Yosh is at 134 preshot

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Remember that vets are also basically general practitioners...they have to treat a lot of different animals for a lot of different diseases. So they have to have a lot of general knowledge. We here at FMDB treat cats for diabetes...so we have a lot more knowledge of that. Plus vets are going to be more conservative usually since they can't be there for you and your cat 24/7.

I think the plan Kris laid out is perfect.
 
Kris & Teasel said:
That's why you need to do a curve. However, insulin is a very powerful hormone and can have an effect even when the tiniest dose is given.

If you like your cat vet for everything else and they either:
  • will work with you as a hands on owner OR
  • you can agree to disagree without them going ballistic
then there's really no need to change. We can help you here with Yoshi's FD.
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I've had no real need for them except a few cat colds and injested hair ties. This is the
Most that I've worked with them. She is allowing me to curve at home and home test, so she is working with me.

I feel like they don't get it or help much. I'm always sent to a vet tech who has to talk to the vet before I hear anything, so I often just email her directly.

This vet is super young. She's only been practice a year
 
Rachel said:
Remember that vets are also basically general practitioners...they have to treat a lot of different animals for a lot of different diseases. So they have to have a lot of general knowledge. We here at FMDB treat cats for diabetes...so we have a lot more knowledge of that. Plus vets are going to be more conservative usually since they can't be there for you and your cat 24/7.

I think the plan Kris laid out is perfect.
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You're right. Maybe I shouldn't be so hard on them. But after spending 1000$ + on his diagnosis.... I'm just baffled by...everything.

I appreciate you guys more than you know. Thank you
 
Even if you find a more experienced vet, it's unlikely they will be very helpful with FD. Like Rachel said, they are general practitioners, and this is a very specific and somewhat complicated thing. It sounds like your vet is supporting you in taking charge of your cat's diabetes, and that's super helpful.

You might tell your vet about this site. My vet told me that he has spent time on here since my cat was diagnosed and he's learned a lot from reading this forum!
 
Stressedcatmom said:
She is allowing me to curve at home and home test, so she is working with me.
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This is a good thing!

Stressedcatmom said:
I feel like they don't get it or help much.
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See our previous comments. My vet is great and has said to me that she has other FD cats who took to insulin and got regulated very easily. She doesn't know how to handle a case like my guy's so I just do my own thing and let her know periodically where we are.

Stressedcatmom said:
This vet is super young. She's only been practice a year
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Not necessarily a bad thing. She might be less entrenched in her attititudes and more open to owners asking questions/doing things differently. Rather like young human doctors these days - they have a harder time acting like the fonts of all knowledge with human patients.
 
Sam hasn't been to a vet this time either. His initial diagnosis was through the vet, but when he relapsed a couple of months ago, I just called the vet and he had a new bottle of insulin waiting for me to pick up. He is going soon though just for a general check-up/blood work. I definitely believe vet care is important. It's just a matter of keeping in mind that they can do things we can't do (blood work, diagnostic tests, etc.), but that just like with our own health, we take some responsibility too.
 
Once I started home testing, my vet basically let me do my own thing. I didn't even have to bring her in to get new insulin...just called and ordered it. I would just take her in for her checkup when needed or when she seemed like she was getting sick.

She has since retired and the vet I go to now has quickly realized I know a lot about my cats (even though they are all civvies). He's been great about letting me ask questions and understanding that I am going to do my own thing to an extent. I feel like I will stick with him because he knows this about me and accepts it...if you find a vet who will work with you, that's really all you can ask.
 
That's a pretty great +2 on such a tiny amount of insulin! Are you putting pressure on the ear as soon as you've taken the blood sample? It really does help reduce the bruising. What size lancets do you have?
 
Djamila said:
That's a pretty great +2 on such a tiny amount of insulin! Are you putting pressure on the ear as soon as you've taken the blood sample? It really does help reduce the bruising. What size lancets do you have?
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Well that's good news....

I do. I use 28.
 
Do you have any lancets that are a higher number? The higher number, the thinner the needle. At the beginning, it's easiest to use 26 or 28, but if you're more comfortable with testing, and if Yoshi's ears will bleed enough now, you might try the thinner lancets and see if they leave less of a mark.

Also if you aren't already, you might try to rotate where you're poking. I go right back, right front, left back, left front. That gives each place some time to heal before I poke it again.

But regardless, try to remember that testing is often harder (emotionally) on us than it is on our kitties. And also, that you are doing this to help Yoshi, and that it's an essential step to keeping him safe. His ears are going to be okay. Sending you hugs! :bighug:
 
Stressedcatmom said:
I just got 100 of the 28 o_O
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Don't worry. Two quite different numbers can happen. You could try a third test or go with one of these for your SS. Let's see where he is 2 hours from now. After that test you could feed him so he has 2 hours without food for the following test.
 
Kris & Teasel said:
Don't worry. Two quite different numbers can happen. You could try a third test or go with one of these for your SS. Let's see where he is 2 hours from now. After that test you could feed him so he has 2 hours without food for the following test.
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No no, I meant 28 gauge lancets! Sorry for the confusion. He was at 141 +2
 
It's fine to keep using those. There isn't that much of a difference. I use the back side (although you can use the inside of the ear too - but Sam has long hair inside his ears so that gets in the way). I use the side of the ear closest to his body, and then the side closest to his face. So in this picture....

upload_2017-4-14_8-32-24.jpeg

The "sweet spot" is shown on the right. I also use the part on the left toward the top that has a lot of capillaries as well. And on a day when I'm doing a curve and taking more samples, I'll aim for the top of the sweet spot on one test, and toward the bottom of the sweet spot on another test. Just trying to space out the pokes.

Other people just use the same spot and their kitty isn't bothered by that. You just have to decide what works best for Yoshi.
 
Djamila said:
It's fine to keep using those. There isn't that much of a difference. I use the back side (although you can use the inside of the ear too - but Sam has long hair inside his ears so that gets in the way). I use the side of the ear closest to his body, and then the side closest to his face. So in this picture....

View attachment 27551
The "sweet spot" is shown on the right. I also use the part on the left toward the top that has a lot of capillaries as well. And on a day when I'm doing a curve and taking more samples, I'll aim for the top of the sweet spot on one test, and toward the bottom of the sweet spot on another test. Just trying to space out the pokes.

Other people just use the same spot and their kitty isn't bothered by that. You just have to decide what works best for Yoshi.
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Ahh. Thank you. I know about the sweet spot, but I didn't know you could test on the other side of it.
 
He's at 128 +4. I had to poke 3x. His ear is red and has so many marks on the edge I don't know where else to prick. The sweet spot doesn't generate much for me. It's just below it near the edge that works for us. But again, it's kind of full of little marks.

I was shaking after that one. Hopefully I can stop in 2 hours.
 
It's okay....take a minute to sit down and breathe. Yoshi is okay, and so are you. I think curve days are tough too, but you're going to make it through this.
 
Are you warming Yoshi's ear before doing the test? Put uncooked rice in a small sock, or other pouch-type fabric, warm in the microwave for a few seconds, and hold to his ear to warm it first. It makes a world of difference for Sam. He doesn't bleed at all if I don't do that first - or don't wait long enough for his ear to warm.
 
Yep. I'm doing everything. He's at 162+ 6 I feel like this is bad. It's the highest he's been in a while :(

I think we are done with the curve. The vet said I could stop after the sugars came up. He was growling etc. Could be elevated from stress. Dunno but we're done.
 
Stressedcatmom said:
Is it weird that he was at his lowest at +4? I thought it took 6 hours to be at lowest?
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The nadir can move around day to day. Generally it's between + 5 and +7 most of the time with ProZinc but every cat is different, and different on one day compared to another. Those blues are actually very nice numbers. They could come down a little and you might want to try a curve on 0.5 u at some point.
 
Are you holding him down when you test? You shouldn't have to restrain him much, but when I first started....I would put Frank on the floor and like saddle him so he was confined but not really restrained. Food in front of him, and the testing on his ear. I know every cat is different, but there's got to be an easier way for you to test that won't upset him so much.
 
He wasn't that bad until the last poke. He actually usually sits and sort of let's me do it now. He can get fussy but only when blood doesn't come out right away or if I'm shaking and fiddling with the meter.
 
Stressedcatmom said:
He wasn't that bad until the last poke. He actually usually sits and sort of let's me do it now. He can get fussy but only when blood doesn't come out right away or if I'm shaking and fiddling with the meter.
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Are you putting everything at close reach and partially inserting the test strip? Then you can get Yoshi in position, warm his ear, push in the test strip, poke his ear and by that time the meter will be ready to take a reading.
 
Kris & Teasel said:
Are you putting everything at close reach and partially inserting the test strip? Then you can get Yoshi in position, warm his ear, push in the test strip, poke his ear and by that time the meter will be ready to take a reading.
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I am doing it freehand. Maybe I'm doing it too lightly sometimes
 
You did a great job today! I know that was stressful, but the data you got today will really help. Sam's nadir was usually between +4 and +5 as well. Now it's kind of all over the place. But knowing that Yoshi's nadir might be a bit earlier can help you focus when you get the mid-cycle tests to get the most helpful information. That's one of the reasons why doing a curve is so helpful (even if they are a stress). And those are really great numbers - especially considering the tiny doses last night and this morning.

If you don't hear back from the vet (and really, even if you do!), you can post here after your pre-shot test, and before shot time for some guidance on the dose.
 
She got back to me and thinks we should reduce to 1 u. Says if below 150 not to give insulin. She was very nice and said she didn't mind the questions I had. She said that she relies on me so we can decide the best treatment options.

I'll let you guys know what he's at at preshot then I'm going to give his ears a break for a bit.

I'm exhausted! Thank you all again.
 
Stressedcatmom said:
She got back to me and thinks we should reduce to 1 u. Says if below 150 not to give insulin. She was very nice and said she didn't mind the questions I had. She said that she relies on me so we can decide the best treatment options.

I'll let you guys know what he's at at preshot then I'm going to give his ears a break for a bit.

I'm exhausted! Thank you all again.
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Sorry, but I don't understand. Your vet said to reduce to 1u and yet your last three doses have been 0.5 u, o.25 u and 0.25 u? Those doses gave you some quite good blues.
 
This is what she said: Let’s go ahead and decrease Yoshi’s insulin dose to 1U twice daily. If he is below 150 on his blood sugar when you are able to take a pre-shot reading, skip the insulin. Otherwise, give 1U. The insulin syringes are barely accurate at 0.5U, so I would not bother trying to give 0.25U – just skip.
 
Stressedcatmom said:
This is what she said: Let’s go ahead and decrease Yoshi’s insulin dose to 1U twice daily. If he is below 150 on his blood sugar when you are able to take a pre-shot reading, skip the insulin. Otherwise, give 1U. The insulin syringes are barely accurate at 0.5U, so I would not bother trying to give 0.25U – just skip.
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I understand. Yes, vets often don't see the point of microdoses. They also change doses in half or full unit increments. However, many people here would disagree about the effect that a tiny dose can have. I like that she's advising caution at a BG of 150 - ie., no shot. As for the rest, well we can agree to disagree. How do you feel about all this?
 
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Wow, you got some good numbers today! My vet poked fun at my .25 increments as well. She said....how do you even measure that? My answer was "very carefully". I think you should stick to a dose between 0 and .5, even if it isn't exactly .25. Yoshi is looking good on .25!
 
Hmmmm...that is curious that the vet would want to keep the dose so high. I think if you are willing and able to test during the mid-cycle tonight, you could try it. However, if you aren't up for testing tonight, I would be worried about giving the full 1u on the numbers you're getting the past few cycles. Please know that by nature of being a peer-reviewed forum, no one gets their feelings hurt if you make an informed decision that differs a bit. There may be slight differences of opinion about dosing, but we are all here to help and support. That being said, I would either stick with .25u since nighttime cycles are often lower than daytime cycles (there isn't any PM cycle data for Yoshi, so we can't be sure if that's true in this case), or go with .5u, but try to get one more test (in addition to the PMPS) before bed to make sure he is safe. Something around +4 would be ideal, but if that's too late in your timezone, a +3 will still give you an idea.

Of course, all of this depends on the PMPS number. If Yoshi is low again, we will need to reconsider.
 
GREAT job testing today!

I disagree with your vet about the microdoses...we've seen them to have good effect in other kitties on this board. And clearly, they've been doing well for Yoshi!

Considering all the testing you did today, I would want to give a low dose tonight if he's low again...I'd probably go with 0.25. That way, you hopefully won't end up with needing to do many tests after all you did today.

1 unit just seems awfully high with the numbers he's been getting lately...that is just my opinion. If you do decide to go with that, please make sure you get several tests in and have a hypo kit ready to go in case.
 
Here's another observation: Yoshi has given you blues since he's come down in dose. Those reds, blacks and pinks at higher doses tell me that he was overdosed and bouncing then.
 
Rachel said:
GREAT job testing today!

I disagree with your vet about the microdoses...we've seen them to have good effect in other kitties on this board. And clearly, they've been doing well for Yoshi!

Considering all the testing you did today, I would want to give a low dose tonight if he's low again...I'd probably go with 0.25. That way, you hopefully won't end up with needing to do many tests after all you did today.

1 unit just seems awfully high with the numbers he's been getting lately...that is just my opinion. If you do decide to go with that, please make sure you get several tests in and have a hypo kit ready to go in case.
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