Advice Needed - Insulin Problem or Mild Hypo?

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@Squalliesmom. That's interesting that Squallie has thicker skin in one ear. Kismet has one ginger ear, one black. I keep trying on the ginger one cos it's easier to see the vein and it's on my right hand side when her back is turned. Maybe I need to try poking her black ear in case the skin is more responsive there? Definitely worth a try. Thanks for that! xxx
 
Trish J said:
HI @Squalliesmom Lucy, @Cat Ma @Robin&BB and @woodsywife. Hey, thanks for all the encouragement and info . It really is appreciated, and I am taking it all on board even though I'm loathe to report I still haven't managed to bleed Kismet enough for the test strip! I managed to buy a box of 28g Unilet Lancets. Got everything prepared, ear warmed and vaselined, treats etc. She wriggled as I was about to poke and I panicked and poked twice. Only poked her right thru the ear and tissue and stabbed myself! Result: she yowled, but still no blood from her while I bled like crazy trying to milk her ear - STILL no joy! I've decided to laugh rather than cry over it now, I WILL get there!

Kiz also decided today she didn't want to use the replacement urine test litter tray she's been fine with up to now. She just held on, even though I could see she desperately wanted to go. Afer 4 hours of this I got frightened in case she got a UTI and caved in. Of course she went straight in and did her business before I could even grab a test strip to shove under her.

I'm not giving up, but I am going to give my Home BG attempts a break for a couple of days in an effort to calm both of us. I haven't been sleeping and I think she's picking up on my stress levels, even though I've tried to be very calm around her.

Despite all this Kismet seems to be okay. Her urine is more compact during the day/evening, it's just the mornings it seems to be puddling. She's definitely had more energy today and been hungry but not ravenous. We have an appointment at the vet for blood tests on Monday. Maybe she can give me some extra pointers.

Lucy, thank you so much for all your support in particular! People on this forum have been so lovely and generous with their time, it really is a lifesaver. It does give me the impetus to get beyond the despair and stay determined to keep trying :) Bless you All xxx
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You will get there, I promise! Just like you are patient with Kismet, you have to be patient with yourself, as well. :) And you are very welcome, I'm sure, from everybody here. Keep us up to date on Kismet's and your progress, please! :bighug::bighug::bighug:
 
@Trish J, I'm still learning about bounces also. I certainly can not offer advice for that. I could not find what kind of meter you are using and I am only familiar with alpha trac 2. But maybe I can offer these insights. The strips I use can get blood from either side, I don't knows if yours does. And sometimes i used both sides. One day I really read the directions. It said not to. But yet I couldn't get the meter to beep and some blood drops were definitely enough. I practiced on my self. I found the angle I held it at was the problem. Smokey has dark ears with long hair in them. I could never find the sweet spot as shown in the picture someone posted above. I get blood from middle of ear where the vet showed me. Once I corrected these I have no problems. Having a cat that cooperates is very important and my Smokey just lies down for me. I can not for any reason use one ear. It just won't bleed and Smokey does fight me on that ear. Maybe these tips will help.
 
Hi, Trish - Wow, you've had quite the day! Just popping in to say hang in there - we all have great faith in you ... and bless your heart, you're so determined. I KNOW you'll get there with this ear-poking business!:bighug: - Robin
 
@Trish J Try testing when Kismet is sleeping/relaxed. Be sure to use lots of praises and have a low carb treat handy. I used to have to chase after CJ but now she sits and waits to be poked! I sing to her before I poke and that calms us both. You will find what works for you and Kismet. It will get easier!
 
Hi @Squalliesmom @Robin&BB @woodsywife and @Cat Ma, at some point soon I'll learn how to do more of those emot0-thingies, but for now: xxxxxxx :) Thanks for all the great tips. I have an Accucheck glucometer, btw, it's supposed to need a miniscule amount of blood, which was one of the reasons I chose it and on recommendation from other good folk around here. Even the vet struggles getting blood out of the fluffy one. But on my next try, definitely going to try the other ear and maybe I'll sing to her too, I like to think she enjoys my little nonsensical songs for her, but haven't done that while testing, so TY for that too @Cat Ma ! :) She gets treats for her insulin, for exercising and my sorry BG attempts. :)

Can I ask another question? I did the Ketodiastix urine test tonight about two hours before her insulin shot. It tested very high like the other day when her Caninsulin failed, yet she's been much better overall since being on the new bottle. My vet told me to feed her little and often and she had a small meal just before this. Should I avoid feeding her at any point in the insulin cycle or is this likely just the Caninsulin dropping off? She seems to start yowling for food around 10 hours after the first insulin injection and her tray is always fuller in the morning, though it seems to be a lot less during the day. She's on a high protein/very low carb diet, so I don't even understand how she's producing so much glucose!

Any thoughts or good links much appreciated. :) xxx
 
I'm not well-versed in diabetic ketoacidosis, but if you're seeing a "very high" readout from a ketone test, it's my understanding that Kismet should see a vet right away, because you don't want DKA to develop. How many days ago did you get that other high reading?
 
@Robin&BB ....I don't think she's talking about the ketone measurement....the Ketodistix urine strips also measure for glucose and I think that's what she's talking about by measuring "very high", but you're correct....if you're measuring for ketones, anything over a "trace" is a medical emergency

@Trish J Without going back through all your posts, has anyone given you the list of low carb Foods available in the UK? I see Kismet has a cereal allergy, but generally, low carb is also going to be low on any types of grains

I totally understand you're having lots of problems with testing, but I know you'll get there!!

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

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

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

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) 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!

By desensitizing him to having his ears fooled with and having him associate a special spot with food, maybe it'll really help get those REAL tests in!
 
Robin&BB said:
I'm not well-versed in diabetic ketoacidosis, but if you're seeing a "very high" readout from a ketone test, it's my understanding that Kismet should see a vet right away, because you don't want DKA to develop. How many days ago did you get that other high reading?
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Hi Robin, Thanks for your quick reply and concern. The Ketone part of the test stick is negative thankfully! :) The KetoDiastix do both glucose and ketones. It's the glucose that is high 10 hours after her insulin. As far as I understand it, she shouldn't have any glucose in her urine if she is regulated?

I know it's early days and she isn't fully regulated yet... also that the urine test isn't as good as the home BG! Can't help wondering whethera high reading 10 hours after her insulin means that the Caninsulin loses effectiveness way too early and whether free feeding her might be responsible.?!

Regards, Trish J
 
Chris & China said:
@Robin&BB ....I don't think she's talking about the ketone measurement....the Ketodistix urine strips also measure for glucose and I think that's what she's talking about by measuring "very high", but you're correct....if you're measuring for ketones, anything over a "trace" is a medical emergency

@Trish J Without going back through all your posts, has anyone given you the list of low carb Foods available in the UK? I see Kismet has a cereal allergy, but generally, low carb is also going to be low on any types of grains
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Hi @Chris & China,
Yes I've read through that UK Low Carb list - it's been really useful thanks. :) and you're right Kismet is grain-free because she was vomiting everytime we fed her anything containing grains. Unfortunately I realise now a lot of the grain-free foods may have still been High Carb. :(

Because she had an awful attack of Pancreatitis and wouldn't eat for three days around the time she was diagnosed, I took the decision to move her straight on to High Protein very Low Carb wet food. I don;t see why that would cause any glucose rise, but wondering if the free-feeding the vet suggested has an effect on her insulin. I know food and insulin are related, I just can't get my head around how exactly! :)

The Home BG probs I think are simply down to a mix of her thick skin and wriggling and my stress unnerving her! I'm determined to get there, but taking a break on attempts for a few days in order to calm both of us down. I also have the `Kitty Crack' Thrive treats she goes insane for - they are eating through my bank overdraft as fast as she eats them ;) xxx
 
Trish J said:
Hi Robin, Thanks for your quick reply and concern. The Ketone part of the test stick is negative thankfully! :) The KetoDiastix do both glucose and ketones. It's the glucose that is high 10 hours after her insulin. As far as I understand it, she shouldn't have any glucose in her urine if she is regulated?

I know it's early days and she isn't fully regulated yet... also that the urine test isn't as good as the home BG! Can't help wondering whethera high reading 10 hours after her insulin means that the Caninsulin loses effectiveness way too early and whether free feeding her might be responsible.?!

Regards, Trish J
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Hi Trish. In my brief experience with Vetsulin (Caninsulin) I have found that, for Squallie, it does tend to lose some effectiveness around 10 hours. I can't speak to the free-feeding; all my cats were free-fed until Squallie was diagnosed, at which point I changed over to regulated feedings, and also began weaning them off dry food (What a challenge, I can't believe we've come so far!). I make sure Squallie gets snacks when his BG starts to drop, he always lets me know, lol.

What kind of food is she eating when you free-feed?
 
Squalliesmom said:
Hi Trish. In my brief experience with Vetsulin (Caninsulin) I have found that, for Squallie, it does tend to lose some effectiveness around 10 hours. I can't speak to the free-feeding; all my cats were free-fed until Squallie was diagnosed, at which point I changed over to regulated feedings, and also began weaning them off dry food (What a challenge, I can't believe we've come so far!). I make sure Squallie gets snacks when his BG starts to drop, he always lets me know, lol.

What kind of food is she eating when you free-feed?
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Hiya Lucy, :)

That's interesting, does Squallie still `drop off' on Caninsulin even if he's regulated? Were you advised to regulate his food post-diagnosis, or did you have another reason for changing from free-feeding?

I'm feeding Kismet a mix of Thrive Complete wet food - very expensive and virtually all meat and broth! - and home-cooked rabbit/chicken stew with lots of added broth and cat-nutrients like taurine, B vits, bonemeal/calcium (I've ordered some Fellini feline nutrients to ensure it's as complete as any processed cat food). Also a few Thrive treats which are just dehydrated meat/fish. Apart from a bit of fat there's no actual starchy carbs in her diet now.

Previous to her pancreatitis she ate the only grain-free wet food in the supermarket along with grain free kibble. Afterwards she refused both, perhaps becuase of the nausea assocation.

My vet - who admits she isn't experienced with feline diabetes - told me to feed her little and often and just add protein to tinned cat food with tuna and sardines. I've always been under the impression too much fish isn't so good for cats though! I'm now wondering whether free-feeding is affecting the insulin, or whether this is just the way Caninsulin works - it makes me nervous though!
 
There is an FDMB guide on using Vetsulin/Caninsulin here. Thought you might find it helpful to read over. One of the important notes is to allow some time after eating before you shoot.
 
Hi @BJM, sorry for the delay in reply, but thanks for pointing me to that Caninsulin link. Very helpful and somewhat reassuring, as I've almost instinctually been using a lot of the recommendations given and also explains the ongoing problems we've been having. Appt at vet's today for Fructosamine Blood Test and I will discuss whether Caninsulin is the best option for her. Regards, Trish
 
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