry food until he was dx diabetes. The vet is very concerned if he had UTI when his appetite was not good and he ate only 2 to 2.5oz per meal.

2. What type of food does Jai Jai eat? Does he drink any water himself.

We give him Thrive Complete, a low carb canned food. Each meal is 40g tuna + 50 chicken breast. He is obsessed with tuna, though we are concerned that tuna caused UTI, we are afraid him losing his appetite again.

3. VERY IMPORTANT - How confident are you about the diabetes management advice and instructions for giving insulin that you have received from your vet? For the record, you are not testing Jai Jai too frequently. Your testing has provided us with data that will help us to help you keep him safe on insulin.

Honestly, we do not have much choice here. I took Jai Jai to several vets before confirming his diagnosis. They turned out did not take Jai Jai's case by telling us that they did not have the staff to monitor Jai Jai's BG. This vet is a new one, she took up Jai Jai's case because the previous one was on vacation. We found that this vet is more experienced in using Lantus than the previous one.

MOST IMPORTANT OF ALL -

I recommend that for the next several days you ask for help here with Jai Jai's dosing: it could help a lot to bring all those wild swings under control. Take the preshot test and then post asking for help with Lantus dosing (include the preshot number in the thread title). You can post on this board at first, and hopefully one of the Lantus & Levemir Insulin Support Group members will be able to guide you toward posting in their group. (It's very busy, hence my suggestion to post for advice on Feline Health first - less overwhelming when getting started! :) )

It is a very good suggestion, indeed. However (also forgive me about it), I am unable to get his reading until he has his meal finished. It is particularly difficult for me to wait for your guys reply for the AM shot, because I rush for work. I will give it a try for the PM shot instead.
 
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PMPS sounds good. If you let the people answering your posts know that you need a guide about what to do for the evening dose AND the morning dose, they should be able to give you a good steer.

Thank you also for the additional info. Saoirse's in this boat after she was prescribed Royal Canin veterinary diet following removal of bladder uroliths - Urinary s/o dry ring a bell with you?

Saoirse has also taken Samylin for liver support. I've recently switched her to Hepatosyl 50 for cats. I give it to her twice a day mixed up with a teaspoon of tuna and a little water (tuna masks the taste well). Samylin contains vitamin C - and the pills are humongous! Saoirse has recently been diagnosed with early stage II kidney insufficiency (CKD) and I joined Tanya's Site support group to learn more. Apparently vitamin C supplementation isn't so great for CKD kitties - the cat can manufacture all the vitamin C it needs in its own body.

Talking of CKD I see that Jai Jai has elevated creatinine levels. With Jai Jai's history of UTIs and now diabetes, I'd suggest asking your vet to run a full kidney panel next time he gets blood tests done. It may be a good idea to check the phosphorus levels in his food. I really can relate to the worries you have about appetite and food - Saoirse has chronic pancreatitis and finding a food she could cope with was a real challenge. Here's information on nausea and appetite from Tanya's site - lots of advice and treatment recommendations to be found there for helping with appetite issues. Freeze-dried treats, warming the food a little, and raising the bowl have all helped Saoirse, as have her supportive meds (she takes ondansetron for nausea and famotidine for stomach acid).

Dr Lisa Pierson's site, catinfo.org has useful information on helping kitties prone to UTIs.

I'm glad I've been able to help you a little. I know how scared and overwhelmed I have been many times in the past year. Neither Saoirse nor myself would be doing as well with this were it not for the wisdom and kindness of others here who have helped us along the way. Now that I've learned a bit more, I'm only too happy to do anything I can to help and reassure others who may be feeling the same way. :)



Mogs
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heyhollis said:
His reading at PM +3 is 355 (19.7 mmol), seems that there was some Lantus injected into him.
Click to expand...

Indeedy! :) He will also be able to draw on the Lantus insulin stored in his little depot - it's a bit like a mini 'chemical pancreas'. It will be interesting to see what his PMPS reading does.

.
 
BJM said:
Here's what I see:
1 unit is too much - on 7/25 Jai Jai went hypo and then bounced up into the 400s.
Any time the glucose goes below 50 mg/dL on a human glucometer, the cat has earned a reduction of 0.25 units. So, do not give 1 or more units ever again.
On 7/18, after several shots at 0.5 units, Jai Jai got down to 67, a beautiful and safe number. And then you raised it after only 3 shots. Ooops. Too soon to raise it. You must be patient!

Go back to 0.5 units. Stick with it for a minimum of 3 full days (6 shot cycles) and up to 5 full days (10 shot cycles) unless he drops below 50 mg/dL again.
Click to expand...

Thank you, BJM. I will give him 0.5 units starting from tomorrow's morning. Let us see what happens in his glucose curve on the coming Saturday.
 
Critter Mom said:
Indeedy! :) He will also be able to draw on the Lantus insulin stored in his little depot - it's a bit like a mini 'chemical pancreas'. It will be interesting to see what his PMPS reading does.

.
Click to expand...

I am going to test again at PMS+ 5 (one hour later), then the next one is AMPS.
 
Critter Mom said:
Urinary s/o dry ring a bell with you? .
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This is exactly what I gave to Jai Jai for a long time. We rarely gave our cats (we got three) wet food because most of the time they craved the real meat so much they ended up choking and vomiting ...... creating a bigger mess

Critter Mom said:
Talking of CKD I see that Jai Jai has elevated creatinine levels (actually not CREA, it's UREA, my apology for the typo). With Jai Jai's history of UTIs and now diabetes, I'd suggest asking your vet to run a full kidney panel next time he gets blood tests done. It may be a good idea to check the phosphorus levels in his food. I really can relate to the worries you have about appetite and food - Saoirse has chronic pancreatitis and finding a food she could cope with was a real challenge. Here's information on nausea and appetite from Tanya's site - lots of advice and treatment recommendations to be found there for helping with appetite issues. Freeze-dried treats, warming the food a little, and raising the bowl have all helped Saoirse, as have her supportive meds (she takes ondansetron for nausea and famotidine for stomach acid).
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Jai Jai did a lot of blood tests during these few months, I remember that the first time we took him to the vet on 1 May 2015, his renal is perfectly within the normal range. However, things went a little wrong after starting insulin (loss of appetite, dull). From his last test results on 26/7, UREA was 14.6 mmol (a little higher than normal range), CREA (normal), BUN/CREA 21, ALT 98 U/L (normal), ALKP 38 U/L (normal). If more tests should be done, I will ask the vet tomorrow.

Critter Mom said:
I'm glad I've been able to help you a little. I know how scared and overwhelmed I have been many times in the past year. Neither Saoirse nor myself would be doing as well with this were it not for the wisdom and kindness of others here who have helped us along the way. Now that I've learned a bit more, I'm only too happy to do anything I can to help and reassure others who may be feeling the same way. :).
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Your support and advice mean a world to me. I was not aware that I was using a wrong way to adjust the dosage. How silly I was!!! The game needs to restart and hopefully everything will be on the right track.
 
His PM +5 is 383 (21.3 mmol), it starts elevating:nailbiting:

Tomorrow morning's reading must be terrifying. Need to sleep right now. It's already 00:30 at my time zone, will get up at 6:00.
 
I'm not up to speed on lab results yet - struggling to get my head around these for Saoirse (I have PTSD - makes it difficult to understand the unfamiliar, especially when trying to assimilate written information.)

There is an absolute goldmine of information on many aspects of cat health on both catinfo.org (not just nutrition) and Tanya's Site (not just CKD). Here is a link to some information on diagnostic test results at Tanya's Site. It may be of help to you in understanding some of Jai Jai's test results (the main focus is on kidney values, but it's still worth a read). You can also post a thread on Feline Health in this forum and ask for someone to look at Jai Jai's results. Some members here are very knowledgeable about lab workups.

Before your vet visit tomorrow, I'd strongly recommend reading Tanya's nausea / appetite page (link in earlier post). Inappetence can be caused by a number of things, including pancreatitis and CKD. It might be worth asking your vet about some of the anti-nausea treatments mentioned on Tanya's site if Jai Jai is showing symptoms of nausea. Also I'd suggest asking your vet about maybe giving you something like cyproheptadine if Jai Jai continues to struggle with appetite problems (NB: a little cypro goes a long way). Your vet may consider doing a check on Jai Jai's pancreas using a specific test. There are two. The SNAP fPL is (I think) one that the vet may be able to offer in-house. It gives a yes/no result as to whether pancreatitis may be present. If there's a yes result, then a further test called a Spec fPL can be run but this needs to be assayed at an external lab (IDEXX). The Spec fPL returns a numeric value which can indicate the severity of any pancreatitis present.

heyhollis said:
The game needs to restart and hopefully everything will be on the right track.
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Absolutely. The main thing is that you've now identified that you needed further information on dosing and that Jai Jai seems to have been on too high a dose (and those high numbers and swings may well be at the root of why he has been feeling a bit crummy). Fingers and paws crossed that things will start getting better - and easier - from here on in. And remember we're here to help and support you. Ask, ask, ask!! :)
:bighug:



Mogs
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PS... I know you're worried about what number you'll get for AMPS, but we have a saying here: better too high for a day, than too low for a minute. Hope that will reassure you a little. :)
 
Everything went dramatic this morning. I fed him like I usually do at 6:00 (he did not eat much before so we fed him earlier, but he now completes his meal almost every time). I split the meal into two portions, giving him 15 minutes rest between the two smaller meals. But, he ended up vomiting all the intakes with a hairball (similar to Tanya's illustration on "regurgitation" in the vomiting part).

OK then, I fed him another meal and he has already eaten up 70g (2+ oz). I'll let him settle down a bit, then test him and give the dose of 0.5 units.
 
In the future, we suggest that you Test/Feed/Shoot...all in about 5-10 minutes and that you don't let them eat for the 2 hours before shot time.

We want to know what their blood glucose is right before the shot without the influence of food
 
heyhollis said:
Everything went dramatic this morning ... he ended up vomiting all the intakes with a hairball (similar to Tanya's illustration on "regurgitation" in the vomiting part).
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Oh, poor wee thing. :(

I'm about to sign off, but there will be other people in different time zones. Glad to see you confirm that you're planning to give the reduced dose. When you take the preshot reading, if it's less than 200/11 - post here and ask for help. To attract attention to this thread, go back to your first post then click on Thread Tools (up at top right hand side). Then select Edit Title. Click where it says "No prefix." You'll see a drop-down list of optional icons. Choose the question mark icon by clicking on it, then save the changes. (Members keep an eye out for these icons - they are used to let people know that you need help fairly quickly.)
 
Chris & China said:
In the future, we suggest that you Test/Feed/Shoot...all in about 5-10 minutes and that you don't let them eat for the 2 hours before shot time.

We want to know what their blood glucose is right before the shot without the influence of food
Click to expand...

Thank you for your advice. I understand your viewpoint and I want to follow your suggestion (then I need not to get up so early everyday that is already made me really tired), but sometimes he does not eat much. We cannot leave his meal after we rush to work because we do not know how much food he eats.

He is also quite aggressive when I prick his ear for the blood sample......it always takes me 15 minutes to test him if he is in bad mood. He yells and bites.....

Like this morning, I want to test him at around 7:30, but I can only do that at 8:00.....his reading is 499 (27.7 mmol), so we have just given him the 0.5 units.
 
Can you test him while he's eating?

I'm not judging you in any way...We all do the best we can with our kitties!

Have you tried desensitizing him to having his ears played with?

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) works well

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!
 
We are now at the vet clinic. The vet suggested giving Jai Jai 1 unit twice daily considering that:

  • Jai Jai has an increased meal portion since last Sunday (from 2.67 oz to 3 oz per meal, twice daily) (I forgot to mention that in my previous messages).
  • His BG readings were rising (I showed her all the data I have).
  • His UREA and ALT figures are a bit higher than the normal ranges. These were explained as elevated BG levels.

I tried to discuss with the vet for giving 0.5 units for few more days but she did not agree. Once again, she asked me not to test him so frequent because the vein will drain (she said that it is like IV injection).

I am quite confused and had no idea what dose should I give. Considering her reasonings for higher dosage, I am inclined to follow her instructions. We will also visit her two weeks later. And, in the meantime, we will send her the glucose curve.
 
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heyhollis said:
I tried to discuss with the vet for giving 0.5 units for few more days but she did not agree. Once again, she asked me not to test him so frequent because the vein will drain (she said that it is like IV injection).

I am quite confused and had no idea what dose should I give. Considering her reasonings for higher dosage, I am inclined to follow her instructions. We will also visit her two weeks later. And, in the meantime, we will send her the glucose curve.
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Hi - I'm a fairly new person here but I would venture to say your vet has not given you good advice - no disrespect intended. If you look at many people's spreadsheets here, they test upwards of 6 times a day and many have achieved remission. Certainly there is no harm I'm aware of that comes from the ear-pricking, that's just nonsense. There can be bruising but from the sounds of things you are taking the greatest danger because Jai-Jai tries to bite you!!

Please also know that dosing Lantus - which I have started recently after a different kind of insulin didn't give the best results -- is based on the lowest reading, or nadir, within the cycle, not the pre-shot.

Is your vet not concerned about how low Jai-Jai's blood sugar went at the higher dose?

This might be a good time to smile and nod at the vet and take the advice of the very experienced folks above. If Jai-Jai were my cat, I would give the 0.5 as suggested here, hold the dose for at least 3 days, ensure I got mid-cycle readings so I knew how low he was going and by all means be patient. And nod and smile at the vet!
 
You have given me a lot of good advice, I really appreciate your time and efforts. I will try whatever I can do to follow your suggestion, will do it step by step though.

Chris & China said:
Can you test him while he's eating?
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I tried it before, he would rather give up eating than let me do my job. He is kinda hard to deal with.....

Chris & China said:
I'm not judging you in any way...We all do the best we can with our kitties!
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Please feel free to comment and advise, no need to feel sorry.

Chris & China said:
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.
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I need to find yummy low carb treats for Jai Jai. Limited choices here though.

Chris & China said:
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.
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I regard myself quite persistent and patient after his dx, haha. My EQ has already reached a higher level, and I know that this gives "more good" to his health conditions.
 
Chris & China said:
Does he enjoy being brushed or cuddled? Some cats that aren't so "food motivated" get their "reward" in other ways
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Um.....not really I think. I spend much time to comfort him before trying to prick his ear.....not working at all as he still want to bite or scratch my hands.

The best time to do it is when he falls asleep. He stays calm and does not resist much. That is why it is difficult to prick him before meals because he is awake and starts begging for food.
 
heyhollis said:
I spend much time to comfort him before trying to prick his ear
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That may be part of the "problem"....if you're making a big deal out of testing by trying to "comfort" him, he may be picking up on your stress. Try to be as "matter of fact" as you can

And if poking while he's asleep works, try to get him before he wakes up to eat!...LOL
 
Brashworks said:
This might be a good time to smile and nod at the vet and take the advice of the very experienced folks above. If Jai-Jai were my cat, I would give the 0.5 as suggested here, hold the dose for at least 3 days, ensure I got mid-cycle readings so I knew how low he was going and by all means be patient. And nod and smile at the vet!
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My hubby suggested that we follow the vet's prescription. He thinks that we should trust her profession. If otherwise, we should not take Jai Jai to the consultation. The vet's argument was that Jai Jai now had bigger meals and his figures were rising during the days on 0.5 units.

I will type in the amount of food Jai Jai at in the spreadsheet to let you to get to know more about Jai Jai's diet and dosage for the past month.

Please trust that I take your points, but we are also concerned if his numbers are unstable, he will be feeling unwell and develop other associated health problems.
 
Hi, all. I wonder if anyone will give an advice to whether 1 unit or 0.5 fits Jai Jai's case. It's been evening in my time zone, and I have less than two hours to decide the dose..........I know it is not quite an easy decision, considering that there are not many data on his spreadsheet.

I want to hear from you, in particular when you are more familiar with Lantus, and feline diabetes. Thank you.
 
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