Newbie Introduction and request for UK Glucometer Recommendation!

[Trish J]

Hi everyone,

Just to introduce us and hearty thank you for all the great information on this site! Our cat Kismet is newly diagnosed with diabetes – confirmed blood test for fructosamines with no signs of ketones. Unfortunately she had a serious health crisis the same time the blood results came back last week, refusing to eat for well over 24 hours, was dehydrated and in obvious pain. It could have been a UTI, but I believe on the evidence of the symptoms of previous months was likely to be an attack of severe pancreatitis. She was in a terrible state and the stress of the vet treatments made it worse.

The vet wanted to hospitalize her but as we couldn't afford that, suggested putting her to sleep. We decided instead to see if we could pull her through it on a wing and a prayer, so she was put on a drip for an hour and given antibiotics and insulin and after a hair-raising and sleepless couple of nights of home-nursing we got her through it!

A week on, her appetite is back (only occasionally ravenous – which I hope is a good sign) and I'm injecting her with just over 1 Unit of 40IU Caninsulin every twelve hours with a 0.5ml Caninsulin syringe. To attempt to manage the pancreatitis I'm feeding her little and often, as suggested by the vet, high protein, low carbs wet food, with some Thrive (all protein) treats for taking her injections so well. We'll take her back to the vets for a blood check early next week.

I have so many questions and my brain still won't take so much in... but firstly:
I realise I need to purchase a glucometer and start home monitoring her BG. If anyone has recommendations for a UK available version which is affordable to buy strips/lancets for, I'd be eternally grateful! I've been looking at the Home Health Codefree Blood Glucose Monitor on Amazon UK, but don't know if it fits the purpose. Anything in particular I need to know to ensure it'll work for cat blood?

Many thanks in advance for any thoughts/recommendations. Trish J

 

[Shiloh & Rhonda (GA)]

@Critter Mom , can you help?

And Welcome Trish and Kismet! We have members from all over so I am sure someone can help. I'm in the US so not much meter advice that I can give.

And what does Kismet eat? Low carb canned food is best.

 

[Critter Mom]

Hi Trish and welcome to yourself and Kismet. (Lovely name!)

I'm also in the UK and my cat, Saoirse, has chronic pancreatitis. She had a really severe flare last year and it was harrowing for both of us. You did really well to pull Kismet through the crisis. I home nursed Saoirse and it's tough going.

Regarding glucometers my main meter is an AlphaTRAK 2 veterinary glucometer. The strips are expensive but I value the peace of mind it gives me. (I have chronic PTSD so I worry a lot about things.) My backup meter is an Accu-Check Aviva. You can get fairly good deals on ebay for strips plus it's a popular meter so if you were to unexpectedly run low on strips you can pick them up locally at places like Boots or Morrisons in-store pharmacy. Because of species differences in plasma glucose concentration cat blood gives a lower reading on a human glucometer compared to a veterinary meter. You simply use a different reference range with the human meter to monitor the cat's BG levels. We can help you through all of that side of things as you go along.

It can take a little time to get the hang of home testing, but it is the best way to help you keep your kitty safe on insulin. Key tips are to make sure the ear is warmed long enough to improve blood flow to the test area, and also to smear a thin film of Vaseline onto the test area so that the blood droplet will bead up instead of wicking into the fur. Here are a couple of forum stickies to help you improve your testing technique, and also a link to tell you how to set up a Google spreadsheet in which to store your test results. The spreadsheet is an invaluable tool to help you monitor BG patterns and it will help you with both regulation as well as safe dosing. Sharing the spreadsheet will enable experienced members here give you better suggestions when you need help.

Home Testing Hints and Tips (includes how-to videos)

Testing and Shooting Tips (includes a very useful diagram of the ear to show the 'sweet spot' for getting samples more easily.

How to Set Up a Spreadsheet and Link it to Your FDMB Forum Signature

As well as the spreadsheet link, it is helpful to put both of your names, insulin and glucometer type, plus brief details of any other health issues/medications. Have a look at other members' signatures to get an idea of what to include.

In addition to home blood glucose monitoring, we also recommend using urine test strips to monitor regularly for ketones (e.g. Keto-Diastix). I use MultiStix 10SG test strips because they have 10 different tests on them including ketones so I can test for more things at home. Again, you can get good prices for urine test strips on ebay.

On pancreatitis, these are very useful links:

Nausea Symptoms and Treatments page from Tanya's Site

IDEXX Pancreatitis Treatment Guidelines


I've recently posted details of meds, supplements and feeding tips which helped Saoirse for another member. Here's a link to that post:

http://www.felinediabetes.com/FDMB/...nt-hyperosmolar-syndrome.142373/#post-1484755


If Saoirse is any way typical of a pancreatitis kitty, then nausea control is key to managing the condition successfully both in the acute phase and also longer term. Whereas meds like ondansetron help, the real key to controlling nausea and discomfort is the diet. That's the tricky part: it can be extremely difficult to find a food that agrees with an individual cat.



Mogs
.

 

[Elizabeth and Bertie]

Hello Trish and extra-sweet Kismet, and welcome to FDMB.
It sounds like you've had a tough time of it with Kismet's diabetes diagnosis, so here's a reassuring hug for you.

Regarding glucose meters, quite a few UK folks use the one that Mogs referred to in her post above, the Accucheck Aviva.
I've always used the One Touch Ultra meter. But it does use a smidge more blood than the Accucheck.

You may want to avoid the Freestyle Lite meter as some members have found that this reads high blood glucose numbers incorrectly (ie. lower than they actually are.)

Test strips for most human glucose meters are available on Ebay, sometimes for half the cost of those in pharmacies.
Lancets are pretty cheap anyway, though it's still possible to save money by buying on Ebay.

And if you're buying Caninsulin syringes from your vet do know that (unless your vet's prices are very good ) you can save money by buying online. They're pretty widely available. And I think VetUK do their own generic version also.
If it turns out that your cat needs very small doses of Caninsulin then you may, at a later date, want to consider getting U100 syringes and using those with a conversion chart (ie. our chart that shows how to draw up the appropriate dosage of U40 insulin.))

While you're waiting to get your glucose meter you can start to get Kismet used to the idea of testing now. If you hold or massage her ear for a few seconds, and then reward her with one of those Thrive treats, she should soon come to associate 'ear handling' with 'yummy stuff'. And it can help, especially initially, to always test the kitty in the same place. I used to pop Bertie up on my desk and test him there. Pretty soon he learned to jump up on the desk himself when he heard me rattle the test strip vial!

I've got a feeling you are going to do just fine, Trish.
Do ask any questions you want to. We're here to help.

Edited to add: Here's a link to some UK food info that might be useful:
UK Diabetic Cat Food Info (including link to low carb food list)

Eliz

 

[Critter Mom]

www.animeddirect.co.uk is probably the cheapest overall for veterinary stuff (with the possible exception of VetUK's 'own brand' lines).

As Eliz mentions above, you can get cheap lancets on ebay. Thanks to a tip I got from a member here I now buy Freestyle lancets for my Alphatrak 2 lancing device on ebay. They're identical to the Alphatrak ones, but a fraction of the price. I buy my U100 0.3ml demi syringes on ebay, too.


Mogs
.

 

[Trish J]

Hi @Critter Mom, @Elizabeth and Bertie and @Shiloh & Rhonda,

Thank you so much for the warm welcome and all the equally welcome information - it really helps! I'll read through everything and try to absorb as much as I can. As money is an issue, I'll go for the Accu-Check Aviva – think it's probably sensible to buy one that a few of you have already had success with. Can I ask if you've had any problems with test strips bought from Ebay? The reason I ask is that I was told by a diabetic friend that there are a few counterfeits around. Our vet charged us £40 for a supply of syringes so the link to buy them online is most welcome too!

I had a worrying morning as Kismet (Kiz for short) vomited in the night, was drinking loads of water early on and leaving puddles in the litter tray. This is what she was like in the lead up to being diagnosed, but not since being on insulin (though I guess that's worn off by the time she has her morning shot at 8am?). I'm hoping it was down to a different brand food my partner gave her yesterday - it seemed to resolve itself by this afternoon. She was being fed Sheba sachets up until the pancreatitis attack as they were one of the only supermarket brands which didn't make her vomit. I thought that like me she was just intolerant to wheat/soya. Now she refuses to eat them - presumably due to the nausea/stomach acid caused by her not eating?! Now I'm giving her Sheba Pate flaours and Gourmet Gold, both of which are on that useful list of under 10% carbs, with added fish or meat protein. She seems okay on both of those in small portions spread over the day.

Really hoping I can master glucose testing so I won't just have to rely on symptoms, though must admit it utterly terrifies me. Like you Mogs, I suffer from PTSD/anxiety disorders so you have my utter empathy! Thanks also for the info on Pancreatitis. Tanya's CKD site is so useful, I used it previously for Kismet's late mother. Luckily I had some slippery elm already in when she had the pancreatitis attack as it seemed to help, but I will certainly look into buying some of the medications you mentioned in case of any future emergencies.

@Elizabeth and Bertie thanks for the idea of practicing rubbing Kismet's ear while offering treats. I think it'll make me less nervous about approaching her to get blood too if I have some dry practice runs!

All your cats look so adorable. I'll have to sort out a photo of Kismet to upload. She's a fluffy, plump 16 year old Tortie – I love all cats, but Torties never fail to make me swoon.

Many thanks again for all your help you lovely people. I have loads more questions, but will try to get them out gradually in a calm and orderly fashion. Very best regards, Trish

 

[Critter Mom]

Like you Mogs, I suffer from PTSD/anxiety disorders

In fact, a truckload of them.

.

 

[Trish J]

@Critter Mom - Aw, Mogs, thank you and back atcha! xxx I purchased the Accu Check Aviva today and am going to do loads of reading and watch lots of videos in order to prepare. Feel very cowardly about it right now, but know if I can do it, it will lessen the anxiety about hypos and hypers somewhat!

 

[Critter Mom]

Feel very cowardly about it right now, but know if I can do it, it will lessen the anxiety about hypos and hypers somewhat!

Boy, that sounds familiar, Trish!

At the practice where Saoirse was first diagnosed the vet assigned to her was positively hostile to home testing. (We're with a different, much more diabetic-friendly practice now.) I had to give Saoirse insulin completely blind. They were some of the worst weeks of my life. It took me a little while to get the ear prick technique right but even though my first attempts were cackhanded at best the relief I experienced at finally knowing Saoirse was in safe numbers was overwhelming and so welcome, even though the numbers themselves were depressing. Home testing is without question the best thing I've done to help Saoirse with both her diabetes and her pancreatitis.

Freeze-dried protein pieces are great treats for test time. You can get Thrive brand at Sainsbury's (and probably other major supermarkets) and zooplus do Cosma Snackies. Saoirse likes the chicken variety of the latter.


Mogs
.

 

[BJM]

While you work on blood glucose testing, take a look at my signature link Secondary Monitoring Tools which describe some other options for assessing how your cat is doing. In particular, water consumption and output, and urine ketones and glucose are key for diabetics.

 

[Elizabeth and Bertie]

Can I ask if you've had any problems with test strips bought from Ebay? The reason I ask is that I was told by a diabetic friend that there are a few counterfeits around.

Hi Trish, I've been buying test strips on Ebay for over 8 years and during that time have only ever had two boxes that seemed a bit 'off'. They were genuine, I think; but had possibly been stored badly.
Quite a few test strips sold on Ebay UK seem to be those that diabetic folks have got on prescription on the NHS. (They sell on what they don't need...)
I buy One Touch Ultra test strips. 'OTU' meters are widely used by the NHS and so there is good availability of test strips. I think the Accucheck Aviva is another meter that the NHS recommends; and if that's the case there should be plenty of Accucheck test strips available on Ebay also...
.

 

[Trish J]

Boy, that sounds familiar, Trish!

At the practice where Saoirse was first diagnosed the vet assigned to her was positively hostile to home testing. (We're with a different, much more diabetic-friendly practice now.) I had to give Saoirse insulin completely blind. They were some of the worst weeks of my life. It took me a little while to get the ear prick technique right but even though my first attempts were cackhanded at best the relief I experienced at finally knowing Saoirse was in safe numbers was overwhelming and so welcome, even though the numbers themselves were depressing. Home testing is without question the best thing I've done to help Saoirse with both her diabetes and her pancreatitis.

Freeze-dried protein pieces are great treats for test time. You can get Thrive brand at Sainsbury's (and probably other major supermarkets) and zooplus do Cosma Snackies. Saoirse likes the chicken variety of the latter.


Mogs
.

Hi Mogs,

It's actually quite reassuring to read that you had problems at first. I've made two attempts to get blood and got nothing so far! I got blood from myself no problem on a low lancet setting, but even using a slightly higher one, with a warmed up, well-rubbed ear on Kismet's supposed `sweet spot', nothing!!

Having really primed myself in the lead up to it, watching videos and reading all the tips and hints, I thought I'd prepared pretty well. I'm going to try again later, perhaps with a higher number on the fastclik lancet next time.

I didn't know you could get Thrive treats at Sainsburys or other supermarkets, I usually get them from Amazon UK as they do a Subscribe and Save option which makes them slightly cheaper. Kismet began throwing up a while ago, and taking her off cereals seemed to fix it, so I discovered Thrive back then. We call them `Kitty Crack', cos she goes literally wild for her fix!

I'm thinking long-term about buying a food dehydrator and attempting to make a home-made version. Nearly used up four tubes of treats in the last fortnight and let's face it they ain't cheap!

I really appreciate all the help and encouragement, thank you soooo much xxx

 

[Trish J]

While you work on blood glucose testing, take a look at my signature link Secondary Monitoring Tools which describe some other options for assessing how your cat is doing. In particular, water consumption and output, and urine ketones and glucose are key for diabetics.

Thanks so much @BJM - the secondary tools link is really useful. I've ordered some Keto-diastix and am monitoring her closely in the meantime. I know she's not regulated fully as yet (still drinking/weeing a lot, especially in the morning). Getting any blood is proving a big challenge, but I'll try to persevere. Good to know that other monitoring is valid too, gives me a bit more confidence doing the `start low, go slow', which is the antithesis of what my vet initially wanted to do.

 

[Trish J]

Hi Trish, I've been buying test strips on Ebay for over 8 years and during that time have only ever had two boxes that seemed a bit 'off'. They were genuine, I think; but had possibly been stored badly.
Quite a few test strips sold on Ebay UK seem to be those that diabetic folks have got on prescription on the NHS. (They sell on what they don't need...)
I buy One Touch Ultra test strips. 'OTU' meters are widely used by the NHS and so there is good availability of test strips. I think the Accucheck Aviva is another meter that the NHS recommends; and if that's the case there should be plenty of Accucheck test strips available on Ebay also...
.

Hi Eliz,

Thanks for getting back to me on that, it's very reassuring. I bought some from Boots, but I can see that the full-price cost on top of everything else would be challenging, especially if I do any proper `glucose curves'. Also I can always find stuff to sell on Ebay to pump up my Paypal balance.

Having said that, finding it damn near impossible to get any blood from the little tinker right now, but I shall persevere!

Many thanks, Trish xxx

 

[Shiloh & Rhonda (GA)]

Trish, I had to go to the deepest level with Shiloh in order to get blood.

 

[BJM]

Make sure you have lancets for alternate site testing. They are 25-28 gauge (thicker) and make a bigger hole.

 

[Trish J]

Trish, I had to go to the deepest level with Shiloh in order to get blood.

Hi Rhonda,

Thanks for the input, much appreciated. xxx I've tried 3 times now, with no success, but I did start on the lightest setting, which worked on my weather-beaten gardening hands, tho not on her soft ears! The last time I tried, I got blood, but not enough.

I will try on a deeper setting as you recommend and perhaps try making two jabs. If that doesn't work I guess I need to try another site/ buy some different gauge lancets. Feeling on a real downer today about it, as she yowled when I gave insulin this morning - she's begun to get a bit restless when I do it and I think I may have hit muscle by mistake.

I just know she's not right yet, and am worried about what damage it'll do to her if I don't get her regulated quick enough, though I also know it makes sense to `go slow and give low'. Unfortunately the new local vet doesn't have much experience with diabetes and made some mistakes initially that made me very wary.

Thanks, it helps knowing there's other folk who have been through this and battled thru. xxx

 

[Trish J]

Make sure you have lancets for alternate site testing. They are 25-28 gauge (thicker) and make a bigger hole.

Thanks BJM. I re-read a lot of the literature yesterday, and a thicker gauge makes a lot of sense. I've done all the other steps, warming/massaging the ear, vaseline etc. I'll try a deeper setting later today as Rhonda recommends and failing that, perhaps I'd find it easier free-handing the lancets than using the fast-clik system or using her paw pads. Perservance seems to be the key here, or so I keep telling myself. I'm really trying hard not to let it get me down, but I'm a bit teary-eyed today, so getting feedback/help is Much appreciated. xxx

 

[Mogmom and Goofus]

Hey Trish, and welcome! If the ear poking doesn't go well for you, try the paw pads. They have little feeling and bleed quite easily. After a few days of trying to test Goof's ear, several meltdowns and poking a hole right thru his ear, I called my vet. He calmed me down and assured me I wasn't really hurting Goof, he suggested the paw pads. It worked the first time.

I also used the deepest setting at first, then after I got the hang of it and Goof got used to it, I backed off a click. I also find that after the poke, if you can use both hands, to "pump" the poke hole a bit, it makes the blood come easier. Also, to rub down the leg helps to draw the blood down some.

P.s. I'm so glad you decided to give her a chance!

 

[Mogmom and Goofus]

One other thing, don't worry too much about getting her regulated quickly, it'll make you crazy. She didn't become diabetic over night and it'll take some time to get there. My vet says an average time for regulation is 4-8 weeks, every cat is different.

 

[Trish J]

One other thing, don't worry too much about getting her regulated quickly, it'll make you crazy. She didn't become diabetic over night and it'll take some time to get there. My vet says an average time for regulation is 4-8 weeks, every cat is different.

Hi Mogmom,

Thanks so much for the advice. I just tried to get blood again an hour ago on a deeper setting after a good 10 minutes of ear-warming. Still no luck and now her ear seems sore (she yowled when I touched it just now). She's weird about having her paws touched at the best of times, but it's good to know there's other options if I really can't master this one. I think I'm going to leave it a couple of days before I try again, and I'm going to order some thicker lancets to try.

Thanks for reassuring me about the regulating. It has been really panicking me, worrying about what damage may be happening while she's under-treated, but I'm scared of rushing her into a hypo, which she nearly had on her starting dose of 2 units 2x. Unfortunately our vet is fairly inexperienced over feline diabetes. I feel better knowing the average is 4-8 weeks! She's only been on insulin a couple of weeks now, so that's REALLY helpful! xxx

 

[Elizabeth and Bertie]

Hi Trish,

Just in case you've not been shown this yet here's the link to the FDMB page of hometesting tips, tricks and example videos:
Hometesting Links and Tips

Please be kind to yourself. Learning to hometest is like learning anything else new, it can involve a bit of 'trial and error' at first, and it can take a while to 'get the knack'. But you will soon get the hang of it, honestly. I promise you!

Things I found most helpful were/are;
1. Making sure the ear is warm.
2. Putting a teensy weensy smear of vaseline on the outer edge of the ear. That helps the blood to 'bead up' and stops it disappearing into the fur.
3. Being sure to put a little pressure against the underside of the ear, on the opposite side to where you're pricking. This gives the lancet something to resist, otherwise it can push the ear away rather than pierce it. Some folks use a bit of tissue or cotton wool. I just use a finger tip (though do occasionally prick my own finger that way... )
4. Massaging immediately below the ear prick can 'milk' out a little more blood. I almost always do this.
5. Two ear pricks close together can often produce enough blood for a test where one ear prick might not.
6. Don't be afraid to try different places on the edge of the ear to see if they bleed better: Try a little higher or lower, or a little further in or further out.
7. Remember to reward kitty for any test or attempted test. (And reward yourself too. Chocolate is good.....)
8. Pressing on the test site for a few seconds afterwards (with a bit of tissue or cotton wool) will help to minimise bruising. And do be reassured that cats' ears seem to toughen up. That bruising is often an initial/temporary thing.

And maybe try to take a few deep breaths before you attempt a test? It'll relax you a bit. Cats pick up on our stress. If you are relaxed, Kismet is likely to be more relaxed too.

Reassuring hug to you,

Eliz

 

[pevsfreedom]

I have a little video in my sig showing how I test Luna if you wanna look.

I found the 'secret' is to poke and then massage the ear from the base to the poke. Even if you don't see blood immediately you can usually get it to bead up if there was any puncture.

 

[Trish J]

Hi Eliz,

Thank you so much for the reassurance and support, it means a lot and I will try to be a bit kinder to myself + with chocolate xxx I'm menopausal too, which doesn't help!

I'm blown away with how much support I'm being given here, it's so affirming, especially after yesterday which was definitely the worst day since her initial pancreatitis/diabetes diagnosis.

I'm giving myself a couple of days off from trying so I'll feel refreshed when I make another attempt. I read/tried most of the Hometesting Tips, but there's a few that you and other people have suggested, that I haven't tried yet, so I'll definitely utilize them too.

Kismet has been yowling the past two days over her insulin injection, which hasn't happened before, so that's spooked me a little too. My vet taught me to do it about two inches down the back from the scruff of the neck, though I've read on the main website that may not be the best place. Do you think it could already be getting too sensitive there, just a couple of weeks in? Or perhaps she's just picking up on me feeling a bit overwhelmed by the task-at-hand. I really am doubting my own judgement at present!

Deep breaths... yes, definitely need to take more of them! Thanks again Eliz.

Trish xxx

 

[Trish J]

I have a little video in my sig showing how I test Luna if you wanna look.

I found the 'secret' is to poke and then massage the ear from the base to the poke. Even if you don't see blood immediately you can usually get it to bead up if there was any puncture.

Thanks pevsfreedom, good video and what a cutie Luna is. Once again I'm thinking that using a free-hand lancet may be easier to handle than the auto-clik one I bought. It looks more comfortable and controllable. Thanks for the input

 

[pevsfreedom]

Thanks pevsfreedom, good video and what a cutie Luna is. Once again I'm thinking that using a free-hand lancet may be easier to handle than the auto-clik one I bought. It looks more comfortable and controllable. Thanks for the input

I tried for click-stabber thing for like 10 seconds and threw it away. Free-hand is way easier. Best of luck to you and Kismet! You couldn't have found a better community for help, support, and advice. You may find treating diabetes to ALMOST be like a fun challenge to be overcome rather than something 'bad'. (helps me deal with it at least!).

 

[pevsfreedom]

Hi Eliz,

Thank you so much for the reassurance and support, it means a lot and I will try to be a bit kinder to myself + with chocolate xxx I'm menopausal too, which doesn't help!

I'm blown away with how much support I'm being given here, it's so affirming, especially after yesterday which was definitely the worst day since her initial pancreatitis/diabetes diagnosis.

I'm giving myself a couple of days off from trying so I'll feel refreshed when I make another attempt. I read/tried most of the Hometesting Tips, but there's a few that you and other people have suggested, that I haven't tried yet, so I'll definitely utilize them too.

Kismet has been yowling the past two days over her insulin injection, which hasn't happened before, so that's spooked me a little too. My vet taught me to do it about two inches down the back from the scruff of the neck, though I've read on the main website that may not be the best place. Do you think it could already be getting too sensitive there, just a couple of weeks in? Or perhaps she's just picking up on me feeling a bit overwhelmed by the task-at-hand. I really am doubting my own judgement at present!

Deep breaths... yes, definitely need to take more of them! Thanks again Eliz.

Trish xxx

Generally shooting in the scruff is a bad idea. I am not sure if it's more sensitive, which very well may be, but insulin is much better absorbed in the sides/flank region. I gave insulin for like 8 months before I finally realized I was doing it kind of wrong. I like to shoot Luna when she's eating (IDK if you can do that with caninsulin, I don't think so) but part the fur to find the skin, squeeze it upwards and make a 'tent' almost, and just pierce the skin (where I can visibly see) and shoot. She doesn't even notice it.