17 year-old tortie, so hard to get blood from her ears

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I think that would be good. I would go ahead and get a test at your normal +12 time. It'd be interesting to see whether the food was making a big impact previously.

So I would expect her to be high in the am, because it would be 24 hours since her previous shot. If you can get some tests in (a +2 is nice to see if she is dropping fast, maybe a +5 and +8 to see if you can find her nadir) it will help you figure out what is really happening. I would dose 0.5 and plan to do some testing. Sound doable?
 
strangely, her 3 highest readings have been her last 3. could giving her insulin cause her body to not produce her own insulin? at 369 should we go ahead and give her her shot tonight at +12?
 
Well, she didn't go up for the last 3 hours. Up to you. If you do give her the shot, plan to get a test in 2 hours and 5-7 hours after. Print off the hypo info, just in case

It may be that she is very carb sensitive. My thinking is that she has been eating before those high tests and, if the 32 was "real", it was a fasting test. It may be worth your while to research some low carb foods - below 8% carbs - and see if that makes a difference downward in her levels. This vet has a great food chart on her website: www.catinfo.org
 
are there some high-protein, low-carb canned foods that are particularly recommended for a cat that needs to gain weight? i guess ones that are preferably available without prescription. i guess the Natural Balance that we are giving her aren't as low carb as we thought they were.
 
Twyla17 said:
strangely, her 3 highest readings have been her last 3. could giving her insulin cause her body to not produce her own insulin? at 369 should we go ahead and give her her shot tonight at +12?
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Not saying this is happening but if the cat goes -low- from insulin they can "bounce" almost like a rubber-band back up high from the liver basically releasing glucose to 'fight' the unexpected surge of insulin. It could be ~200-220 is the 'normal' uncontrolled range, and the #'s are getting quite low from the insulin (the 32 and perhaps a few other unseen #'s), and 'bouncing' back up to 300+. Could also be carb sensitivity like Sue mentioned. What makes me think this is

Did you find the carb % for the food you're feeding anywhere online? Some brands/types are easier than others to find info on.

If you shoot tonight get a +2 test and perhaps set your alarm for another one around +5. If the +2 is LOWER then your PMPS then you know she might 'drop' hard number-wise during the night and you need to be on the look out basically.

Are you finding home-testing to be any easier? :)
 
thanks pevsfreedom and all of you. tomorrow we both have work unfortunately, but we'll test after work and at intervals thereafter. we still haven't gotten any better at taking her blood yet though. sigh....
the fifth ingredient of her Natural Balance Indoor Formula is oat bran and the 4th ingredient of her Chicken & Liver is carrots.
 
Twyla17 said:
they don't seem to mention the carb content, unfortunately.

http://www.naturalbalanceinc.com/product.aspx?ProductId=39&product=Ultra Premium Chicken & Liver Pate Canned Cat Formula

http://www.naturalbalanceinc.com/product.aspx?ProductId=34&product=Ultra Premium Indoor Canned Cat Formula&ProductCategoryID=9&category=Ultra Premium Canned Cat Formulas
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The chicken & liver is 13%, and the indoor seems to be 16%, both of which are much too high. You wanna use something under 10%, Friskies Pate is pretty good (minus Mixed Grill flavor) at 48 cans for $25 at most stores, and Fancy Feast CLASSICS is cheap and under 7% I believe, but your food is pretty much too high carb.

Twyla17 said:
thanks pevsfreedom and all of you. tomorrow we both have work unfortunately, but we'll test after work and at intervals thereafter. we still haven't gotten any better at taking her blood yet though. sigh....
the fifth ingredient of her Natural Balance Indoor Formula is oat bran and the 4th ingredient of her Chicken & Liver is carrots.
Click to expand...

The blood will get easier, trust me. Not sure what to say about work hours, etc. Hopefully this weekend you guys can run a full curve. I might even consider trying a lower dose (.25) tomorrow until you can get a few tests in +4, +6, etc. since you guys won't be home to monitor and by the time you're home it's probably past nadir - that 32 is a super dangerous number.
 
@Twyla17, what size gauge/lancet are you using? Starting out, we suggest using a lower number such as a 26 or 28 gauge. It will help the blood come out faster. If you are using a higher gauge, say a 30 or 31 that comes with the meter, it can be harder and take longer to draw blood. If you do have the higher # gauge, you can try poking twice or more in the same place and see if that works.
 
@pevsfreedom, adding the annotations to the video was helpful. The only thing I'd suggest is adding a note that a 26 or 28 gauge lancet is recommended starting out. Otherwise, a lot of newbies watching will assume to start with the 31 gauge.
 
8/10/2015
8:00 am
AMPS= 294 blood sugar
able to produce blood after in two trys - with 31 guage lancet

i plan to give 0.5pzi before i go into work..?

Sue, & Pevsfreedom, should i give her her shot?

we'll get new low carb food tonight
(Friskies Pate or Fancy Feast kitten turkey and giblet)
(8:15)we just gave Twyla the patte =2 table spoons because she won't eat the evo. low carb kibble.
 
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First I want to say that you are doing great with your crash course on Feline Diabetes. :) in the beginning, my learning curve was straight up but when I didn't feel so alone thanks to people here on FDMB it was so much easier to study. :)

I don't know if you've noticed that there are several areas to this message board. The area you are posting in now is the introductions area. There is also a "Feline Health" area, which is actually considered the "main" discussion area. Another area that's important to know about is groups of people who are all using the same insulin. The reason I mention this is because when you need help, you will get more assistance -more eyes if you will- by posting in the Main feline Health area. I think when dosing advice is needed it's a good idea to talk with others who use that same insulin. I hope this is making sense to you. Keep up the good work. :)
 
I think .25 will be fine. 0.5 could have been fine also, but if you aren't there to monitor, the lower dose is likely best.

Interesting that she did not go high overnight even without insulin. Normally we'd see a very high amps without insulin for 24 hours. It'll be interesting to see how lower carb food affects her levels.
 
Twyla17 said:
Jan- we'll start using the Main feline Health area board today.

i gave Twyla .25 and am observing her. she is not behaving differently so far.

we are so grateful for the support of you all on FDMB.
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I think I would have done the same thing. We wanna find out if that "32" was a fluke or not and since you won't be home to test I think this is safest, like someone mentioned a high number for a few hours is better than a (very) low for a few minutes. You'll get more eyes over on Main Health or the ProZinc forums.

Sue and Oliver (GA) said:
I think .25 will be fine. 0.5 could have been fine also, but if you aren't there to monitor, the lower dose is likely best.

Interesting that she did not go high overnight even without insulin. Normally we'd see a very high amps without insulin for 24 hours. It'll be interesting to see how lower carb food affects her levels.
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I agree. I kind of think the yellow #'s are her more normal range, with the pinks being indicative of bouncing up from wherever low she's going.

Do try and run a curve the next day you guys have off. Good job grabbing some new food.

This cat food chart is fantastic:

http://www.catinfo.org/docs/SortableCatFoodChartCatinfo.org2-22-13.htm

Find anything under 10% carbs basically - Friskies Pate and Fancy Feast Classics are probably the two cheapest and readily available.

You guys are doing great. Also someone mentioned to try 26 or 28 size gauge lancets - might make your first few weeks of 'poking' easier since they're bigger.
 
As Sue suggested, it is best to post in the ProZinc forum. Sue gave you the link above. There are experienced members there who give their cats ProZinc and will be able to guide you with dosing-related questions.

You could post in the General Forum for suggestions on what to feed your cat because she's underweight. BJM and others here gave some good suggestions. It's always helpful to have more members, who wouldn't normally check here, advise for this issue.
 
@Twyla17 , no dosing advice from me. But I did want to address your original question. First I have a tortie as well. Is is that you are having trouble getting blood, or having trouble seeing it? Both will improve with time. You also mentioned any other testing sites. I know some test from the paw pads. If Twyla will let you mess with her feet, it might be easier.
 
Shiloh,
7:20pm Twyla ate 2 table spoons of new low carb we food we just bought after work
8:20pm blood test with 28 gauge lancet -worked on 3rd try.
8:20pm PMPS 348

Yes, i am very hesittant to give her insulin .5 or .25 shot that's she's due for right now 8:28

i will go to the PROZINC forum now.
 
From a pre-shot of 230, with 0.5 PZI , she dropped to 32 previously!
I would be very, very cautious in any dose.
The higher numbers you've seen may be due to bouncing, that is, due to a low number triggering the release of stored glucose (glycogen), which zooms it back up.
You might want 12 hours to see if it settles down. Also, dose adjustments are made based on the nadir, the lowest glucose post-shot, NOT the pre-shot tests (those are to make sure it may be safe to give insulin).
 
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thank you BJM
i am scared to give her prozinc, i will not do so until we can determine the nadir"the lowest glucose post-shot"
we'll try and do her full PMPS +1 through +11 tonight
and no insulin tonight
 
Twyla was a careful neat water drinker just 3weeks ago.
The past week i have noticed her mouth chin cheek area fur drenched with water.
after she drinks.

Could it be that she is just exhausted and can't keep her-self poised
are her whiskers not registering the water depth.
i don't think my vet will know the answer.

we are not noticing extra urine, clumps look the same amt. in the litter.
we are not noticing more than usual water consumption.
 
My first thought was excessive water consumption but since you state that is not a factor then I am wondering if she may be drooling due to a dental issue.
I'd suggest having the vet look at her.
 
the vet said her teeth did not look great when he visited 7/24,
but that he was not worried about this at her age.
she does not drool,
i see her drink and see her getting her face into the water.
she was not doing that last month.
 
Dental issues can contribute to increased glucose levels and infections. That's why dental cleanings are strongly recommended for sugar cats. A member here had her 20 year old sugar cat's teeth cleaned in April.

Other than the way she is drinking water, have you noticed anything unusual? Is she lethargic? Does she have difficulty walking? I am wondering if diabetic neuropathy might be involved.
 
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we could ask our new house call vet again for a cleaning
i asked him if we should brush her teeth and he said he didn't think so.
i don't know ;-( maybe i should get a new vet who will come to the house....

she is not active. she seems very tired.
she is slow and wobbly.
4 years ago we took her to have her thyroid gland destroyed because - she was hyper thyroid
she seemed a bit wobbly ever since then yet still able to jump up on counters and jump back down
play & run away from me
fight with our younger cat
she had spirit and she was stronger than she is now

during the last 2 months we've seen a decline in her "normal" energy levels.
 
"neuropathy generally resolves once good glycemic control is achieved"
http://veterinaryteam.dvm360.com/managing-complications-diabetic-cats
i just read about the diabetic neuropathy in the link above.

maybe Twyla will have smoother gait if we can get her blood sugar normalized.
the vet told us that she is not an extreme diabetic.
her blood glucose level was in the yellow range 210 when he did her blood panel a few weeks ago, July 24 2015.
 
Were Twyla's thyroid levels also checked recently? After my Cootie had radioactive iodine treatment for hyperthyroidism, she developed hypothyroidism. I couldn't get her blood sugar regulated until she started meds for the hypothyroidism.
 
yes, during the week of July 24th the vet did a full blood panel and found completely normal thyroid levels
kidney function fine
every thing's in normal levels, except the 210 blood sugar.
thank you for your concern and trouble shooting, everyone.
 
Twyla17 said:
we could ask our new house call vet again for a cleaning
i asked him if we should brush her teeth and he said he didn't think so.
i don't know ;-( maybe i should get a new vet who will come to the house....

she is not active. she seems very tired.
she is slow and wobbly.
4 years ago we took her to have her thyroid gland destroyed because - she was hyper thyroid
she seemed a bit wobbly ever since then yet still able to jump up on counters and jump back down
play & run away from me
fight with our younger cat
she had spirit and she was stronger than she is now

during the last 2 months we've seen a decline in her "normal" energy levels.
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If it is (I don't know) a dental issue teeth cleaning (like home brushing) won't help, you'll need to bring the cat in and actually put her under to get the teeth cleaned. Drooling and slopping water can be a symptom of dental issues, but unless your vet specifically thinks dental IS a problem I don't know if I'd worry about it.

You guys said you're switching foods right? I honestly think you might want to switch to the FF classics (4-5% carbs I believe) and NOT give insulin for 1-2 days, and try and get a curve during this time to see how she reacts to the lower carb food. It could be the 15-20% stuff you used before was making her BG's jump and she could barely need any insulin if any at all if she's diet controlled. 210 is not a painfully high number, and if food was an issue I'm interested if insulin is truly necessary, or if at least a good reduction is warranted.
 
pevsfreedom,
yes we switched foods since last night.
joe got us the" BFF best feline friend " and "EVO the ancestral diet" canned foods based of the Forum food chart.

we should get FFclassics if the carbs are lower than in BFF & EVO (?)

Twylas reading this morning was 295 AMPS.
She has finished eating her morning meal of BFF

she growls and trys her best to escape when blood test time comes.
i wonder if her blood sugar is higher than 210 because the blood test is stressful

We won't be able to do more tests until 6:00 in the evening.
So is should not give her .25 shot of the morning, and wait till the weekend for resuming shots - after curve #s that support the shots decision/or not?
"NOT give insulin for 1-2 days, and try and get a curve during this time to see how she reacts to the lower carb food."
 
I don't know what to tell you, Joe. It is looking like the 32 was a fluke or a bad test and that she tends to run in the 200s on her own. If that were the case, .25 should be fine. But it is always scary to give a shot and leave. On the other hand, I hate to see you wait 4 days before giving insulin twice daily.

Is there a chance that you could set up an alarm and get a number 5-7 hours after the shot overnight tonight? Or, are you a certain age like me, and get up about the that time? It would really only take one nadir number to let us see how low she really goes.

Do you give her a treat after each test? That is what really makes the process work; they come to want the treat more than they worry about the poke. PureBites are popular low carb treats at our house.
 
Twyla17 said:
http://www.catinfo.org/docs/SortableCatFoodChartCatinfo.org2-22-13.htm

carb chart says "2" for
BFF (Best Feline Friends) Seafood Tuna & Bonito Be Mine
i think Joe got this food over FFeast because of the nutritional value(?)

carb chart says "0" for
Fancy Feast Flaked Fish & Shrimp Feast
Click to expand...

Lower the better basically, you guys can use whatever you want that's under 10%, or 5% preferably, that isn't too expensive to maintain regular use. And I agree with Sue. Could you guys set an alarm for 3am maybe this morning like she mentioned to try and grab a nadir test (around +4/5 probably)? Otherwise I think I'd feed this new super low carb food until this weekend and then see how things are. If she's still running yellow all day perhaps do .25 sunday morning and get a curve for the day. People in your prozinc thread might have more info for you. you guys are doing good - it's just hard to advise without more info re: how low twyla is going. And Im sure it's hard for a 17 year old cat to start getting his ears poked! you guys should get used to it soon and he should too. if he likes meat we gave luna small slices of 0 carb deli meat every time after she tested as a reward for a few weeks.
 
Twyla is at the emergency vet overnight. she was very weak today, and not eating, and throwing up mostly water.
We took her to the emergency vet because we didn't want to wait for her vet appointment tomorrow. They did tests. they said her glucose was over 600. the test they showed me didn't have a specific number, it just said ">600". they said that we couldn't trust home tests and that home tests aren't calibrated for pets. they said we had to leave her or she would likely die. she is on IV fluids. i took her blood when i got home from work today and her glucose was 293. frankly, i trust you people here more than i trust an emergency vet i don't know, but we are torn every which way. i don't know if they said she had ketones or just assumed she did. they said her potassium was low, for comparison, her potassium was 4.9 on 7/22. she is on IV fluids with potassium. she is getting phosphorus. they said she was acidic. i'm just trying to remember the things the vet said. they gave her an x-ray and are planning on giving her an ultrasound tomorrow. they are giving her antibiotics. so far it's costing us $1650. i guess we're going to try to sleep now. thanks for your kindness and concern.
joe
 
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we just got an email of her bloodwork from the emergency vet. things that were out of range from their in-house bloodwork are
BUN 73.2
Calcium 7.8
Glucose >600
Cholesterol 216
Sodium 165
Potassium 2.5
LYM 0.10
NEU% 94.5
LYM% 0.9
EOS% 0.9
MCV 60.4
pH 7.029
PO2 43
Base Excess -19
HCO3 11.5
TCO2 13

handwritten
PCV 34
TP 9.8
 
I am so sorry to hear to hear about Twyla's setback. I know this is a very hard time for both of you. Yes, home testings are more accurate. Illness, infections and stress can raise BG levels. You both did the right thing taking Twyla to the ER. Please get some rest and keep us updated. We care.
 
Twyla17 said:
we just got an email of her bloodwork from the emergency vet. things that were out of range from their in-house bloodwork are
BUN 73.2
Calcium 7.8
Glucose >600
Cholesterol 216
Sodium 165
Potassium 2.5
LYM 0.10
NEU% 94.5
LYM% 0.9
EOS% 0.9
MCV 60.4
pH 7.029
PO2 43
Base Excess -19
HCO3 11.5
TCO2 13

handwritten
PCV 34
TP 9.8
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@Larry and Kitties @BJM are you able to advise?
 
Truly sorry about all this. You guys must be a wreck. I hope Twyla is ok and they can figure out what's going on. Please call them and ask about ketones tomorrow, this sounds like a DKA crisis. If they didn't check please ask them to (for ketones, it's easy test) and ask if it is ketoacidosis.

As far as 'not trusting a meter', that is ludicrous, plain and simple. Human meters read exactly the same as pet meters, they just use varying reference ranges. @BJM's signature how good info on this. For reference Luna rises 250+ points at the vet.

DKA:
At the same time, massive amounts of ketone bodies are produced, which in addition to increasing the osmolal load of the blood, are acidic. The potassium level of the body as a whole is reduced by the polyuria of ketoacidosis
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Link: http://petdiabetes.wikia.com/wiki/Ketones

Treatment involves fluids and flushing out the ketones and is quite a big deal. I hope Twyla pulls through.
 
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