New to diabetes; Not me, but the dumb cat

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jbfrank

jbfrank

Member Since 2017
I'm a long term diabetic and been on insulin for over fifty years. Buddy (the cat) was officially diagnosed yesterday, although I was aware of the signs and had tested his glucose level the day before.

Buddy was an outdoor feral whom I fed for five or six years before we moved almost three years ago. When my wife TOLD me that we were moving, I informed her that Buddy and Alby (his outdoor partner) were coming with us. We currently have five cats and a dog.

So right now I'm just trying to get Buddy stabilized and finding that it's a lot easier to test my own blood sugar than Buddy's. The vet got him started on NPH (mostly because I think that is what she's comfortable with), but I am hoping that ProZinc will be in our future.
 
Hi there and welcome! I'm so sorry to hear about Buddy's diagnosis, but your experience with human diabetes will definitely help. There are certainly differences, but you'll learn those quickly enough!

Can you tell us a little more about what's difficult with testing Buddy? Does he take off and hide? Bite? Just hard to get the blood out? We have lots of tips and tricks since there are so many ways cats respond to all of this. I have a semi-feral kitty as well, so I'm happy to help in any way I can!
 
Hi...and thanks for the welcome. Buddy is not too bad about the testing, but the problem is that I'm having a difficult time bringing the blood out. I'll poke him a couple of times before I piss him off and then he just gets up and walks away. But after a couple of minutes he'll come back and we start over.

I have not tried warming his ear yet, but will give it a try within the hour. I'm hoping that will help. The only real time that it seemed to put him in discomfort was when I used a 27 ga lancet instead of the 30 ga one that I use for myself. I've also been pricking his ear with the freehand technique because when I first tried it I used the lancet device with no luck.

I've actually got three ferals right now (along with the two regular house cats), and I'm kind of lucky that Buddy is the diabetic since he's the only one that I'm sure that I'd be able to manage.
 
Warming the ear should definitely help. And try to stay as relaxed as possible. Most of us get into a routine which involves a little treat (for both human and cat!) after the testing process, so everyone comes to associate it with something positive.
Good luck!
 
It sounds like you're doing a great job so far! And glad to hear that Buddy is being so cooperative!

The warming thing will likely help a lot, depending on your house. I live in Seattle, and the cold makes it so Sam's ears won't give up anything if I don't warm them first. I hold the rice sock on his ear for at least 30-40 seconds first. Of course, he won't let me do that all at once, so it's about ten seconds at a time, then he shakes me off, another ten seconds, head shake again...until his ear feels warm.

The 27 gauge will help at first, although it does hurt a bit more. Their ears to "learn" to bleed, and then the smaller gauge works, but in the early days, most people have better luck with the fatter lancet. If he doesn't tolerate it though, then it's certainly possible to go with the 30.

Also, this diagram shows where exactly to get the easiest sample:
upload_2017-4-8_11-44-33.jpeg


You can poke other places, but the "sweet spot" bleeds the easiest. Keep us posted on how it's going!
 
PS It also helps to give them a treat. Sounds like Buddy is being cooperative regardless, but I just feel better giving my cat something nice after stabbing him. ;)

It speaks highly of you that you can gain the trust of those feral kitties! They can be a handful!
 
I didn't know they made 27 gauge... I thought it was 26 or 28. Maybe moving to the 28 gauge would be more comfortable for him. And aim for the sweet Spot like in the diagram as hitting the vein hurts more. You're doing great.
 
JanetNJ said:
I didn't know they made 27 gauge
Click to expand...

Ha ha...they probably don't. I just looked on the box and it's 26 gauge. They're from WalMart and I was looking for the fattest ones that they carried.

Djamila said:
Also, this diagram shows where exactly to get the easiest sample:
upload_2017-4-8_11-44-33-jpeg.27458
Click to expand...

Thanks for the diagram. I was unaware that there were those capillaries on the top of the ear ('sweet spot'). I've been poking a bit lower and apparently missing anything that would draw blood. On a positive note, I bumbled my way through another attempt and Buddy's blood sugar was down to 226 (been just under 500 for the past three days). But the time that I took it also corresponds to the nadir of the NPH so it will be curious to see what it is tonight.

Djamila said:
It speaks highly of you that you can gain the trust of those feral kitties! They can be a handful!
Click to expand...

Thanks, but I can't take that much credit. Among the three ferals, I have the trust of 1 1/2 of them. I've always been able to handle Buddy, even when he was living outdoors. Trixie, who I've had the longest of the three, trusts me pretty much in so far as I can pick her up and put her on my lap, but she does have her limitations. Alby, who was Buddy's outdoor partner, still keeps her distance from me...usually. When she thinks that I'm not looking at her, she'll get relatively close.
 
Djamila said:
It speaks highly of you that you can gain the trust of those feral kitties!
Click to expand...

Ha ha, the kitties have always seemed to like me and I've never had a problem with them. Women, on the other hand, are a completely different story. It took me over forty years to find my wife. She is more of a dog person (Coco is our Westie), but does love our cats...while I am like that only in reverse.
 
jbfrank said:
Ha ha...they probably don't. I just looked on the box and it's 26 gauge. They're from WalMart and I was looking for the fattest ones that they carried.



Thanks for the diagram. I was unaware that there were those capillaries on the top of the ear ('sweet spot'). I've been poking a bit lower and apparently missing anything that would draw blood. On a positive note, I bumbled my way through another attempt and Buddy's blood sugar was down to 226 (been just under 500 for the past three days). But the time that I took it also corresponds to the nadir of the NPH so it will be curious to see what it is tonight.



Thanks, but I can't take that much credit. Among the three ferals, I have the trust of 1 1/2 of them. I've always been able to handle Buddy, even when he was living outdoors. Trixie, who I've had the longest of the three, trusts me pretty much in so far as I can pick her up and put her on my lap, but she does have her limitations. Alby, who was Buddy's outdoor partner, still keeps her distance from me...usually. When she thinks that I'm not looking at her, she'll get relatively close.
Click to expand...
Ah ok. Maybe try 28 gauge... A little more comfortable than the 26.
 
And the more you poke, the more little capillaries grow. After awhile, getting a test is super easy. But those first couple of weeks can be tough to get blood. The fact that you already know what an appropriate sized "bead" looks like will really help.

And now for the next step...

We all set up these great little spreadsheets to keep track of our data. All you have to do is enter the numbers, and the color coding happens automatically. It really helps in identifying if Buddy is at the right dose, and keeping track of the drop between the pre-shot and the nadir. By the way, that test result you got was great! What a nice drop!

Here is the link to the spreadsheet information: Spreadsheet

And just in case....if Buddy hits 50, that's hypo for a cat using a human meter. It's a good idea to keep some high-carb canned cat food around in case that happens to help bring him up to safer numbers.
 
jbfrank said:
So right now I'm just trying to get Buddy stabilized and finding that it's a lot easier to test my own blood sugar than Buddy's. The vet got him started on NPH (mostly because I think that is what she's comfortable with), but I am hoping that ProZinc will be in our future.
Click to expand...
I don't know what insulin you use, but lantus and levemir are both great for cats, too. The least expensive way to use them is to order the pens, then use them like small vials, without the needle tips. If refrigerated, the insulin can be used for months. Check out http://petdiabetes.wikia.com/wiki/Main_Page for information about specific insulins.
 
Oh, and I should have added: If you have any trouble with the spreadsheet, we have a member that can help get it set up for you. Just let us know and we'll put you in contact.
 
Djamila said:
We all set up these great little spreadsheets to keep track of our data. All you have to do is enter the numbers, and the color coding happens automatically. It really helps in identifying if Buddy is at the right dose, and keeping track of the drop between the pre-shot and the nadir. By the way, that test result you got was great! What a nice drop!
Click to expand...

Thanks, spreadsheets are really useful for tracking data like this. In fact, I started one last night (Excel) and have it on my computer. But for now, that is the only one that I'll be using although I'll probably create a Google Sheets for longer term use. My vet's numbers are a little more lax than what I've generally seen published online and there are a number of variables that Buddy and I need to address, and the first one is just to make sure that he responds well to insulin therapy. My earlier test result for him was a step in the right direction.

Maggies Mom Debby said:
I don't know what insulin you use, but lantus and levemir are both great for cats, too.
Click to expand...

I'm on an insulin pump, so I use a very quick acting insulin called Humalog. All of these other insulins are new to me, but I've read some very good things about the two that you mention for treating feline diabetes. The vet has Buddy on NPH right now, but my goal is to eventually get him over to ProZinc based on the crammed research that I've done. I also like the fact that the ProZinc is a U-40 concentration of insulin which I find kinda funny, since that was the only concentration that was available when I first started on insulin in the early 60s. Also, thanks for the wiki link for the different insulin types.
 
Both Prozinc and Lantus are excellent insulins. They have different protocols, but both are dosed every 12 hours. Prozinc has a little more flexibility, but since you manage your own diabetes and understand how important monitoring and timing are, I'm sure you could manage either one quite well.

I'm going to push a little on the spreadsheets, but you can just say, "back off, lady" if you really don't want to use it for now. If you click on the blue words that say, "Sam's Spreadsheet" in my signature, you can see the form we all use. Having it linked and in the same format makes it easy and clear for everyone to help and give the most accurate advice, and avoid confusion. Now I won't bug you about it anymore. :);)
 
Maggies Mom Debby said:
I don't know what insulin you use, but lantus and levemir are both great for cats, too.
Click to expand...
Djamila said:
Both Prozinc and Lantus are excellent insulins. They have different protocols, but both are dosed every 12 hours. Prozinc has a little more flexibility
Click to expand...

Thanks to both of you guys. I have, and will continue to do some more research on ProZinc and Lantus. At this point, I still have a slight preference for ProZinc but the Lantus seems like a very viable option. I will be seeing the vet on Tuesday with the intent of switching Buddy's insulin to one of these.
 
I just wanted to say Hello jbfrank.

I'm brand new here as well and I will be interested in seeing how your cat responds to NPH since my cat is also on it. We also have the feral aspect in common, my cats were feral kittens when I rescued them and I know ferals are much different creatures than ordinary cats.

I despise pricking my cats ear. I usually get it by the second try, but it seems like a torture-game, all this pricking and poking. I put a piece of cotton on the inside of the ear (edge) and use the lancet w/a quick poke. I've noticed his left ear is easier to get blood from then his right. Take a small flashlight and hold it to the ear to get an idea right where the capillaries are. I watched a couple of videos on youtube that helped. Here is one of them, first part is about the meter and about 2:50 it shows the blood testing.
 
Cat mom said:
I just wanted to say Hello jbfrank.

I'm brand new here as well and I will be interested in seeing how your cat responds to NPH since my cat is also on it. We also have the feral aspect in common, my cats were feral kittens when I rescued them and I know ferals are much different creatures than ordinary cats.

I despise pricking my cats ear. I usually get it by the second try, but it seems like a torture-game, all this pricking and poking. I put a piece of cotton on the inside of the ear (edge) and use the lancet w/a quick poke. I've noticed his left ear is easier to get blood from then his right. Take a small flashlight and hold it to the ear to get an idea right where the capillaries are. I watched a couple of videos on youtube that helped. Here is one of them, first part is about the meter and about 2:50 it shows the blood testing.
Click to expand...
the only problem with their instructions is that they say to prick the vein! NOoooooo it hurts them and makes them bleed WAY TOO MUCH. prick between the vein and the outter edge of the ear where it won't hurt! That poor kitty!
sweetspot.jpg
 
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Cat mom said:
I'm brand new here as well and I will be interested in seeing how your cat responds to NPH since my cat is also on it. We also have the feral aspect in common, my cats were feral kittens when I rescued them and I know ferals are much different creatures than ordinary cats.
Click to expand...

Hi Cat mom, I've only got about two days worth of blood sugar data on Buddy, but at this point I'm not very happy with it. I'm diabetic and not familiar with all of these new fangled insulin types...but I learned years ago how to read an insulin curve that shows how long a type of insulin lasts and when it peaks. NPH seems to be more of an intermediate type of insulin and I/Buddy need one that has a curve that ideally would cover over a 12-hour period. For the past two days I've gotten his AM BG, his PM BG (about 12 hours apart, and an intermediate BG number. I can see from the intermediate BG that the insulin is working but it creeps up too high by the PM reading. Granted, this is with a limited data set...but based on the reaction times of the NPH this is what I would expect. I feel the NPH is better suited for a 3 shot a day routine.

From what I've learned, the two better options...as have been mentioned by others in these posts...are ProZinc and Lantus. Lantus seems to be the preferred choice amongst vet endocrinologists, although ProZinc is a strong second choice. From what I've seen, in using the Lantus you need to be on a more regular and regimented routine as there is significant 'unreacted' carry over of this insulin beyond the 12 hour window that I am more concerned with and there is somewhat of a cumulative effect until it eventually evens out. I think that if I had one cat on a strict routine and regulated diet, I would go with the Lantus. But the ProZinc offers a little more flexibility in diet (remember, I have three ferals living here) and persists in the cat's system from 10-14 hours and due to that it lessens the likelihood of hypoglycemia, at least the way that I understand things, due to the fact that there is little overlapping of the insulin. If I just had Buddy or if I could isolate him, I'd choose the Lantus. But the ProZinc seems a more practical choice for us and our situation.

The only downside to the Lantus and the ProZinc that I can see is the cost, and they are each $250 or so (equalized on a 1,000 unit basis). I've also seen some mention that the Lantus can deteriorate over time, but that was a mixed opinion and I don't think that it's a significant concern. The NPH that I got from WalMart was a little less that $25. The Humalog that I use in my insulin pump would be similar in cost to the Lantus and ProZinc without insurance, so to me the WalMart Reli-On NPH is dirt cheap and that's what I'd use if I had to.
 
Many caretakers get their Lantus/Levemir for Canada, specifically from:
https://rxcanada4less.com/
A lot less expensive than from a USA place.
You are correct that ProZinc allow more shot timing flexibility than Lantus and that NPH/N is OK for most cats if dosed three times daily.
 
Thought I'd post a follow-up on Buddy and how we're doing, but first a big THANK YOU to everyone that posted advice and suggestions.

I met with the vet last week and thought that I'd have to twist her arm to move Buddy from NPH to ProZinc. But she was impressed with the case that I presented and was very agreeable to prescribing the ProZinc. Buddy started the PZ on 4/14 and there's been a steady improvement in his blood glucose values. I'm using a bit of a sliding scale in his dosing because that's what the endocrinologists used on me when I was doing shots and I am comfortable with it and the reasoning behind it. I've also posted Buddy's spreadsheet with the initial goal of keeping his 12-hour numbers in the yellow and the middle numbers in the blues and greens. I had a good idea where the nadir should be and did some spot checks there to make sure I was not going to hypo him out.

Also, Buddy's (and the other two ferals) diet has transitioned from the crapola that I used to feed them to Friskies Pate with a little dry food mixed in. I received a sample of the Young Again Zero Mature and they all seem to have a little preference for that over the EVO. I ordered a bag earlier today, and although expensive I think that it will go a long way.

Buddy was never a problem with the ear pokes, but at times I did annoy him. I've gotten a little more proficient at it and at this point it has become routine...for both of us. He's been a real sweetheart and a pleasure to treat.
 
jbfrank said:
Thought I'd post a follow-up on Buddy and how we're doing, but first a big THANK YOU to everyone that posted advice and suggestions.

I met with the vet last week and thought that I'd have to twist her arm to move Buddy from NPH to ProZinc. But she was impressed with the case that I presented and was very agreeable to prescribing the ProZinc. Buddy started the PZ on 4/14 and there's been a steady improvement in his blood glucose values. I'm using a bit of a sliding scale in his dosing because that's what the endocrinologists used on me when I was doing shots and I am comfortable with it and the reasoning behind it. I've also posted Buddy's spreadsheet with the initial goal of keeping his 12-hour numbers in the yellow and the middle numbers in the blues and greens. I had a good idea where the nadir should be and did some spot checks there to make sure I was not going to hypo him out.

Also, Buddy's (and the other two ferals) diet has transitioned from the crapola that I used to feed them to Friskies Pate with a little dry food mixed in. I received a sample of the Young Again Zero Mature and they all seem to have a little preference for that over the EVO. I ordered a bag earlier today, and although expensive I think that it will go a long way.

Buddy was never a problem with the ear pokes, but at times I did annoy him. I've gotten a little more proficient at it and at this point it has become routine...for both of us. He's been a real sweetheart and a pleasure to treat.
Click to expand...
So glad it's going well.
 
All fixed! I can see it now. It sounds like things are going really well, and glad you were able to switch to the insulin you wanted. See you over on the Prozinc forum!
 
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