NEW/terrified, BG low and afraid to give insulin

[TommysMom]

Hi all,

Short:
My name is Anna and I am new to caring for a diabetic cat. I'm worried my cat Tommy's dose it too high. I am awful at/basically unable to test his BG at home but my fiance got his BG today (half an hour before I was going to blindly give him his next shot) and his BG is at 114. He's on 3 units of Lantus twice a day. Am I wrong for not wanting to give him his next shot? I am terrified I am sabotaging his treatment and chance at remission by skipping doses but he has had BG at 83 and then 53 recently and I'm scared.

Background (Long):

My cat Tommy got diagnosed October 25th after sudden weight loss/no appetite. Was diagnosed with BG in the high 550-590 range and put on Lantus at 3 units twice a day. Before his diabetes he was at 18 lbs (big frame but was a little chonky), at diagnosis he was at 12 lbs. Now he's around 13-14. I changed his diet to half wet (no carb) and half dry (carb content of food way below 10%).

After diagnosis I went to vet every 7 days for a BG test and for the first two weeks it didn't really improve (week 2 it was higher than the week before) but I also didn't realize I had to take him in 4-5 hours after injection so I think they might have tested him 1-2 hours after getting insulin and gotten a high result that way. Week 3, Nov 9th, we tested him 4 hours after injection and he was at 456 and finally out of the 500's range but still they increased his Lantus intake to 4 units twice a day. Nov 16th I take him in 5 hours after his injection and his BG is at 83. They get worried. I ask them to lower it. Vet tells me to do 3 1/2 units and buy a home BG monitor. Says not to test before giving shot but to test 4-5 hours after. I got the monitor this last Sunday (NOV 17) and give him his shot at 7PM and tested him for the first and last time at 11:30PM. His BG was 53!!

I freaked out, went to this forum and followed advice about giving him food (the dry one with some carbs) and watched him all night. He WOULD NOT let me take his BG again. I had accidentally pierced his ear the first time. It was Sunday so I couldn't call the vet but I decided to skip his 7AM dose because I was terrified to give him another 3 1/2 units before leaving for a 15 hour work day. I called the vet that Monday (yesterday) and told him the result and they said to lower it to 3 units and give him his nightly dose since I had skipped that morning. I tried for an hour to test him before giving him his nightly dose and got bit and scratched to heck. He wouldn't let me near him especially with the monitor so I gave him his 3 unit shot blindly and stayed up (another night) to monitor him physically since I couldn't get the BG reading to feel safe otherwise. At some point during the night he started galloping around the house and screaming for attention (he almost never does this). I made sure he had food out and kept an eye on him. I haven't really slept since the weekend and this morning I defeatedly gave him another 3 units of Lantus blindly because I could not get his BG reading after trying all the tricks on this website. At shot/after he didn't want to eat his breakfast (unusual for him). I spent my lunch break coming home to check on him and coax him into eating. While I was at school/work (15 hours again) my fiance who has been trying to help me get the cats BG somehow ambushed him and got his BG 30 minutes before I would have blindly given him another 3 unit dose. It was at 114. I heard somewhere on here that I shouldn't give a cat under 200 BG insulin so I am cautiously deciding to skip yet another dose tonight. Am I doing the right thing? I feel like an idiot and like I have let my cat down because I can't get his BG readings and I think his dose might be too high but I don't know how to react. I am grateful for ANY and all help. Thank you all.

 

[Chris & China (GA)]

You're doing the right thing to keep your kitty safe. 114 on the AlphaTrak is too low to shoot until you have a lot of testing and truly understand how Lantus works.

3U is a HUGE dose. It's way too early to be on that much insulin!!

 

[TommysMom]

3U is a HUGE dose. It's way too early to be on that much insulin!!

Thank you so much for responding! I see you also use Lantus and am so relieved to hear from someone definitely more experienced than me. If its not asking too much, do you have any suggestions on what a reasonable Lantus dose might be given how early into treatment he still is? I thought I'd be safe with 3Units bc he started out on it and was fine for 3 weeks, but I suspect that's changed. He's also moving around a lot more now and I think that might affect his treatment.

 

[Chris & China (GA)]

How much does he weigh?

 

[TommysMom]

How much does he weigh?

He's fluctuating between 13 and 14 pounds. Probably 13.5 on average with another pound or three that he can gain while still being in his ideal weight range (big frame)

 

[Chris & China (GA)]

OK...at the most, a 13.5lb cat should have been started at no more than 1.5U

It will really help us to help you if you'll start keeping track of your numbers on our spreadsheet. We're very data-driven here and rely on it to give you the best advice. Here are the instructions on getting the FDMB spreadsheet . If you have trouble with it, let me know and I'll be happy to do it for you. Just click on my name and choose "start conversation" to send me a private message.

I think it this were my cat, I'd definitely reduce the dose and start keeping track of the test numbers you get. You could probably start at 2U since he's been getting insulin for several weeks. Also, I'd get rid of the TikiCat dry food. Kibble isn't good for any cat (even if it's low carb and I'm not convinced the TikiCat is low carb)

You need to test before every shot and then test at least once between shots on both the AM and PM cycle (if you absolutely can't test mid-cycle on the AM cycle due to work, try to get at least 2 on the PM cycle and then do a curve at least once a week on days off)

If you've been testing, you should be able to go back on your meter and get some of the test numbers off the history to put in. If you can go back 2 weeks that'd be great.

 

[Chris & China (GA)]

I had accidentally pierced his ear the first time.

I pierced China's ears so many times that I joked that I should buy her a pair of diamond stud earrings! It's totally normal and won't hurt anything. You'll get better as you develop a feel for it. Trust me!

Here's something I wrote up for others for testing...maybe it'll help you too!

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you.

Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

You also have to remember...you're not poking him to hurt him...you're testing him to keep him safe and understand what's going on inside his body. There's just nothing better than truly understanding what's going on inside your kitty's body and with this disease, the more knowledge you have, the more power you have against it. The edges of the ears have very few pain receptors, so it really doesn't hurt them. Also, if you're nervous and tense, it's going to make your kitty nervous and tense too. As silly as it might seem, try singing! It forces you to use a different part of your brain!

It's also important to make sure his ear is warm. A small sock filled with a little rice and microwaved or a small pill bottle filled with warm water (check temp against your wrist like you would a baby bottle) works well

For new kitties, using a heavier gauge lancet is also really helpful. A 25-28 gauge lancet pokes a bigger "hole" than a 31-33 gauge lancet does, so look for "Alternate Site testing" lancets that are usually a lower number

Finding the right "treat" will be a great help too! Freeze dried chicken, bonito flakes, little pieces of baked chicken...whatever low carb treat you can find that he really enjoys will help him to associate the testing with the treat! China's Achilles heel was baked chicken, so I'd bake a piece, chop it into bite sized pieces, put some in the refrigerator and freeze the rest to use as needed. It didn't take long for her to come any time I picked up the meter!