Shorty, first at home shot

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Shorty

Shorty

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We just gave Shorty his first shot at home. Here is a kind of, quick recap of what has happened.

6/29 - blood lab test at vets (not expecting diabetes) - 359
Glucose found in urine. Ketones present.
Given 1 Unit PZI
6/30 - AM AlphaTrak at vet - 341.
6/30 Given 2 Unit PZI in AM
6/30 Alphatrak blood curve at vet:
299
272
397
408
450
6/30 Given 2 Unit PZI in PM
7/1 AM AlphaTrak at vet - 444
7/1 Given 2 unit PZI in AM
7/1 Alphatrak blood curve at vet
374
324
212
243
228
7/1 given 2 unit PZI in PM

7/2 AM AlphaTrak at vet - 493
7/2 AM - Given 2 unit PZI in AM.

Brought home.

As for the times of the tests and shots, I do not know.

I am noticing a definate change in Shorty, since his behavior initially bringing him home, and now since his first shot at home. When first brought home, he just wanted to wander around, and then hide. After his shot a 9, 2 hours ago, he is interacting with us, coming up and being his more normal self. He is also being more picky about his water source, to the point of ignoring the water bowl the other cats use. I keep finding him in the tub, licking the dripping faucet, instead of drinking brand new fresh water bowls. But, he's always been a little weird like that with water bowls.
 
Glad Shorty is feeling some better tonight. Since he showed ketones it is important that you test his urine regularly with ketone test strips. It's also important to start home testing his glucose. That's the best way to keep him safe and find out how well the insulin is working. You got some good data from Shortys vet stay, if you set up a spreadsheet and plug those numbers in adding any new data you collect, it will help you, your vet and us to see what's going on.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help setting it up, just ask and someone will help. It's a little quiet this weekend due to the holidays, but @Sue and Oliver (GA) and @Rachel will be along to help with any questions you have.
 
Well, I had been worried about home testing, not on mine or Shorty's sake, but with arguing with the vet about it. But, the Vet who had been attending Shorty (we took him to a clinic with multiple vets).... she ran out after me and double checked everything before I left, and it turns out her dog is diabetic too. She wants us to bring him in, here in a week or so for a fasting blood sugar check. Also, some kind of lab check that would show a history of blood sugars....

I feel much more comfortable now, knowing that the vet that has been working on Shorty's case, has a diabetic at home. I feel it will make her much more approachable about home testing and regulation.
 
Sharon14 said:
Glad Shorty is feeling some better tonight. Since he showed ketones it is important that you test his urine regularly with ketone test strips. It's also important to start home testing his glucose. That's the best way to keep him safe and find out how well the insulin is working. You got some good data from Shortys vet stay, if you set up a spreadsheet and plug those numbers in adding any new data you collect, it will help you, your vet and us to see what's going on.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
If you need help setting it up, just ask and someone will help. It's a little quiet this weekend due to the holidays, but @Sue and Oliver (GA) and @Rachel will be along to help with any questions you have.
Click to expand...

Well, we don't have a home meter yet. I'm happy, with 2 units twice a day at the moment, it's low considering that he hit mid 450's in his initial testing.
 
Hello! Glad to hear that Shorty seems to be feeling all right.

Sound like the vet wants to do a fructosamine. I'll tell you we never had one done. What that test is is an average of the BG levels over the last few weeks. It can be misleading since it might say that the BG is in the 200 range, but that could be because he's getting 500s preshot and lower numbers...like in the 100s during the day (this may not be accurate math...I'm NOT a math girl!). Basically, if you're home testing, there is no need to worry about that test.

My vet mentioned home testing in passing, but I just started and didn't tell her. When I went for a rehceck a few weeks in, I brought my spreadsheet along. That seemed to convince her I knew what was up, and she let me do what I needed from then on!

As Sharon said, the ketones mean it is VERY important to check for them at home. Do you have ketostix? Did the vet check for them again before you left?
 
Just some notes:
- A blood ketone meter will pick up ketones sooner than urine testing, so if your cat has had ketones, getting this kind of meter will alert you to the need for vet intervention sooner.
- Vet stress may raise the glucose 100-180 mg/dL according to one research study done.
- Changing the food to low carb from high carb may drop the glucose 100-220 mg/dL and drop the insulin dose 1-2 units, according to reports here, thus the importance of home testing if changing food carbohydrate levels while giving insulin.
 
I agree. It would be wise to get some ketone strips so you can keep track of ketones since he had ketones. With Oliver, we had to put him in a room by himself with a clean box filled with aquarium gravel (that wouldn't absorb the urine). He'd be compelled to christen the new box and would urinate. Then we'd swoop in and get our sample.

And yes, I would definitely home test. You do not need your vet's permission. You are Shorty's first and best advocate and you need to keep him safe. One of my concerns is that often numbers from the vet can be inflated by 100+ points because of vet stress. If you subtract 100 from the vet numbers, he is not terribly high. It would be really good to get some levels at home and see how the insulin is working.

We have taught hundreds of people how to test at home. We'd be happy to teach you.
 
Sorry, busy couple of days. Glad you guys are following up on us! :)

Picked up a glucometer today. I went with the Walmart ReliOn Confirm. Reading the instructions now and watching videos on ear sticks.

@Rachel - yeah, that's what she had said. Fructosamine. I'm already having my doubts on that, as Kelly's first two attempts at giving Shorty his insulin resulted in him getting fur shots. So I'm already looking at the fact that his insulin hasn't been consistent.

Also, in regard to ketones, they tested twice a day, and he was negative everytime except for the test during his initial diagnosis. The vet said she was even surprised at how quickly they disappeared. It isn't on the chart that they sent home, but I made sure I grabbed the clipboard with everyone's notes on it and read it too, and every k test was negative. Somehow, getting the test for ketones slipped my mind today. I was more concerned with getting the glucometer, because of our work schedules, there may be times were one of us has to come home on our lunch break to test and shoot.

Shorty, for sure, seems to be urinating less. I had my first panic moment sometime yesterday, when he just looked TOO peaceful sleeping, and then when I shook him he didn't move or respond. But I picked him up and set him on his feet, and he looked at me like "Really? REALLY? I had just gotten comfortable"... and he wandered off to nibble, drink, and then to find a sunny spot on the back of the couch.

I'll start his spreadsheet tonight, with a PM pre-shot test. Is it better to feed first, test, then shoot? Or test first, feed, then shoot?

Dan
 
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Test first, then feed then shoot- if the test number was high enough. Under 200 stall, don't feed and post here for help.
 
@Sharon14 Thanks. Looking at Colin's SS, I am wondering (especially since you say do not copy dosing), is that high dosage typical with Levemir?
 
No, Colin has a condition called acromegaly, a tumor on his pituitary that is causing his diabetes. Acrocats often need large amounts of insulin to overcome the excess growth hormone excreted by the pituitary.
 
Kelly got a good ear stick. I couldn't get blood from the ear at first, and tried his right rear foot pad. Got blood, but not enough. We let him settle down a few minutes, and Kelly got a fantastic ear stick on her first try. 445. After the test, he ate .5 oz of the DM wet food before he was happy. Good shot, 2 units PZI. No fur shot. He is now munching on the DM dry. For sure, a calm kitty.

Dan
 
Yep the testing gets easier as you go. The cat gets used to it too and that makes it much easier.
 
A tip, if the blood (in the first weeks) doesn't come out enough, get a towel or something like that, put some warm water on it and let it cool until it's nice 'warm' that you can touch it and it doesn't feel hot and put that against Shorty's ear for 10-15 seconds and then you can stick him, that way more blood comes out and you 'spare' shorty the second or third time sticking ;)
Later on, after a couple of weeks you don't need to do that anymore because the ears (i think) are used to it and more blood comes out by itself.
 
Well, this morning didn't go as easily. I still couldn't get any blood from his ear, and then Kelly hit the vein, or pretty close to it. Bloody mess. I think next time I'll try just holding a lancet instead of using the pen. His BG was 450 this morning.
 
The pen is harder in the beginning because you don't really know where you are sticking it.. But i've always used it, you'll get the hang of it!
 
I think we've all hit the vein before. Stick the needle very close to the edge of the ear and milk the ear, working from the base up toward the poke spot.
 
Well, his +3 test was an even worse disaster. He's got one ear that has a tear from years ago, right through the sweet spot, so we can't hit it as often. That was the one we used last night. After hitting the vein in his good ear this morning, we decided to try for a paw sample. Couldn't even get blood, even though you could see the pricks. Kelly finally got a little out, but it ended up not being a full sample. Shorty is noticing that Mommy and Daddy are a little nervous with taking the samples. It's spooking him a little. But he's not running off and hiding either, he's just skiddish through the process.
 
They can definitely sense your nerves and frustration. Take a deep breath before you try next time. Make sure his ear is warm, I rub Colin's ear vigorously first, others use a baby sock filled with rice and warmed in the microwave. I had trouble in the beginning too, I promise it will get easier!
 
Heating definitely helps, as Sharon said. Also a 25-27 gauge lancet (called alternate site lancets) can help at first. Sometimes the 30-31 gauge humans use are too thin. Also, if you get blood, you can put it in your fingernail and test from there.

Hope you can get a number in the 5-7 range.

What is he eating?
 
Sue and Oliver (GA) said:
Heating definitely helps, as Sharon said. Also a 25-27 gauge lancet (called alternate site lancets) can help at first. Sometimes the 30-31 gauge humans use are too thin. Also, if you get blood, you can put it in your fingernail and test from there.

Hope you can get a number in the 5-7 range.

What is he eating?
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The last few days, we've been putting down 1/4 cup of DM Dry for him, twice a day, and supplementing with however much DM wet he will eat before his shot. Once we can get used to testing him, I plan on transitioning to a full wet diet, for him and for the other two cats too. After doing some reading and research, I think that's best. If I would have done that reading and research a few years ago when Sarge, who underwent urethral blockages several times in his life, and switched to wet food then, we might not even be having this problem.
 
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Food can make a huge difference. In our Oliver, he dropped 100 points overnight from his usual preshot number when we switched from dry to wet. But yes, you want to have a safe transition. It's important that he eat. Have you seen this site by a vet: www.catinfo.org. She has great tips on transitioning from dry to wet.

Lots of cats aren't excited about Purina DM wet. It is liver based and they seem to tire of the taste. And its ingredients are no better than pet store food. There's nothing "prescription" about it except the price.
 
Sue and Oliver (GA) said:
Food can make a huge difference. In our Oliver, he dropped 100 points overnight from his usual preshot number when we switched from dry to wet. But yes, you want to have a safe transition. It's important that he eat. Have you seen this site by a vet: www.catinfo.org. She has great tips on transitioning from dry to wet.

Lots of cats aren't excited about Purina DM wet. It is liver based and they seem to tire of the taste. And its ingredients are no better than pet store food. There's nothing "prescription" about it except the price.
Click to expand...

I actually have her P/F/C chart bookmarked, and have been looking through it at the various foods. I'm surprised I haven't seen a lot of people talking about Tiki Cat, or Hounds and Gatos on here. Have those been debunked or discredited? According to the chart, they've got amazingly low carbs.

http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf
 
I think people feed Tiki Cat pretty regularly. Have to admit I haven't seen much about Hounds and Gatos. I shopPetSmart and PetCo and haven't seen either there. One caveat- feed fish only once or twice a week. Too much Mercury for daily feeding.
 
Ok, +7 test went ok. Took both of us though. I skipped the pen, and hand lanced his "gimp" ear. I used Mark and Buddy's technique (
).... got a good sample without him bleeding like a stuck pig. He tested at 313.

And I usually try to avoid feeding a fish based food except for special occasions. I prefer chicken or turkey usually. No particular reason why for the cat's reason, but I can't personally stand seafood, so the less of it in the house, the better. lol
 
So he dropped some. The early high number can be food related - especially if high carb is in the picture.

Great job getting data. You can use it to keep him in safe numbers and refine your dose, once you have a few cycles worth.
 
We've all hit the vein before! It happens.

A suggestion: when trying to get blood, try 3 times, then take a break. Give a treat, walk away for 5 minutes, then come back and try again. They can definitely sense our stress. It does get easier as the ears "learn to bleed". I don't remember the science to it, but over time, the ear bleeds easier because of more capillaries (or something like that lol). I noticed with Gypsy, after a few weeks, it was super easy to get blood. Until then, I usually did 2 quick pricks, right next to each other, to try to help get enough.

You'll get this! Keep trying...before you know it, it will be routine.
 
Kelly's turn to try to test. We used the sock with rice in it trick. Don't know if she hit the vein again, but it was a good sized drop. His PMPS was 369! He had managed to sneak some food while we were gone at around +9.5, but it was some of the other cats wet food. After his test, he ate .2 oz of the wet DM, then gave 2 units. We've been looking and researching wet foods. Went to the store and picked up a few of the lower carb options that we could find at Petsmart and Petco, to start checking which flavors might be big hits. Made sure not to get any seafood varieties for this. We got:
Friskies Classic Pate (Turkey & Giblets, Mixed Grill, Poultry Platter, Supreme Supper, and Liver and Chicken)
Nature's Valley Instinct (Lamb, Duck, Rabbit, Chicken)
Natural Balance Stew (Catatouille)
Fancy Feasts Classics (Chicken Feast, Tender Beef and Chicken, Tender Beef, Turkey Giblet)

In the long run, we'll probably pick up some Tiki Cats too, according to the website, their is a vet in town that carries it.

We do have a partial case of Fancy Feasts Gravy Lovers that we will slowly get rid up with the two healthier cats too. But I surely don't want to give Shorty a wet food with 20% carbs in it.

Dan
 
You may want to save a few of the Gravy Lovers. It's a great way to raise Shorty's blood sugar if he were to ever go too low. Most of us keep a few cans of it around, just in case. The Friskies mixed grill, at 11 carbs, is a little higher in carbs than the other flavors, maybe give that to your other kitties.
 
Save a few of the gravy lovers for your hypo kit. If he drops low, a teaspoons of gravy can be very helpful raising the levels when you need it.

Great minds think alike, Sharon.:p
 
I feed Tiki Cat to one of my 3 diabetics. Fancy Feast didn't agree with him so I had to find something else. He loves it. I only buy the ones without fish. I found the best price on PetFlow, they frequently send email coupons for 10-20% off which helps. If you have PetSupplies Plus in your area they carry it in the store, or at least mine does. I think the Tiki Cat site has a store locator.
 
Kelly has gotten rapidly better at testing. She has gotten to where she can solo test and get a perfect blood drop the first try usually, suddenly. I'm almost jealous. His readings are still high pre-shot, but we are still adjusting the feeding a little. We finally were able to get some Ketone testing strips, the local Wal-marts had been out, got a batch from Walgreens tonight.
 
Well, I can now see what everyone says, the ears get better and used to bleeding. I just did a solo test, and not only was Shorty more allowing to "abusing" his ears, but he bled a perfect sample on the first hit. We've been a little more radical with changing the food than I initially planned. It was getting just too hard to keep the other two cats out of his intended 1/2 cup a day of Dry DM.... so all the dry food got put up. Cats are just getting fed at shot time now. No more dry "kibble" left out while we are home and able to watch and monitor. If we need to leave somewhere, we'll either put down a little wet (non-gravy lovers type), or maybe a little dry DM.
 
Nice! Those are some nice yellows, and I'm glad testing is getting easier! Removing the dry food will probably help you get some lower numbers.
 
I think we're going to start shooting 2.5, if he keeps going higher for his pre-shot tests. We've been restricting food better between shots, even though we've got two other cats who seem to be going bat-ass bonkers over their new diet. But, his next shot is in two hours, and he's already back up to 475.
 
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Today is the first day in the date range I told the vet we may be in for the fructasomine, I don't think we've been consistent enough in his feeding, and for sure with the fur shots on Sunday, to consider it yet. We just managed to get Keto stix last night, the first time we went to get them, both Walmart and Walgreens were out. (?!? Really? Yup, Really!). I figure I'm gonna follow him around with a pair of tongs and a test strip, unless he decides to pee on the couch again, at least then it'll be easier to know it's his urine and not one of the other cats.
 
Good job on testing! If you're removing dry food it's probably wise not to increase Shorty's dose just yet. You might want to wait 3 or more cycles to see how his numbers respond to the lower carb intake. His numbers already seemed to be responding better last night without an increase. It can take some time for their bodies to start efficiently using insulin.
 
I follow Colin around with a little plastic cup:rolleyes:-the kind you get condiments in at fast food restaurants- he's used to it now.
 
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