Charlie is doing fine now, +8.5 119

charliesmom1

charliesmom1

Member Since 2019
I'm worried about Charlie. He is lethargic and did not eat this morning. I have been struggling with his insulin shots. He runs away, hisses at times and is a challenge to get the shot into him. I am never sure how much I am getting into him especially because I can smell the Lantus on him. I don't want to create an unpleasant experience with the shots, but felt I needed to make sure he got the insulin yesterday because his numbers are not improving. I had my son hold him down so I could get the shot in and was successful. As you can see by his spreadsheet his numbers then went way down yesterday. He was acting fine during the day until last night when his number was high and then he was lethargic. Is this a "bounce" he is experiencing? He has had high numbers before and while tired, will still be interested in eating. Thanks for any advice.
 
Have you checked for keytones? With that 62 I wouldn't be surprised that he is bouncing and yes they can feel yucky just like you do after a sugar low or high. Can I ask what method are you following TR or SLGS?
The other comment I have is there is no night testing. You are missing half the picture on how this dose is doing and cats can go lower at night. A before bed test is what I got.

ETA: Have you created a treatment spot? Where he gets loves and treats while being poked? Even if you do it a few times a day without a poke to get him used to it? If he is calmer you will be calmer and then the process seems to get better.
 
Tracey&Jones (GA) said:
Have you checked for keytones? With that 62 I wouldn't be surprised that he is bouncing and yes they can fill yucky just like you do after a sugar low or high. Can I ask what method are you following TR or SLGS?
The other comment I have is there is not night testing. You are missing half the picture on how this dose is doing and cats can go lower at night. A before bed test is what I got.

ETA: Have you created a treament spot? Where he gets loves and treats while being poked? Even if you do it a few times a day without a poke to get him used to it? If he is calmer you will be calmer and then the process seems to get better.
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Thanks Tracey for helping
 
Tracey&Jones (GA) said:
Have you checked for keytones? With that 62 I wouldn't be surprised that he is bouncing and yes they can fill yucky just like you do after a sugar low or high. Can I ask what method are you following TR or SLGS?
The other comment I have is there is not night testing. You are missing half the picture on how this dose is doing and cats can go lower at night. A before bed test is what I got.

ETA: Have you created a treament spot? Where he gets loves and treats while being poked? Even if you do it a few times a day without a poke to get him used to it? If he is calmer you will be calmer and then the process seems to get better.
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No I have not tested for keytones and being new to this did not know that is something I should be doing or even how to do it. Trying to follow SLGS but did not feel comfortable upping dose quickly when I know he is not getting good doses of insulin. His shots are given at 9 and 9 so I could do a glucose test at around 11 before bed. Am I suppose to get up with him during the night to test? Yes I have a treatment spot where he would jump up on the ottoman for a treat and glucose testing which he sits fine for, and then he knows the shot is coming and takes off. I would try to be quick and catch him before he goes and thats where the ineffective shots are happening. Also he is very skinny now and it is challenging to grab an area to poke.
 
For the keytones - yes you should test. Even if it is just to take one worry away. You can buy the sticks at the pharmacy and you just stick it in their urine. I had a metal soup spoon that I had by the litter box and I would stalk Jones and grab it and put it under him when he was mid-stream. Worked like a charm.

That is a +2 and that can be an important indicator if you have an active cycle or a normal one.

Even with those fur shots you are getting good numbers on that 1.25u. I am going to check something and be right back.
 
Tracey&Jones (GA) said:
For the keytones - yes you should test. Even if it is just to take one worry away. You can buy the sticks at the pharmacy and you just stick it in their urine. I had a metal soup spoon that I had by the litter box and I would stalk Jones and grab it and put it under him when he was mid-stream. Worked like a charm.

That is a +2 and that can be an important indicator if you have an active cycle or a normal one.

Even with those fur shots you are getting good numbers on that 1.25u. I am going to check something and be right back.
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I can't imagine following Charlie around for a day and trying to catch him in the litter box! Are the strips for humans when you are trying to check for ketosis on the keto diet for example? Can you explain what you mean by active cycle vs a normal one? Thanks for your help!
 
Ok, With that 62, Charlie actually earned a reduction to 1u not an increase. You should start the one unit tonight.

For the eating - has he eaten anything yet today? I would also get another test in to see especially if his appy is low.

You can try to heat the food for like 5 seconds in the microwave or add a bit of warm water and stir it up to see if that helps. Try parmesan cheese on top, or tuna water - I used the crunched up fish freeze dried treats. Very smelly. We need to see if we can get his nose working and telling him he should eat.
 
charliesmom1 said:
catch him in the litter box
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I wouldn't follow all day but I would see him get up from a nap and head in that direction and then I would stalk him. I usually did it when he wasn't eating, just to make sure but he had other issues that complicated matters. And they are the ones humans use as well. Keostix is the brand I used.

Active - looks like they are going to drop low on you. If the +2/+3 is lower or the same as the PS number - usually indicates that the sugars are going to drop and dramatically - more testing maybe required. If it is higher than usually indicates that it will be a more normal cycle with the +2 food bump and then a slow downward slide.

The blanks in the dose columns - did you skip the shot? If so can you put NS in the cell?
 
Tracey&Jones (GA) said:
Ok, With that 62, Charlie actually earned a reduction to 1u not an increase. You should start the one unit tonight.

For the eating - has he eaten anything yet today? I would also get another test in to see especially if his appy is low.

You can try to heat the food for like 5 seconds in the microwave or add a bit of warm water and stir it up to see if that helps. Try parmesan cheese on top, or tuna water - I used the crunched up fish freeze dried treats. Very smelly. We need to see if we can get his nose working and telling him he should eat.
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He has been sleeping most of the morning, but I did get him to eat some cooked chicken a while ago. I will test his sugar shortly and post it and try to get him to eat some more.
 
Tracey&Jones (GA) said:
I wouldn't follow all day but I would see him get up from a nap and head in that direction and then I would stalk him. I usually did it when he wasn't eating, just to make sure but he had other issues that complicated matters. And they are the ones humans use as well. Keostix is the brand I used.

Active - looks like they are going to drop low on you. If the +2/+3 is lower or the same as the PS number - usually indicates that the sugars are going to drop and dramatically - more testing maybe required. If it is higher than usually indicates that it will be a more normal cycle with the +2 food bump and then a slow downward slide.

The blanks in the dose columns - did you skip the shot? If so can you put NS in the cell?
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I will try to get a urine test but Im not sure I will be successful! Thanks for explaining the cycle. Im doing my best to take good care of him but don't feel like I am doing a good job at this point. Yes blank areas are not shot given, I will enter NS. I was out of town and my son was in charge and there were times he had to work and couldn't get the shot in. I was moving my daughter to AZ to start med school and she was the one previously doing the majority of his shots so I am now on the learning curve and trying to get better!
 
charliesmom1 said:
but don't feel like I am doing a good job a
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But you are doing a good job...you are trying....It takes a bit to get all the pieces to fit together. :bighug::bighug::bighug::bighug::bighug:

I expect Charlie to bounce from that 62, so don't be discouraged if you see high numbers for up to 6 cycles. Lower the dose to 1 unit and we will see where we are at in a week as we will hold that dose for 7 days unless he throws us another low number and then we will reduce again.
 
Tracey&Jones (GA) said:
But you are doing a good job...you are trying....It takes a bit to get all the pieces to fit together. :bighug::bighug::bighug::bighug::bighug:

I expect Charlie to bounce from that 62, so don't be discouraged if you see high numbers for up to 6 cycles. Lower the dose to 1 unit and we will see where we are at in a week as we will hold that dose for 7 days unless he throws us another low number and then we will reduce again.
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Thank you so much for your help and encouragement, it means a lot. I just checked him and its been about 2.5 hours and glucose is now 369. I also got him to eat more chicken.
 
Tracey&Jones (GA) said:
But you are doing a good job...you are trying....It takes a bit to get all the pieces to fit together. :bighug::bighug::bighug::bighug::bighug:

I expect Charlie to bounce from that 62, so don't be discouraged if you see high numbers for up to 6 cycles. Lower the dose to 1 unit and we will see where we are at in a week as we will hold that dose for 7 days unless he throws us another low number and then we will reduce again.
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I have a follow up question if you don't mind. Charlie is free-fed and I have 3 other cats as well. I do not hold food at any time during the day. Do I need to be doing that prior to am and pm glucose testing?
 
charliesmom1 said:
I will try to get a urine test but Im not sure I will be successful! Thanks for explaining the cycle. Im doing my best to take good care of him but don't feel like I am doing a good job at this point. Yes blank areas are not shot given, I will enter NS. I was out of town and my son was in charge and there were times he had to work and couldn't get the shot in. I was moving my daughter to AZ to start med school and she was the one previously doing the majority of his shots so I am now on the learning curve and trying to get better!
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That learning curve can seem steep and intense but in a couple weeks when his SS fills in with data and you gain knowledge - , active vs normal cycles, etc -- and hands-on experience poking your cat :cat: -- I think a sense of calm and confidence will begin to seep in and you'll feel less anxious and inadequate. I've only been using a SS for a few weeks now and I feel more capable and knowledgable than I have in six years of having a diabetic cat! I did go through a mental review of the care I've given him over the years and judged myself but I can't split my focus right now and lament over that. Each day we start new and make all effort to heal. Game on! My cat is 18 so I'm going to make the rest of his life as best as it can be. He's improving already.:cool::joyful: A win for Butternut and worth being awake off and on each night for the past 3 or so weeks. :blackeye: (Dark circles).

This forum rocks so hang in and ask for help! :)
 
Dandelion said:
That learning curve can seem steep and intense but in a couple weeks when his SS fills in with data and you gain knowledge - , active vs normal cycles, etc -- and hands-on experience poking your cat :cat: -- I think a sense of calm and confidence will begin to seep in and you'll feel less anxious and inadequate. I've only been using a SS for a few weeks now and I feel more capable and knowledgable than I have in six years of having a diabetic cat! I did go through a mental review of the care I've given him over the years and judged myself but I can't split my focus right now and lament over that. Each day we start new and make all effort to heal. Game on! My cat is 18 so I'm going to make the rest of his life as best as it can be. He's improving already.:cool::joyful: A win for Butternut and worth being awake off and on each night for the past 3 or so weeks. :blackeye: (Dark circles).

This forum rocks so hang in and ask for help! :)
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Thank you for the support! Definitely feeling anxious and inadequate lol. I will keep at it and do my best and hope both Charlie and I get better with the shots!
 
charliesmom1 said:
I have a follow up question if you don't mind. Charlie is free-fed and I have 3 other cats as well. I do not hold food at any time during the day. Do I need to be doing that prior to am and pm glucose testing?
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Jones was free fed as well. For his IBD issues it worked best for him. I did do careful observations though to know most times he didn't eat 2 hours before the shots. Which is recommended here to know if a PS was food influenced or not. If he did eat something it may have been a few bites about 1/2 hour before. I always had a bit of food at his testing and shot site so I also new he was getting a bit more then as well. You know Charlie and your situation best, so you need to work with what you have.

I had 3 other cats at the same time...fat cat on a diet, growing kitty that needed her fudz and a diabetic kitty that had special food that Jones couldn't eat. I ended up getting the surefeed feeders. Expensive but saved my sanity. That said, Jones always had food in his bowl to eat if he wanted it.
 
There are also blood ketone meters. You test just like you do for BG. Unfortunately, the strips are expensive but if you have a cat that's prone to ketones, the meter is a lifesaver. Precision Xtra and NovaMax are reliable brands.

I always worry about ketones if someone says their cat is lethargic. I worry even more if numbers have been running high and the kitty isn't eating. If you can't test for ketones now, it may mean a trip to the vet. If Charlie has a history of ketones, I'd err on the side of caution.

I'd also strongly encourage you to start getting some tests (at least a before bed test) every single night. Lantus dosing is based on the lowest number in the cycle. Charlie's numbers could be bottoming out during the PM cycle and you would be completely unaware. At the moment, you're missing half of your data without any PM tests. Charlie could be doing exactly what he did yesterday during the AM cycle and you may have needed to reduce his dose on any number of occasions. Those sizable drops you've seen during the AM cycle are a good clue that Charlie may also see low numbers at night since many cats do have lower numbers during the PM cycle.
 
Sienne and Gabby (GA) said:
There are also blood ketone meters. You test just like you do for BG. Unfortunately, the strips are expensive but if you have a cat that's prone to ketones, the meter is a lifesaver. Precision Xtra and NovaMax are reliable brands.

I always worry about ketones if someone says their cat is lethargic. I worry even more if numbers have been running high and the kitty isn't eating. If you can't test for ketones now, it may mean a trip to the vet. If Charlie has a history of ketones, I'd err on the side of caution.

I'd also strongly encourage you to start getting some tests (at least a before bed test) every single night. Lantus dosing is based on the lowest number in the cycle. Charlie's numbers could be bottoming out during the PM cycle and you would be completely unaware. At the moment, you're missing half of your data without any PM tests. Charlie could be doing exactly what he did yesterday during the AM cycle and you may have needed to reduce his dose on any number of occasions. Those sizable drops you've seen during the AM cycle are a good clue that Charlie may also see low numbers at night since many cats do have lower numbers during the PM cycle.
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I think I need some help with clarification. I don't understand why his dose would be decreased if his numbers are not good during any part of a 24 hour cycle? What is a 2+ going to tell me? If BG is lower at 2+, should I be testing throughout the night?

I don't know if Charlie is susceptible to ketones. Has never had them to my knowledge. Since my earlier post he has eaten and perked up a bit so I am not overly concerned at this point.
 
I think Charlie is a bouncer...so any low number is shooting him sky high. By lowering the dose the hope is you get to point where the dose gets him in consistent more level numbers and if needed we can take the dose back up to get to the lower desired numbers.

If you get a lower +2, then try to get a +3 to see if he continues to drop.
 
Hi Charliesmom!
Charlie will get used to testing/shooting! Prepare a spot that you can consistently use so that you can have all your supplies (except for the insulin of course) on hand and have the syringe ready before you put Charlie there. It helps if you have an extra set of hands to help out until he gets used to it and you gain confidence doing it but I wouldn't "hold him down" because that will just scare him. Let him go, pick him back up and place him in the spot. Maybe offer a treat if he stays on his own. If there is another person there that Charlie is comfortable with, have that person gently hold him in place. And you can also offer a treat after the shot!

Some people shoot while the cat is eating since the cat is distracted.

Meanwhile, I agree that you should test for ketones, especially since he's not eating today.

Sorry....this is kind of rushed! I know you've got some good advice above!
 
Tracey&Jones (GA) said:
I think Charlie is a bouncer...so any low number is shooting him sky high. By lowering the dose the hope is you get to point where the dose gets him in consistent more level numbers and if needed we can take the dose back up to get to the lower desired numbers.

If you get a lower +2, then try to get a +3 to see if he continues to drop.
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If its lower at all from pre-shot number? For Charlie is seems like its always lower to some degree! Thank you for clarification on dosage change, it makes sense to me. I agree Charlie is definitely a bouncer.
 
Judy and Boomer said:
Hi Charliesmom!
Charlie will get used to testing/shooting! Prepare a spot that you can consistently use so that you can have all your supplies (except for the insulin of course) on hand and have the syringe ready before you put Charlie there. It helps if you have an extra set of hands to help out until he gets used to it and you gain confidence doing it but I wouldn't "hold him down" because that will just scare him. Let him go, pick him back up and place him in the spot. Maybe offer a treat if he stays on his own. If there is another person there that Charlie is comfortable with, have that person gently hold him in place. And you can also offer a treat after the shot!

Some people shoot while the cat is eating since the cat is distracted.

Meanwhile, I agree that you should test for ketones, especially since he's not eating today.

Sorry....this is kind of rushed! I know you've got some good advice above!
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Thank you for the advice, I have been doing all of the above. He should be used to it by now! I wonder if it is hurting him somehow and that is why he is not cooperative. It is difficult to find a good spot to shoot because he is so thin. I have been going behind this arm/shoulder area. The minute I even try to grab some skin/fur he takes off. At that point he could care less about treats! I put him back on the ottoman and try again rather hurriedly and thats where the failed shots keep happening.

He has eaten today and perked up a bit so I am not too worried about ketones for now. I think he's just feeling crummy from bouncing.
 
Hi, I've been reading the conversations and you have gotten a lot of excellent advice. One thing I feel I need to comment on and its the shot problem. You mention that you get him on the ottoman to test his BG and then try to grab him to do the shot. Are you feeding him after you get the BG test? We usually test/feed/shoot in that order. You may find that he'll be calmer for the shot if he's eaten. If I have it wrong I apologize, but I know my Jerry (who is very cooperative) gets very antsy if he's hungry. Just a thought. :bighug:
 
Jerry dutchboy said:
Hi, I've been reading the conversations and you have gotten a lot of excellent advice. One thing I feel I need to comment on and its the shot problem. You mention that you get him on the ottoman to test his BG and then try to grab him to do the shot. Are you feeding him after you get the BG test? We usually test/feed/shoot in that order. You may find that he'll be calmer for the shot if he's eaten. If I have it wrong I apologize, but I know my Jerry (who is very cooperative) gets very antsy if he's hungry. Just a thought. :bighug:
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I have done it both ways. I know you are suppose to feed before shooting but my rational has been since he sits nicely for the BG testing I should just try to get the shot done while he is there! He always eats immediately afterwards. I see your point about being hungry, but he has food available to him whenever he wants so I wouldn't think thats the issue. I have also tried to give him a break and feed him first and then try again with the shot afterwards. It's always a struggle.
 
charliesmom1 said:
If its lower at all from pre-shot number? For Charlie is seems like its always lower to some degree! Thank you for clarification on dosage change, it makes sense to me. I agree Charlie is definitely a bouncer.
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All meters have a 15% to 20% variance between strips. So if you had a 300 PS and got a 290 +2 - that wouldn't worry me so much but if you got 200 at +2 - things are dropping and dropping fast.
 
If he doesn't mind the testing but doesn't like the shot...I wonder if he is one of those cats sensitive to Lantus? It can sting a bit. Do you think your vet would be open to a discussion of moving to Levimar? It acts the same as Lantus.
 
charliesmom1 said:
Thank you for the advice, I have been doing all of the above. He should be used to it by now! I wonder if it is hurting him somehow and that is why he is not cooperative. It is difficult to find a good spot to shoot because he is so thin. I have been going behind this arm/shoulder area. The minute I even try to grab some skin/fur he takes off. At that point he could care less about treats! I put him back on the ottoman and try again rather hurriedly and thats where the failed shots keep happening.

He has eaten today and perked up a bit so I am not too worried about ketones for now. I think he's just feeling crummy from bouncing.
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Perhaps spend some time just rubbing/patting/playing with the fur in that area so he gets used to being touched there? If he is long-haired, try combing through with your fingers and actually parting the fur so that you can see skin before you shoot. It may just be that he's sensing your hesitancy (which is because of the way he has reacted previously) and once you have confidence, he will hopefully feel better about it. I had a cat, Allen (non diabetic) who needed sub q fluids each day. I tried, I failed. Tried, failed. etc etc. I paid a vet assistant to come by a couple of times to help me and once she was there I gained more confidence then Allen settled right now and giving him fluids was no problem at all.
 
Tracey&Jones (GA) said:
If he doesn't mind the testing but doesn't like the shot...I wonder if he is one of those cats sensitive to Lantus? It can sting a bit. Do you think your vet would be open to a discussion of moving to Levimar? It acts the same as Lantus.
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Honestly I was thinking of finding a new vet. I don't think the one I have understands diabetes very well! He told me to give him .5 of lantus once a day, don't need to test and then bring him back in 3 weeks for a fructosamine test! I did not follow that advice and instead found this board. I have not heard back from that vet or taken Charlie back.
 
Judy and Boomer said:
Perhaps spend some time just rubbing/patting/playing with the fur in that area so he gets used to being touched there? If he is long-haired, try combing through with your fingers and actually parting the fur so that you can see skin before you shoot. It may just be that he's sensing your hesitancy (which is because of the way he has reacted previously) and once you have confidence, he will hopefully feel better about it. I had a cat, Allen (non diabetic) who needed sub q fluids each day. I tried, I failed. Tried, failed. etc etc. I paid a vet assistant to come by a couple of times to help me and once she was there I gained more confidence then Allen settled right now and giving him fluids was no problem at all.
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I will give that a try! He is a very snuggly cat and sits with me often so I will do that during that time. He is a medium hair cat so yes it is hard to find skin! My latest technique that I found on here is to just grab his fur and pull up and look for skin then inject there. He really hated the pulling up I was doing trying to make a tent which was difficult since he's so skinny.
 
charliesmom1 said:
Honestly I was thinking of finding a new vet. I don't think the one I have understands diabetes very well! He told me to give him .5 of lantus once a day, don't need to test and then bring him back in 3 weeks for a fructosamine test! I did not follow that advice and instead found this board. I have not heard back from that vet or taken Charlie back.
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Might be a good time to discuss it then. Levemir might also help with the bouncing. It might just be a better insulin for Charlie.
 
charliesmom1 said:
I have done it both ways. I know you are suppose to feed before shooting but my rational has been since he sits nicely for the BG testing I should just try to get the shot done while he is there! He always eats immediately afterwards. I see your point about being hungry, but he has food available to him whenever he wants so I wouldn't think thats the issue. I have also tried to give him a break and feed him first and then try again with the shot afterwards. It's always a struggle.
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Good to know, sorry for butting in but thought I'd put it out there to see if would help. Best of luck and I'm sure you'll get there. I remember the days well when I found BG testing and shots so difficult now it's like second nature.
 
charliesmom1 said:
I will give that a try! He is a very snuggly cat and sits with me often so I will do that during that time. He is a medium hair cat so yes it is hard to find skin! My latest technique that I found on here is to just grab his fur and pull up and look for skin then inject there. He really hated the pulling up I was doing trying to make a tent which was difficult since he's so skinny.
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Good luck! You'll get there with Charlie! Happy to hear he's eating for you now.
 
Tracey&Jones (GA) said:
Might be a good time to discuss it then. Levemir might also help with the bouncing. It might just be a better insulin for Charlie.
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I will look into finding a new vet this week and get an appt to discuss how he's been doing and possibly switching to Levemir. Oh boy, just checked Charlie here at +5 and its 85. Thats a big drop from his 2.5-3 hour test. Similar to yesterday.
 
Jerry dutchboy said:
Good to know, sorry for butting in but thought I'd put it out there to see if would help. Best of luck and I'm sure you'll get there. I remember the days well when I found BG testing and shots so difficult now it's like second nature.
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You were not butting in at all and I appreciate the suggestions! BG testing used to be difficult and it's not now, so there's hope for insulin shots as well!
 
charliesmom1 said:
Yikes his +6 reading was just 41 and I did some Karo on his gums. I will check again here shortly to see if it came back up.
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I have to go to work now, but check every 15 minutes. Do you have high carb food, with gravy for example? give him spoons and re-check every 15 minutes until his numbers go up steadily.
 
Penelope and Mačka said:
I have to go to work now, but check every 15 minutes. Do you have high carb food, with gravy for example? give him spoons and re-check every 15 minutes until his numbers go up steadily.
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Yes I tried gravy food first and he wasn't interested so rubbed karo on his gums. will recheck in 10 minutes
 
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