Just diagnosed Cat hides

Status
Not open for further replies.
S

SMJK1229

Member Since 2016
I can try to hide the needle, but when I start to try to tent his skin, he takes off under the bed. I am alone & can't stop him. He squirmed the very first time (yesterday) & I was unable to get the meds in. I don't know what to do.
 
Don't panic. I put Noah in the same place every day, his favorite bed on the stairs, and will usually just comfort him and then walk away for a few minutes so he doesn't equate every visit to getting poked. With another cat we had to put the box-spring right on the floor because there was no way we could reach him and drag him out. I also don't hide things from him. He can see what's there so it doesn't look so ominous. That's just one cat. I know it's hard at the beginning. I've heard that rubbing a cats ears (what you'll have to do anyways to stimulate blood flow) releases endorphins in a cat. It can only get better, good luck from all of us.
 
Can you block the bed so he can't get under it? Also, several times a day take him to the spot where you shoot, but don't shoot, just pet or brush, whatever he likes and give a treat then let him go. You may also try shooting while he's eating. Always take a deep breath and relax too, he can feel your nerves. As woodsywife suggested, post in the main health forum and you'll get lots more suggestions and details.
 
SMJK1229 said:
I can try to hide the needle, but when I start to try to tent his skin, he takes off under the bed. I am alone & can't stop him. He squirmed the very first time (yesterday) & I was unable to get the meds in. I don't know what to do.
Click to expand...
Please can you let us know as soon as possible:

1. Which insulin is your cat receiving, and what is the current dose?

2. How long has your cat been receiving this insulin?

3. Are you home testing your cat's blood glucose levels?

4. Have you made any changes to your cat's diet recently? (If yes, please provide names of the foods - carb values too, if you have them.)

5. Is this hiding a recent behaviour change? (i.e. your cat was initially OK receiving the injections but is now trying to avoid them).


Mogs
.
 
Critter Mom said:
Please can you let us know as soon as possible:

1. Which insulin is your cat receiving, and what is the current dose?
ProZinc 2 units once daily

2. How long has your cat been receiving this insulin?
First dose was at the vet this week...I have been unable to give him one at home.
3. Are you home testing your cat's blood glucose levels?
Not home testing

4. Have you made any changes to your cat's diet recently? (If yes, please provide names of the foods - carb values too, if you have them.)

He has been eating Friskies poultry platter pate & vet wanted me to try Purina DM. He had pancreatitis on October 28 & his glucose was 169 at that time. Emergency vet said that was probably due to stress. He has always urinated a lot, but had started drinking more. And I noticed blood in urine, so I took him to the vet right away. His glucose was 303 (vet said at that time it was probably pancreatitis induced diabetes) & the vet gave me 10 days to try the different food to see if his numbers would get better. I didn't hold out much hope since he hasn't had dry food for over 8 years. He did also eat Friskies Shreds before the diagnosis though (not anything but Friskies poultry platter & DM now). Anyway, this week we did the fasting test & he was at 291. So she started him on the 2 units once a day. He seemed to feel worse that day & I'm wondering if that was too much?

5. Is this hiding a recent behaviour change? (i.e. your cat was initially OK receiving the injections but is now trying to avoid them). Just started trying to inject him.


Mogs
.
Click to expand...
 
@Critter Mom
SMJK1229 replied to your questions above.
I know it's hard and frustrating and worrying and seemingly impossible at first, but it does get better.:bighug: Keep posting and we'll keep helping you.
What is your name and what is your cat's name? Kitties are creatures of habit and they do get used to the whole process. Hang in there.
I am home alone too, and do everything by myself. It was scary at first, but became easier and easier. Does your kitty like freeze dried all meat cat treats or any kind of all meat treat (human all meat without any spices, included)?
 

Members following: I've extracted SMJK1229's answers and tried to summarise below.

History ------------------------------------------------------------------------------------------------------------

- 28 October 2016 - ER Visit: BG=169 (attributed to stress by ER vet);
- ER Vet Dx: Pancreatitis.

- Interim: Increased thirst and urination after this. Also blood in urine. Consulted vet immediately.

- Vet consult: BG=303; Dx pancreatitis-induced diabetes.
- Vet Rx: Feed Purina DM canned (dry?) for 10 days to see if diet change would be enough for remission.

- 27 December 2016 - Vet checkup: Fasting BG=291 at vets (after diet switch trial).
- Vet Rx: Prozinc 2IU SID (once a day). First dose administered at vet. (ETA - NO CURVE RUN!)

- Response to first dose Prozinc: Cat's clinical signs appeared worse after dose admin. ("seemed to feel worse that day - wondering if dose too much?")

- Current Status: Unable to give insulin at home since vet visit (cat runs and hides).

- Home BG Monitoring: Not yet home testing.


Diet ------------------------------------------------------------------------------------------------------

- Pre-FD diagnosis: Friskies Poultry Platter paté; Friskies Shreds.

- 10-day diet switch trial: Purina DM canned. (dry??? - "I didn't hold out much hope since he hasn't had dry food for over 8 years.)

- Current diet: Friskies Poultry Platter paté; Purina DM canned. (dry???).

.
 
Last edited:
@SMJK1229 -

Thank you very much for sending us the above information. We can fully understand how worried and frustrated that you must be feeling at the moment. :bighug:

I have a couple of other questions (sorry! - just trying to get a better picture of what's happened/happening in the hope that we will be able to suggest something to help you.)

- Is it Purina DM dry food that your vet prescribed for your kitty? (Or is it canned DM?)

Very important

- Did your vet run a glucose curve at the office after giving the dose of Prozinc? Or did he just do the BG spot check?

- After your kitty was given the dose of Prozinc by the vet please can you tell us what your kitty was/wasn't doing or how he looked to make you worried that he was feeling worse after receiving the insulin. (Any details you can think of will be a help.)

- How many hours after the insulin dose was given did your kitty look worse?

- Did he seem to feel better later that day? If yes, how many hours after the dose did he start to look/feel better?

- How is he looking/acting today?


Mogs
.
 
Last edited:
I'm sorry...it's the canned DM. I didn't hold out much hope of his numbers getting much better because I knew he was already on a lower carb diet. The first thing the vet said was "no dry", which of course he hasn't had in over 8 years anyway. He's 10 years old.

No glucose curve at vet. Just spot check & gave 2 units at around 10:30am on 12/27. We went home & I figured Tink would be really ready to eat since he had been fasting since 10pm the night before. He ate some & a little through out the day, but not much. Finally, at 4am (next day) he was really ready to eat. He just didn't seem like he felt well & didn't purr or get on me when I sat down (his usual self) up until that point. It was almost like how he seemed when he was recovering from pancreatitis.

I gave him the Friskies poultry platter the next day after the first insulin shot (12/28) & he seems like his old self right now.
 
Hi @SMJK1229 -

I've been mulling over your situation all evening and I think the best thing for you is to go to the vets in the morning (don't delay - can't stress this enough!)

I suggest you explain to your vet:

- that you are concerned about how your kitty reacted to the first dose of insulin (he felt worse - tell the vet the signs that made you think this.)

- that you have not been able to administer your kitty's insulin at home (cat running away and hiding).

- that you are very worried that the dose of insulin your kitty received might have been too high.

I recommend that you bring a urine sample with you and ask the vet to check it for ketones (your kitty has not had any insulin and has had pancreatitis and a urinary tract problem recently so this is really important). You should only need a small amount of urine for this. Here are some tips on how to collect a sample for testing:
https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub
https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

(By the way it is good practice to monitor regularly for ketones at home. I suggest you pick up some ketone test strips (e.g. Keto-diastix) from Walmart or any other pharmacy tomorrow. You can read about the importance of ketone testing in this forum sticky.)

STARTING DOSE FOR PROZINC

Prozinc is normally dosed at 12-hour intervals, not once every 24 hours. (According to the manufacturers each dose lasts c. 10-14 hours, depending on the cat.) Also 2 units is quite a high starting dose for this insulin. Below I have provided you with some information to help you in your discussions with your vet.

Here are the starting dose recommendations and administration instructions for Prozinc insulin from the manufacturer's product leaflet:

- The initial recommended ProZinc dose is 0.1 - 0.3 IU insulin/pound of [lean] body weight (0.2 - 0.7 IU/kg) every 12 hours.

- The dose should be given concurrently with or right after a meal.

- The veterinarian should re-evaluate the cat at appropriate intervals and adjust the dose based on both clinical signs and glucose nadirs until adequate glycemic control has been attained.

(Note: An average cat is c. 10lb at ideal (lean) body weight. For a cat of this weight the starting dose for Prozinc as recommended by the manufacturer would be 1.0 units every 12 hours.)


FDMB has developed a protocol for the use of Prozinc, which recommends a starting dose of 0.5 - 1.0 units per cat.

I hope this helps you. I strongly recommend you get an appointment to see your vet tomorrow. Please let us know how you get on and shout when you need more help.


Mogs
.
 
Last edited:
Nigel&Noah said:
Don't panic. I put Noah in the same place every day, his favorite bed on the stairs, and will usually just comfort him and then walk away for a few minutes so he doesn't equate every visit to getting poked. With another cat we had to put the box-spring right on the floor because there was no way we could reach him and drag him out. I also don't hide things from him. He can see what's there so it doesn't look so ominous. That's just one cat. I know it's hard at the beginning. I've heard that rubbing a cats ears (what you'll have to do anyways to stimulate blood flow) releases endorphins in a cat. It can only get better, good luck from all of us.
Click to expand...
Thank you for your help.
 
Sharon14 said:
Can you block the bed so he can't get under it? Also, several times a day take him to the spot where you shoot, but don't shoot, just pet or brush, whatever he likes and give a treat then let him go. You may also try shooting while he's eating. Always take a deep breath and relax too, he can feel your nerves. As woodsywife suggested, post in the main health forum and you'll get lots more suggestions and details.
Click to expand...
Thank you for your advice.
 
Dyana said:
@Critter Mom
SMJK1229 replied to your questions above.
I know it's hard and frustrating and worrying and seemingly impossible at first, but it does get better.:bighug: Keep posting and we'll keep helping you.
What is your name and what is your cat's name? Kitties are creatures of habit and they do get used to the whole process. Hang in there.
I am home alone too, and do everything by myself. It was scary at first, but became easier and easier. Does your kitty like freeze dried all meat cat treats or any kind of all meat treat (human all meat without any spices, included)?
Click to expand...
Thank you for your help. I'm Stephanie and my cat is Tink. He only really eats his canned food. I haven't seen the freeze dried treats. I'm assuming they have them at Petco, etc. And I could try, but I'm scared to have him try anything new right now.
 
Crosspost! Thanks again for posting the info, Stephanie. :)

SMJK1229 said:
I'm sorry...it's the canned DM.
Click to expand...
Purina DM canned is under 10% kcal from carbs so it's definitely in the right carb range for a feline diabetic. Since Tink has remained in diabetic numbers over the 10-day food trial and the days since it is important to start insulin in order to prevent any diabetic complications. It is also very important to establish his ketone status as soon as possible (see earlier post).

More shortly ...


Mogs
.
 
Critter Mom said:
Hi @SMJK1229 -

I've been mulling over your situation all evening and I think the best thing for you is to go to the vets in the morning (don't delay - can't stress this enough!)

I suggest you explain to your vet:

- that you are concerned about how your kitty reacted to the first dose of insulin (he felt worse - tell the vet the signs that made you think this.)

- that you have not been able to administer your kitty's insulin at home (cat running away and hiding).

- that you are very worried that the dose of insulin your kitty received might have been too high.

I recommend that you bring a urine sample with you and ask the vet to check it for ketones (your kitty has not had any insulin and has had pancreatitis and a urinary tract problem recently so this is really important). You should only need a small amount of urine for this. Here are some tips on how to collect a sample for testing:
https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

(By the way it is good practice to monitor regularly for ketones at home. I suggest you pick up some ketone test strips (e.g. Keto-diastix) from Walmart or any other pharmacy tomorrow. You can read about the importance of ketone testing in this forum sticky.)

STARTING DOSE FOR PROZINC

Prozinc is normally dosed at 12-hour intervals, not once every 24 hours. (According to the manufacturers each dose lasts c. 10-14 hours, depending on the cat.) Also 2 units is quite a high starting dose for this insulin. Below I have provided you with some information to help you in your discussions with your vet.

Here are the starting dose recommendations and administration instructions for Prozinc insulin from the manufacturer's product leaflet:

- The initial recommended ProZinc dose is 0.1 - 0.3 IU insulin/pound of [lean] body weight (0.2 - 0.7 IU/kg) every 12 hours.

- The dose should be given concurrently with or right after a meal.

- The veterinarian should re-evaluate the cat at appropriate intervals and adjust the dose based on both clinical signs and glucose nadirs until adequate glycemic control has been attained.

(Note: An average cat is about c. 10lb at ideal (lean) body weight. For a cat of this weight the starting dose for Prozinc as recommended by the manufacturer would be 1.0 units every 12 hours.)


FDMB has developed a protocol for the use of Prozinc, which recommends a starting dose of 0.5 - 1.0 units per cat.

I hope this helps you. I strongly recommend you get an appointment to see your vet tomorrow. Please let us know how you get on and shout when you need more help.


Mogs
.
Click to expand...
Thank you for all of this information and help. I don't know if the vet started the dosage at once daily because of Tink's usual feeding. His history: he swallowed a needle & had it surgically removed in 2008. The needle had been in him for at least 3 months. I had no idea. Anyway, after that I researched & got him off dry food to make sure he had the best nutrition. He has never been a cat to eat a lot at once. At most, he eats like a tablespoon at a time. In the morning I try to feed him several times in the hours before work. As soon as I get home I start feeding again. I also get up several times a night to feed him (just like a baby). I told the vet this. I was worried he wouldn't ever eat enough at one sitting for a regular insulin shot. The vet asked about his activity level. I think he's more active at night than when I'm at work. He's 15lbs right now (he lost over a pound in the 10 days when he was just on Purina DM canned...I think he didn't eat enough of it). I'm not sure if I should switch vets. I did explain my concerns on how he reacted to the first shot & the vet was not very receptive. She just said she thought we could get him regulated.
 
You're very welcome, Stephanie.

I'm really sorry to hear about the needle! Poor Tink. :bighug:
No glucose curve at vet. Just spot check & gave 2 units at around 10:30am on 12/27.
Click to expand...
This is becoming more concerning to me. (As far as I understand it the vet did not run a fructosamine test either - and made no recommendation for home BG monitoring.)

The normal procedure for diagnosing diabetes is to:

- assess clinical signs and perform physical exam.
- test blood glucose (may be elevated by vet/travel stress).
- test for glucose in urine (not affected by temporary stressors).
- blood test to determine fructosamine level (guide to average BG levels over a period of about a fortnight - again, not influenced by stress and a better guide as to whether the kitty is truly diabetic).
- check for signs of other illness/inflammation which may elevate BG (e.g. gingivitis, periodontal disease, urinary tract problems)
- other appropriate diagnostics to rule in/out other health issues.

BTW did your vet diagnose and treat the cause of the blood in Tink's urine?

(I'm assuming it has been treated but, if not, it needs resolving plus the issue could be affecting BG levels - and they might improve when the UT problem is treated.)

When starting insulin:

- the starting dose is calculated for the particular insulin (see previous post for Prozinc info). Prozinc is intended to be dosed every 12 hours.- glucose curves should be run to determine whether the dose is safe. (Most people have the first curve run at the vets but it is possible to do at home if home testing.)
- the starting dose is held for a number of days (typically a week - unless signs of hypoglycaemia appear and the dose needs to be reduced) and then the kitty should be curved again to determine dose duration and efficacy. Based on curve data dose may need to be adjusted.

(Ideally the kitty should be home tested throughout treatment before each insulin dose and at least once a day mid-cycle to check how low the dose is taking BG levels. Curves run in the home environment provide better data for determination of dose adjustments because they will not be influenced by vet/travel stress.)

SMJK1229 said:
I don't know if the vet started the dosage at once daily because of Tink's usual feeding. [...] He has never been a cat to eat a lot at once. At most, he eats like a tablespoon at a time. In the morning I try to feed him several times in the hours before work. As soon as I get home I start feeding again. I also get up several times a night to feed him (just like a baby). I told the vet this. I was worried he wouldn't ever eat enough at one sitting for a regular insulin shot.
Click to expand...

If 15lb is Tink's ideal weight the starting dose should have been a maximum of 1.5 units Prozinc per manufacturer recommendations (see earlier post). If Tink is overweight the starting dose should be determined based on his ideal (lean) bodyweight.

If there is a question mark over food intake then a more conservative starting dose would have been indicated. The concern over food intake made it even more critical to run curves during start of treatment to make sure Tink didn't go too low on the starting dose (and ideally home monitor BG).


Mogs
.
 
12/27/16
10:00AM - Preshot BG = 291 (after 12-hour fast)
Dose: 2.0IU Prozinc
Food: Ate a little around dose time and grazed a little throughout day. Clinical signs resemblant of recovering from pancreatitis. (Lethargy? Poor mood & sociability.)

12/28/16
04:00AM - +14 hours after dose administration - Tink "really ready to eat".
Later in day: Clinical signs better and back to "old self" on 12/30/16.

SMJK1229 said:
I did explain my concerns on how he reacted to the first shot & the vet was not very receptive. She just said she thought we could get him regulated.
Click to expand...
Another matter for real concern. Cats may become a bit lethargic at start of treatment until their bodies get used to the 'foreign' insulin but what you're describing sounds more pronounced. (I'm familiar with clinical signs of a cat with pancreatitis.)

One thing which caught my eye was your comment about Tink being "really ready to eat" at 4am after the first dose of Prozinc. If Tink showed signs of unusually strong hunger then it is possible that either his blood glucose levels had dropped too far or that they might have shot up higher. Some cats get more hungry at high BG levels but unusually strong hunger more commonly tends to be a sign of hypoglycaemia. If Tink showed signs of abnormally strong appetite I think your vet should have been concerned about this.

The other big flag here is that Tink ran from the next insulin injection. I've seen in my own cat and also read about other cats here objections by the cat to being injected again if the insulin makes them feel really bad. I wonder whether that might be the case with Tink? If he hasn't overreacted to getting other injections in the past I would worry that the hiding behaviour could potentially hint at the dose being too high.

SMJK1229 said:
I'm not sure if I should switch vets.
Click to expand...
The vet did get the 'no dry food' and the low carb, wet food part right but I have serious concerns about the following:

- The starting dose is quite high for a newly-diagnosed cat (higher than manufacturer recommendation).
- Single dose per day is highly unusual and is not the way that Prozinc is intended to work.
- NO CURVE(S) to determine whether dose is safe.
- No recommendation to run glucose curve at home.
- Dismissal of concerning clinical signs after first dose of insulin administered.

- No mention I can see of fructosamine or ketone tests being carried out either at time of Dx or at follow-up visit after food switch.

If it were me, I'd be vet shopping. However, for the time being I strongly recommend you get Tink seem by a vet tomorrow, Saturday (even the current vet if you can't get a consult elsewhere tomorrow). Ketone status needs to be established; also BG level. If appropriate and safe BG-wise ask the vet to give Tink a reduced or token dose of Prozinc at the office (see earlier post for dosing guidelines) so that he'll at least get some insulin. (For information: If Tink were to be positive for ketones he may need to stay with the vet to flush them.)

If insulin is given and the vet can't run a curve tomorrow I strongly recommend you swing by Walmarts and grab a glucometer (Relion Confirm and Micro are very popular here: small sample size and affordable test strips), plus lancets (28 or 29 gauge) and an adequate supply of test strips. If you don't have Vaseline or neosporin ointment at home that's a good thing to add to the testing kit because it makes sampling easier. We have tutorial materials here to help you learn to test (it will give you much more peace of mind) and we can give you lots more advice and help on this via the board. (Note: human glucometers need a cat-specific reference range - more on that when the time comes but cat BG should not go below 50 on a human meter.) We can give you support via the board to run a curve at home. We can help you with injection technique, etc., too.

When you are picking up supplies, make sure you include the items recommended in the Hypo Tool Kit.

Hope that's enough for you to go on for now, Steph. I'm in the UK so I need to head off very shortly. Keep posting with your questions; there are members across all time zones in the US.

Be sure to post an update tomorrow. I get the sense that you're really worried. You're not on your own with this; we'll do all we can to help Tink and yourself.

:bighug:


Mogs
.
 
Last edited:
Critter Mom said:
12/27/16
10:00AM - Preshot BG = 291 (after 12-hour fast)
Dose: 2.0IU Prozinc
Food: Ate a little around dose time and grazed a little throughout day. Clinical signs resemblant of recovering from pancreatitis. (Lethargy? Poor mood & sociability.)

12/28/16
04:00AM - +14 hours after dose administration - Tink "really ready to eat".
Later in day: Clinical signs better and back to "old self" on 12/30/16.


Another matter for real concern. Cats may become a bit lethargic at start of treatment until their bodies get used to the 'foreign' insulin but what you're describing sounds more pronounced. (I'm familiar with clinical signs of a cat with pancreatitis.)

One thing which caught my eye was your comment about Tink being "really ready to eat" at 4am after the first dose of Prozinc. If Tink showed signs of unusually strong hunger then it is possible that either his blood glucose levels had dropped too far or that they might have shot up higher. Some cats get more hungry at high BG levels but unusually strong hunger more commonly tends to be a sign of hypoglycaemia. If Tink showed signs of abnormally strong appetite I think your vet should have been concerned about this.

The other big flag here is that Tink ran from the next insulin injection. I've seen in my own cat and also read about other cats here objections by the cat to being injected again if the insulin makes them feel really bad. I wonder whether that might be the case with Tink? If he hasn't overreacted to getting other injections in the past I would worry that the hiding behaviour could potentially hint at the dose being too high.


The vet did get the 'no dry food' and the low carb, wet food part right but I have serious concerns about the following:

- The starting dose is quite high for a newly-diagnosed cat (higher than manufacturer recommendation).
- Single dose per day is highly unusual and is not the way that Prozinc is intended to work.
- NO CURVE(S) to determine whether dose is safe.
- No recommendation to run glucose curve at home.
- Dismissal of concerning clinical signs after first dose of insulin administered.

- No mention I can see of fructosamine or ketone tests being carried out either at time of Dx or at follow-up visit after food switch.

If it were me, I'd be vet shopping. However, for the time being I strongly recommend you get Tink seem by a vet tomorrow, Saturday (even the current vet if you can't get a consult elsewhere tomorrow). Ketone status needs to be established; also BG level. If appropriate and safe BG-wise ask the vet to give Tink a reduced or token dose of Prozinc at the office (see earlier post for dosing guidelines) so that he'll at least get some insulin. (For information: If Tink were to be positive for ketones he may need to stay with the vet to flush them.)

If insulin is given and the vet can't run a curve tomorrow I strongly recommend you swing by Walmarts and grab a glucometer (Relion Confirm and Micro are very popular here: small sample size and affordable test strips), plus lancets (28 or 29 gauge) and an adequate supply of test strips. If you don't have Vaseline or neosporin ointment at home that's a good thing to add to the testing kit because it makes sampling easier. We have tutorial materials here to help you learn to test (it will give you much more peace of mind) and we can give you lots more advice and help on this via the board. (Note: human glucometers need a cat-specific reference range - more on that when the time comes but cat BG should not go below 50 on a human meter.) We can give you support via the board to run a curve at home. We can help you with injection technique, etc., too.

When you are picking up supplies, make sure you include the items recommended in the Hypo Tool Kit.

Hope that's enough for you to go on for now, Steph. I'm in the UK so I need to head off very shortly. Keep posting with your questions; there are members across all time zones in the US.

Be sure to post an update tomorrow. I get the sense that you're really worried. You're not on your own with this; we'll do all we can to help Tink and yourself.

:bighug:


Mogs
.
Click to expand...
I really appreciate all your work on this & advice. I don't think I can get Tink in to another vet tomorrow since most vets close early on Saturday. I am wondering how much the vet stress affects his numbers. I do know the first time he tested at 303, I could see him get more & more stressed in the waiting room. When he had pancreatitis & the emergency vet wanted to admit him because of low food intake & fear of fatty liver, I brought him home because I knew from past experience Tink would only shut down at the vet. I was the only one who could get him to eat after his surgery in 2008 (I would go to the vet's office & feed him). Anyway, like I said, I wonder how much his numbers might be affected by the vet & I guess the home testing would be the best way to figure that out. Thank you again.
 
Hi Stephanie,

I can fully relate to the worries over pancreatitis, HL, and whether or not your kitty will eat. (Been there - not easy.) :bighug:

Re vet stress, there's no way of knowing for certain how much Tink's BG might be elevated by vet/travel stress without home BG readings to compare vet readings with. That said, I've seen estimates here that the elevation may be by around 100 points but it's not safe to assume that this applies to Tink. The only way to know what his BG is at home is to test him in the home environment. If, for the sake of argument, Tink's BG did read 100 points higher at vet then he'd still be c. 200 at home (lab values) and that's outside the normal BG range (lab normal reference range is approximately 70-150).

PRIORITY TODAY

Get Tink seen by any local vet if at all possible in the morning for BG and urine ketone tests (bring urine sample), emphasise concern over 2IU dose reaction and cat hiding when you tried to give injection and, if Tink needs it, get vet to give SOME insulin (ask for a much reduced dose if the vet can't curve him today.) For info - if ketone test turns positive make sure vet does thorough exam to help identify and treat infection/other illness which may be triggering ketone production. (For info: If positive result for ketones, Tink would definitely need treatment by a vet today - see below).

Get supplies for home testing: (
- urine test strips for checking ketones and ideally glucose, e.g. Keto-diastix. (Even if you were to get nothing else, make sure you get these.)
- human glucometer, e.g.Walmart Relion Micro or Confirm meter.
- plenty of test strips for meter.
- 28 0r 29 gauge lancets.
- neosporin ointment (not the cream) or Vaseline.

Get supplies for hypo toolkit:
- see Hypo Toolkit Link

* * TEST TINK FOR KETONES TODAY * * (A very important precaution!)
- Are you testing your kitty for ketones?
- Catching and testing a urine sample.

For information (not to scare!) if a cat starts producing ketones it can progress to DKA (a serious complication of diabetes - which needs hospital treatment by a vet). Prompt treatment of ketones is key.

Procedure is to test & check result. If test is positive and trace, contact a vet straight away for advice on what to do next (be sure to tell about NO insulin and also generally small appetite). If test is positive and any higher than trace then you need to immediately get cat to vet/ER for emergency treatment to flush out the ketones; and also to identify and treat any infection/other illness which may be contributing to ketone production.

Keep posting your questions and asking for help here.


Mogs
.
 
Last edited:
Educational links for home testing to help you get started (and be sure to post to ask for help with the practicalities!):

Home testing links and tips

Testing and injection tips (has very helpful diagram of testing 'sweet spot' on the ear).

Even if you can't get Tink to a vet this morning, provided you get testing supplies today you'll be able to start getting spot checks immediately to see what Tink's BG levels are at home. (NB: normal reference range for cat blood glucose level measured on a human meter is 50-120mg/dL.)

You need to get Tink's diabetic status and insulin situation sorted out ASAP. Assuming that his insulin treatment will need to continue at home, here is a very helpful video about teaching a cat to accept injections:



You might need to use treats instead of food, bearing in mind Tink's small appetite.

NOTE: If Tink still tries to hide or run from injections, never ignore it and tell your treating vet ASAP (hopefully a more responsive one). Learning to home test will take an awful lot of guesswork out of insulin treatment and will give you much greater peace of mind that Tink is safe.

It would be great if you could give us an update later to let us know how you're getting on. Always let us know when you need help.

:bighug:


Mogs
.
 
Thank again for all of your advice. We went to the vet this morning. He tested at 342, but this was after eating. I just wanted to see. I talked to the vet about reducing the dosage & she agreed to it. And going to twice a day at 1 Unit. I got the ketone test strips & need to go later to get the glucometer. I want to stay close to him right now though.
 
SMJK1229 said:
Thank again for all of your advice. We went to the vet this morning. He tested at 342, but this was after eating. I just wanted to see. I talked to the vet about reducing the dosage & she agreed to it. And going to twice a day at 1 Unit. I got the ketone test strips & need to go later to get the glucometer. I want to stay close to him right now though.
Click to expand...
Hi Stephanie,

Thank you for the update. I'm glad that the vet could fit you in this morning. I'm also glad to hear that you got support from the vet to reduce the dose and switch to dosing twice a day.

Did the vet give Tink any insulin this morning?

When you have your snuggle with Tink, please give him a fuss or two from me. :)


Mogs
.
 
Critter Mom said:
Hi Stephanie,

Thank you for the update. I'm glad that the vet could fit you in this morning. I'm also glad to hear that you got support from the vet to reduce the dose and switch to dosing twice a day.

Did the vet give Tink any insulin this morning?

When you have your snuggle with Tink, please give him a fuss or two from me. :)


Mogs
.
Click to expand...

Yes, he got 1 Unit at 11:00am, so I told her I wasn't comfortable doing anymore today. I want to try to get on a 6:00 dosing schedule.
I love the term 'fuss'...I give him plenty! Thank you.
 
I'm unsure what to do this morning. Tink had the 1 unit dose yesterday at 11am. I was unable to find a glucometer last night. Tink ate this morning & just about 40 minutes ago (he eats such small helpings). Should I give him 1 Unit or hold off until tonight so I can get him on 6:00 dosing schedule & test him prior to eating? I will go hunting for the glucometer today. And I haven't caught any urine to test for ketones yet...I'm either outside with the dogs, asleep or not here when he goes to the litter box. He also seems a little restless this morning, which might be constipation (he's had this before). Thank you for any recommendations.
 
Hi again, Stephanie.

Thanks for the update. I'm glad that Tink got some insulin yesterday.

I'm sorry I didn't reply to your question about giving insulin earlier today; I've only just seen your post. If you haven't given any insulin this morning and want to get onto your 6am/6pm dosing schedule then that's OK.

Re ketone testing, there's a link in one of my earlier posts (#22) giving tips on how to catch a urine sample. The easiest thing to try when you can't supervise the litter box is to put a double thickness of plastic food wrap over one of the 'favourite' spots in the box. It should collect enough of a sample for you to do a ketone test. A good idea is to monitor Tink at mealtimes as cats often go to the loo just after they have eaten.

Re the agitation (or any unusual behaviour) it will help if you keep observations like this in a little notebook. It is very helpful to note how many hours it is after the insulin dose you make the observations so that you'll be able to spot any patterns which might exist.

Have you been able to get a glucometer and test supplies today? Also the syrup/food with gravy/etc. in the hypo toolkit list?

We all understand how overwhelming all of this is in the early days but if you can get home testing quickly it will give you so much more peace of mind because through the meter Tink will be able to 'speak' to you to tell you what his insulin needs are - and you'll be able to keep him safe. Home testing really does take away so much worry about giving our kitties their insulin. :)

I don't know whether you've had time to look at the home testing links above yet. The recommended drill is:

1. Make sure Tink has no access to food for 2 hours before test due.

2. Do a preshot BG test (AMPS - morning reading; PMPS - evening reading.)

3. Feed Tink to make sure he has some food on board before getting the insulin.

4. Administer the insulin dose.

5. Test again at 2 hour intervals if running a glucose curve, or during time when lowest BG level (nadir) is typically expected for Prozinc (see guide below).

6. It is recommended to get both preshot tests and at least one mid-cycle test each day. (We have a useful spreadsheet you can use to track Tink's data. More on this later.)


Forum sticky - Guide to Using Prozinc

Be sure to post with any questions you have and for any help you'd like. :)


Mogs
.
 
Critter Mom said:
Hi again, Stephanie.

Thanks for the update. I'm glad that Tink got some insulin yesterday.

I'm sorry I didn't reply to your question about giving insulin earlier today; I've only just seen your post. If you haven't given any insulin this morning and want to get onto your 6am/6pm dosing schedule then that's OK.

Re ketone testing, there's a link in one of my earlier posts (#22) giving tips on how to catch a urine sample. The easiest thing to try when you can't supervise the litter box is to put a double thickness of plastic food wrap over one of the 'favourite' spots in the box. It should collect enough of a sample for you to do a ketone test. A good idea is to monitor Tink at mealtimes as cats often go to the loo just after they have eaten.

Re the agitation (or any unusual behaviour) it will help if you keep observations like this in a little notebook. It is very helpful to note how many hours it is after the insulin dose you make the observations so that you'll be able to spot any patterns which might exist.

Have you been able to get a glucometer and test supplies today? Also the syrup/food with gravy/etc. in the hypo toolkit list?

We all understand how overwhelming all of this is in the early days but if you can get home testing quickly it will give you so much more peace of mind because through the meter Tink will be able to 'speak' to you to tell you what his insulin needs are - and you'll be able to keep him safe. Home testing really does take away so much worry about giving our kitties their insulin. :)

I don't know whether you've had time to look at the home testing links above yet. The recommended drill is:

1. Make sure Tink has no access to food for 2 hours before test due.

2. Do a preshot BG test (AMPS - morning reading; PMPS - evening reading.)

3. Feed Tink to make sure he has some food on board before getting the insulin.

4. Administer the insulin dose.

5. Test again at 2 hour intervals if running a glucose curve, or during time when lowest BG level (nadir) is typically expected for Prozinc (see guide below).

6. It is recommended to get both preshot tests and at least one mid-cycle test each day. (We have a useful spreadsheet you can use to track Tink's data. More on this later.)


Forum sticky - Guide to Using Prozinc

Be sure to post with any questions you have and for any help you'd like. :)


Mogs
.
Click to expand...
I cannot get any blood from his ear. The vet also had a problem getting his ear to bleed & went further down than the diagram shows. I've tried 3 times. He's getting more upset & I don't know if I'll be able to give him the insulin if I try more.
 
He always gets a treat whether the test is high or low or successful or not. Give him a break for about 20 minutes. Take a big breath, relax, talk to him, sing to him, whatever it take, and try again. It is hard and frustrating at first. You and he will get the hang of this. Relax, and hang in there.
 
Hi Stephanie,

What are you using to warm Tink's ear? Also for how long are you warming the ear? (It can take much longer than you might think when first starting to test - but it does get quicker and easier with repeated attempts.)

If you use a little rice sock and massage the ear for about 20-30 seconds or so it can really help blood to flow to the test sweet spot. Perhaps try just doing the warming without trying to poke so that Tink gets familiar and comfortable with the ear warming - and give him a treat after? Make it a time for attention and fussing first, then start doing the ear poke. :)

SMJK1229 said:
The vet also had a problem getting his ear to bleed & went further down than the diagram shows
Click to expand...
I've seen vet nurses trying to do the same and they had major problems trying to get a sample from Saoirse. It is much, much harder to get a sample further down the ear.


Mogs
.
 
Are you firmly backing up the ear where you are piercing? If not the the ear will tend to deflect vice being penetrated by the lancet.
 
Dyana said:
He always gets a treat whether the test is high or low or successful or not. Give him a break for about 20 minutes. Take a big breath, relax, talk to him, sing to him, whatever it take, and try again. It is hard and frustrating at first. You and he will get the hang of this. Relax, and hang in there.
Click to expand...
Dyana said:
He always gets a treat whether the test is high or low or successful or not. Give him a break for about 20 minutes. Take a big breath, relax, talk to him, sing to him, whatever it take, and try again. It is hard and frustrating at first. You and he will get the hang of this. Relax, and hang in there.
Click to expand...
Thank you for the advice. I wish I could coax him to do anything with treats, but he is only food motivated by his canned food. I give him as much petting & loving to soothe him, but I know he was about to steer clear of me if I attempted again.
 
Critter Mom said:
Hi Stephanie,

What are you using to warm Tink's ear? Also for how long are you warming the ear? (It can take much longer than you might think when first starting to test - but it does get quicker and easier with repeated attempts.)

If you use a little rice sock and massage the ear for about 20-30 seconds or so it can really help blood to flow to the test sweet spot. Perhaps try just doing the warming without trying to poke so that Tink gets familiar and comfortable with the ear warming - and give him a treat after? Make it a time for attention and fussing first, then start doing the ear poke. :)


I've seen vet nurses trying to do the same and they had major problems trying to get a sample from Saoirse. It is much, much harder to get a sample further down the ear.


Mogs
.
Click to expand...
Hi, we sat in front of the heater for a good long time & his ears were quite warm to the touch. I kept rubbing them (which I do normally) to get the blood flowing & keep him happy. The vet attempted higher on the ear several times in front of me & couldn't get the ear to bleed. When she moved further down was when she was able to get a sample more easily. I don't think I can keep him still enough to do that & I feel like that would also hurt him more.

At this point is it better to get the 1 Unit in & try to test for ketones? I understand the importance of home testing & will continue to try, but if it takes a while, should I go ahead & give the insulin? Thank you for your help.
 
Hi again, Stephanie.

Checking in to ask how things are going with yourself and Tink. Is there anything we can help with?


Mogs
.
 
Try singing to him. Tink doesn't care if you can carry a tune or not nor does he care what you sing. Singing forces you to use a different part of your brain that will distract you from being nervous yourself. If you are nervous, your kitty will sense this and then become scared and nervous himself.

Another suggestion is don't plop kitty down, test, shoot, and be done with it. Offer him some food he likes or a few minutes of petting before you poke him with anything. Don't make the time just about his diabetes. Do something he enjoys in addition to doing the stuff he'd rather you not do.
 
Status
Not open for further replies.
Back
Top