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Elizabeth and Bertie said:
Some folks prefer to use the lancet 'freehand', and some prefer to use the lancet in the lancing device.
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Because of my anxiety disorders I have very shaky hands. I put the lancet into the device because I find it less difficult to control with my shakes but I freehand the actual poke instead of clicking the pokey button thing.


Mogs
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Hi Becka, just a quick wave hi from another Uker (near Elizabeth in Surrey) - wanted to say that you're doing really really well and do stick with it as it deffo gets easier with time and when you're confused, just come here and post about anything whatsoever... no question ever too small or too "silly"...
Best of luck!

Diana
 
Diana&Tom said:
Hi Becka, just a quick wave hi from another Uker (near Elizabeth in Surrey) - wanted to say that you're doing really really well and do stick with it as it deffo gets easier with time and when you're confused, just come here and post about anything whatsoever... no question ever too small or too "silly"...
Best of luck!

Diana
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Thanks, I'm glad to hear that it does get better. We had a routine. She is an antisocial kitty and only really sees me in the evenings so for me to be watching her and never giving her a moments rest she must be really stressed out. I can't wait until I can give her the insulin and have some confidence that when I leave her she won't hypo. She is freaked out by me being home so much and it is ruining her usual 'me time'. I'll be glad when I can leave her alone for a bit and things settle.
 
Sounds like a good plan.

If she is bouncing just so you know the bounce may last up to 3 days (6cycles), but Every Cat is Different (ECID) some kitties will bounce more than others, and some cats will have bounces that will last longer than others.

:)
 
Gill & George said:
Sounds like a good plan.

If she is bouncing just so you know the bounce may last up to 3 days (6cycles), but Every Cat is Different (ECID) some kitties will bounce more than others, and some cats will have bounces that will last longer than others.

:)
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I am meant to be going on holiday to NY on 22nd of this month. Do you think I will manage to get her to a place where she can go to the vet run cattery in the next two weeks?
 
Lily-Fish said:
I am meant to be going on holiday to NY on 22nd of this month. Do you think I will manage to get her to a place where she can go to the vet run cattery in the next two weeks?
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If only we had a crystal ball.

We've had to leave George with a very competent friend a couple of times, the first time was about 4 weeks after diagnosis and starting lantus and just about when he started to look like he was on the move with his numbers, we gave him a reduction prior to going away so that he would run higher as my friend would not be monitoring him as regularly. only amps +5 pmps and before bed. We also decided, with the help of the folk here on a no shoot number. When we came back we got right back onto his regular dose.

I know this may be more complicated for you to figure out with Lily's recent DKA, but there are very experienced people on this board who will be able to offer some sensible advice I am sure.

A lot can change in the next two weeks, try not to think ahead too much (pot calling kettle black here), the experienced folk here will help you with making a decision that you can feel comfortable with.

You should try to find out prior to boarding her, how often they would be testing her, how will they handle the 12 hour dosing (I had a problem with my regular cattery who wouldn't be able to do the 12hour dosing), will they be willing to feed her the Low carb food you leave. I wouldn't assume anything even though it's vet run cattery. I wrote a set of notes for my friend so that she would have something to refer to.

Sorry no answers there, but you will be able to figure something out:)
 
Gill & George said:
If only we had a crystal ball.

We've had to leave George with a very competent friend a couple of times, the first time was about 4 weeks after diagnosis and starting lantus and just about when he started to look like he was on the move with his numbers, we gave him a reduction prior to going away so that he would run higher as my friend would not be monitoring him as regularly. only amps +5 pmps and before bed. We also decided, with the help of the folk here on a no shoot number. When we came back we got right back onto his regular dose.

I know this may be more complicated for you to figure out with Lily's recent DKA, but there are very experienced people on this board who will be able to offer some sensible advice I am sure.

A lot can change in the next two weeks, try not to think ahead too much (pot calling kettle black here), the experienced folk here will help you with making a decision that you can feel comfortable with.

You should try to find out prior to boarding her, how often they would be testing her, how will they handle the 12 hour dosing (I had a problem with my regular cattery who wouldn't be able to do the 12hour dosing), will they be willing to feed her the Low carb food you leave. I wouldn't assume anything even though it's vet run cattery. I wrote a set of notes for my friend so that she would have something to refer to.

Sorry no answers there, but you will be able to figure something out:)
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Thanks for your answer! I will go to the cattery tomorrow to have a good chat with them. I hope they will be testing. That is the reason I chose them. I could just go for a dose reduction (although she is already on a stupidly low amount and I don't know how they'll fine dose).

As with all things, it'll work out in the end.
 
Critter Mom said:
I am wondering with Lily's very, very recent DKA history whether the moderate carbs plus an appropriate dose of insulin might actually be more beneficial as a treatment strategy in the short term?
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Since there has been DKA and multiple hospitalizations, I personally would use this approach in order to further the recovery. During DKA episodes, often there is a HUGE weight loss, and really, the cat remains at a higher risk for episodes until that weight is regained (and then some usually). Underweight cats' livers have a harder time compensating when blood sugar goes low, and you'll tend to see high pre-shots and very low nadirs (brittle diabetes). If you reduce the insulin for a brittle diabetic, you can run into all sorts of issues (hepatic lipidosis, DKA, infections, further weight loss, poor appetite). The better solution is to feed a slightly higher carb/higher cal food and give enough insulin to cover that food, and aim for flat curves, resolution of symptoms, and weight gain. Only then should the goals be to reduce carbs in the diet and seek remission.

Also, make sure you are feeding the right amount of food. A common trigger for DKA is malnutrition, whether from poor appetite or from unintentionally feeding the cat too few calories.
 
Meya14 said:
Since there has been DKA and multiple hospitalizations, I personally would use this approach in order to further the recovery. During DKA episodes, often there is a HUGE weight loss, and really, the cat remains at a higher risk for episodes until that weight is regained (and then some usually). Underweight cats' livers have a harder time compensating when blood sugar goes low, and you'll tend to see high pre-shots and very low nadirs (brittle diabetes). If you reduce the insulin for a brittle diabetic, you can run into all sorts of issues (hepatic lipidosis, DKA, infections, further weight loss, poor appetite). The better solution is to feed a slightly higher carb/higher cal food and give enough insulin to cover that food, and aim for flat curves, resolution of symptoms, and weight gain. Only then should the goals be to reduce carbs in the diet and seek remission.

Also, make sure you are feeding the right amount of food. A common trigger for DKA is malnutrition, whether from poor appetite or from unintentionally feeding the cat too few calories.
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What would you recommend I feed? A higher carb pate/wet food? I don't even know how many calories she needs to gain weight safely.
She is literally doing exactly what you're saying (High pre shot, very low nadirs) I will try to feed her moderate carb food. I can see she is putting on weight now, thank goodness. She seems much happier. I have given a reduction this evening due to such a low +3 this AM.
 
I would start with a moderate carb wet food (~10% carbs). The calorie intake will depend on your cat's size and activity level, but most cats need anywhere from 200-300 cal/day. If I'm remembering right, your cat is a forest cat? So because this breed should be on the larger side, I would aim for 300 cals/day until her weight is such that you cannot see the ribs, or feel them too much. The calories is sometimes listed on the cans. Most 5.5oz pates have 150-180ish calories, so that's 1.5-2 cans a day. If this is an increase in her current intake, don't be surprised if her BS goes back up, just increase the insulin to account for it, and monitor carefully.
 
Meya14 said:
During DKA episodes, often there is a HUGE weight loss, and really, the cat remains at a higher risk for episodes until that weight is regained (and then some usually). Underweight cats' livers have a harder time compensating when blood sugar goes low, and you'll tend to see high pre-shots and very low nadirs (brittle diabetes). If you reduce the insulin for a brittle diabetic, you can run into all sorts of issues (hepatic lipidosis, DKA, infections, further weight loss, poor appetite). The better solution is to feed a slightly higher carb/higher cal food and give enough insulin to cover that food, and aim for flat curves, resolution of symptoms, and weight gain.
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Could the above also be applicable to a diabetic cat recovering from surgery, Meya, especially where there's inappetence? I'm thinking about Saoirse. She's eating better now that she's got support back via ondansetron, her UTI issues improved with administration of d-mannose, and her ketone levels have improved accordingly (0.1mmol/L AM and PM for several days) but she did lose a lot of weight in the period following her op (down from 10.6lb to c. 9lb). I've got her back on her normal low carb food (1.6%) but I'm giving her extra to help her regain the weight she lost (about 33% more than she would normally get for maintenance). Over the last number of days I've managed to get her back to 0.25IU Lantus BID and her numbers have improved (sitting just above the top of the euglycaemic range with a couple of dips into the normal range yesterday and today).


Mogs
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Any time there is a sudden weight loss, the brain is going to adjust the pituitary to prevent further loss. The amount of cortisol and other hormones that allow sugar to be released from fat stores is reduced. This can start to be a self perpetuating cycle at times, as appetite can be reduced, and low hormone levels (thyroid, cortisol, insulin, etc) can hinder weight gain. Increasing insulin (and food to cover), can help gain the weigh back, and perhaps normalize pituitary functioning.

In your case, wound healing does much better when blood sugars are in the normal range. Infections are much more common with higher sugars. So it would be a fine line between regaining the weight and keeping blood sugar stable. Of course, too much insulin can lead the opposite direction - obesity.
 
Lily-Fish said:
She has bounced a little but I have given her the 0.25 u and will get a +3 (This seems to be when she drops)
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Your comment here jumped out at me - can you go back and reread what Marje said about testing at +1, 2, 3? The reason Marje is suggesting testing early in the cycle is to PREVENT the fast drop by +3. It would be better for you to prevent her from landing in the 40's or 30's by feeding her, instead of letting her drop that low and THEN feeding her to bring her up. Does that make sense?

One reason is simply for safety, to keep her in safer numbers. The second reason is that if a cat's blood sugar drops too quickly it can cause a bounce to occur. How fast is too fast depends on the cat - most cats will react to more than a 50 point drop in an hour. So if you see (by testing) that she is dropping quickly, you can intervene with food to slow her down. Preventing fast drops helps prevent the subsequent high bounce, which flattens out the cycle overall.

Also, I'm noticing Lily's bounces are not lasting long at all. So at this point you can't assume that just because she's bounced high that she will stay high for any length of time.

As far as your vacation, in the world of feline diabetes, 2 weeks is a very long time. Lots can change in that time. Can you post on the Lantus/Lev group a day or two before your vacation begins and let us suggest a vacation dose for her? It will help us suggest something better if we know if someone there will be testing her blood sugar at the cattery, and how often. Just preshots? any tests in between the shots?
 
julie & punkin (ga) said:
Your comment here jumped out at me - can you go back and reread what Marje said about testing at +1, 2, 3? The reason Marje is suggesting testing early in the cycle is to PREVENT the fast drop by +3. It would be better for you to prevent her from landing in the 40's or 30's by feeding her, instead of letting her drop that low and THEN feeding her to bring her up. Does that make sense?

One reason is simply for safety, to keep her in safer numbers. The second reason is that if a cat's blood sugar drops too quickly it can cause a bounce to occur. How fast is too fast depends on the cat - most cats will react to more than a 50 point drop in an hour. So if you see (by testing) that she is dropping quickly, you can intervene with food to slow her down. Preventing fast drops helps prevent the subsequent high bounce, which flattens out the cycle overall.

Also, I'm noticing Lily's bounces are not lasting long at all. So at this point you can't assume that just because she's bounced high that she will stay high for any length of time.

As far as your vacation, in the world of feline diabetes, 2 weeks is a very long time. Lots can change in that time. Can you post on the Lantus/Lev group a day or two before your vacation begins and let us suggest a vacation dose for her? It will help us suggest something better if we know if someone there will be testing her blood sugar at the cattery, and how often. Just preshots? any tests in between the shots?
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Hey,

Many thanks for the detailed reply. you make a good point about ensuring that the cat surf a flat curve rather than drop and have to be helped up.

I believe I will be gone 11 days, I booked this before her diagnosis and may have not done so if I had known. I am going to go visit the cattery today to discuss what's what. I think she will need to run a little high for ten days as I'm not sure she will be tested all that often. I want her tested at least at pre shot and mid cycle.
 
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