A failure at bg testing

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Shai and The Pirate Fitz (GA)

Member Since 2012
This is such a hard post to put up but there really isn't anyone else who can understand what I'm feeling.

I've been trying to bg test my kitty for the last few weeks. At first I got some readings, but with each succeeding attempt she became more and more agitated. Even with the rice sock I couldn't get a blood drop enough for the meter. Even with treats she was too panicked to eat. I tried the blanket burrito, but she was do scared at being held this way she thew up. I let a couple of days go by w/o trying to let both my kitty and me calm down. But tonight was a miserable replay.

I'm using a lancet with a 28 gauge needle. I've watched countless videos and know where to put the sock and where the sweet spot is on the rim of her ear. But no matter what the blood doesn't come. I end up poking her over and over and nothing wells up. My vet gave me a larger needle to slice open the inside of her ear. I can get blood that way but her ears won't survive that type of abuse and it takes quite awhile to stem the blood after.

I'm faced with two options that rob my kitty of any quality of life and I'm not far behind. I know that shooting insulin blind is playing roulette with her life. She's on .5u of Lantus 2x a day. She's on a high protien wet diet exclusively. My stomach is so tied up in knots and my poor kitty is losing her trust in mommy.

My heart is breaking. My inability to do this will most certainly shorten her life.

I've posted before. My kitty's name is Fitzel.
Shai
 
(((((((((((((((((((((((((((SHAI))))))))))))))))))))))))))))))

First, BREATHE!!!!!!!!!!! Breathe!!!!! Ok.. now. 28 gauge is a large gauge, and sometimes that is needed, and sometimes its too big. Did you try smaller gauge lancets like 30s?

Second.. think about your attitudes, and what you are thinking about. If you are tense, and thinking you are torturing Fitzel, that you are bad because you cant test, then that will come across to her. If you think you cant do it, you probably wont be able to.

Third.... BREATHE. Center yourself first. Say "This will happen, I am going to test her bgs right now" Think it confidently, dont waffle when you go to do it. It might help for you to visualize it first. Imagine confidently going to Fitzel and doing it successfully. You know cats have ESP, and this can work.

Think about Fitzel. Before this, did she have a spot or place where you would give pills? Do you pick her up and put her there or is she a "go to" kitty? My Merlyn wouldnt tolerate being picked up so I usually went to him to do things like medicating. Dont use her name or speak to her like shes a baby during the actual test. Save that for afterwards when you arent doing something that will hurt (even if its just a second) Some cats are restraint reactive.. meaning the holding on is more upsetting than the ear prick. I assume that she wont just stand there for BG check if you didnt hold her?

And...lastly.. yes its not ideal to shoot insulin blindly and not test BG, but DO NOT BEAT YOURSELF UP FOR TRYING!!!
 
Thank you for the hug Lisa. I feel very alone here. Spouse is asleep. Fitzel is hiding under our couch. Before I got the 28 gauge lancet I tried a 31. I thought my problems would be solved by the 28 dice blood was. Of forthcoming from her ear.

Because of our other cats I take Fitzel to a place away from them. She's never been a sick kitty before this. She's 12. So no special place to do this sort of thing. The shots are no big deal and I can give them to her as she waits for her food bowl.

I do understand what your saying about psychic kitties. I know she's picking up my anxiety. But it wasn't there to start with especially since she's so good about her shots. I dont understand why I'm not getting blood with the lancing device. I have it dialed to a deep level. It's lined up with the warmed up rim of her ear. But when I shoot she flinches, cries out. It there's. O blood. I work her ear a bit trying to get something anything to well up. So I try again then again and again. It's torture for her and hell for me.

When I did get readings she was running 226 - 249 pm pre shot and her nadir was 45 to 73. This is when she was on 1u 2x day. Because her numbers were too low she was dropped to .5u 2x day. The last nadir reading I got was 105 and the last pm pre shot was 225. But this was almost a week ago.

I dont understand why this is so hard for us and seems so doable for most.
 
I'm typing on my phone and see that quite a bit of what I posted is typo laden. What I meant to say is that even with the 28 gauge lancet I do hit the rim of her ear but get no blood. Not enough for the meter. I warm her ear with the rice sock until her ear is warm to the touch. I've had the same results with both ears.
 
Have you tried to test when she had treats or food in front of her? It may be a distraction to her.

I know how hard it is at first, but try stay calm. I remember when I first starting testing my baby, I started to get frustrated and so her anxiety grew. I had to tell myself to breathe and calm down, and she did as well. Tell yourself you can do this, and you can. Just dont stop trying. You're doing awesome!

Ive been fortunate enough to never have to use the rice sock. I lay my Buttons between my legs, rub her ears for about a minute, poke, draw blood, hold a tissue and while I'm doing that, I give her chin scratches and praise and then let her go. Question, are you just using the lancet or are you using the pen type thing? (sorry, I dont know the name?!?!) Ive never just poked with a lancet, I've always used the pen. I know that for some cats, the noise of the pen scares them, but maybe that would allow you to get enough blood as you can change the setting of how deep a prick it is.

Dont give up though, and keep trying. It WILL happen, I promise! :YMHUG:
 
Shai- I really want to encourage you because I have only been at this for a little over a month and let me tell you what I have gone through. I have had days where I have (no joke) stuck Caesar's ear 15 times in one sitting and ended up with nothing and running to the bathroom crying and believeing that Caesar will think I am being mean to him and that he won't love me anymore. My son would sometimes hold his head for me and he would flinch either just as or just before we got our precious drop of blood, sometimes smearing it on our clothes, or finger or whatever it may be. He would be growling, or pushing on my leg or just trying to get the heck away from me.
When I was reading posts from veteran testers that said their cats would purr when they heard the zip of the monitor case at testing time, I thought : oh sure, come on, that has to be an exaggeration!! I do NOT believe it!!!
We tried treats, we tried all of these things that were suggested but NOTHING helped us. I believed we were doomed (he was doomed) and that was that. This involved lots of crying, frustration and sometimes throwing the monitor across the counter. (yes, I did that).

In just the LAST WEEK.. Caesar has started to realize- this is our life. Honestly, I can now join with others by saying that, yes, Caesar DOES purr when it is testing time.(I can't believe I am saying this). I do not use the rice sock. I spend 5 minutes just petting him and talking to him, telling him how much I love him, what a good boy he is.. etc...I rub his ears and tug on them (he likes that) and he starts purring.. I don't believe it is because he likes being tested, I think it is because he knows it will be time to eat when we are done. But, I want to reassure you that it has taken over a month of trial and error. Some suggestions work and some don't. I encourage you .. don't give up. You CAN do this!!! Take it from one who was crying DAILY and saying "I can't do this." and "I hate this new life!!!" and believeing I was a failure and I was no good for anyone, let alone my precious Caesar.

From a reformed whining, hopeless, basket case of a diabetic cat mom- I give you (((((HUGS))))) and encouragement. You WILL find what works. Keep up the good that you are doing. Just talking about it on here is a big step and I guarantee, will be a HUGE help!! It was for me!!!
-Jill
 
Where do you live? There may be a member close by who can come over and help you.

Are you free handing the lancet or using a device?

If you are using a device, try free handing instead - you will have more control over how you poke. Also, when poking do not poke straight in (like you are piercing) - horizontally, rather poke at an upward 45 degree-ish angle, this technique worked for me.

Are you sure the ear is warm before you poke? With Maui, I discovered one ear bled more easily than the other.

As another option, there are some that use the paw pad for testing. I haven't done this, but it is an alternative.
 
shai said:
I do understand what your saying about psychic kitties. I know she's picking up my anxiety. But it wasn't there to start with especially since she's so good about her shots. I dont understand why I'm not getting blood with the lancing device. I have it dialed to a deep level. It's lined up with the warmed up rim of her ear. But when I shoot she flinches, cries out. It there's. O blood. I work her ear a bit trying to get something anything to well up. So I try again then again and again. It's torture for her and hell for me.
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My cat DID NOT LIKE the click of the pen. I free-hand the lancet myself as the pen never worked for me.

But... since she senses your anxiety I would try this- rub her ears over the course of the day- 30 seconds, a minute, doesn't matter. No poke, just rub. When it is test time, take the lancet out of the pen. Have a little bit of a cotton ball ready, stand behind her if possible, and just rub her ear. Gentle massage and if you can get her to drool that is a plus :-D (this calms you down as well).

Place the little bit of cotton under the edge of the ear and (the vein should be a little bump-out about an 1/8th of an inch inside the edge- if you don't have a black or hairy-eared cat :lol: ) gently poke between the vein and the edge on a 45 degree angle.

The cotton is there in case you miss-judge and poke through the ear- we all have done it in the beginning and I still do that on occasion now. If you know you poked but don't see immediate blood massage the ear for a few seconds- whole ear, not just the part with the hole- start from the base and push up with the thumbs. You might have made a hole but if there is no blood in that area yet it ain't coming out! If after a few seconds of massaging there is no indication, just smoothly pick up the lancet again and poke once more.

Once you see some blood get it to the back of your fingernail before she flicks it off and then you have plenty of time to praise her (and rub her head with your free fingers while you lightly pinch the hole with two fingers.

It takes practice but she should have the capillaries by now. Don't skip days of playing with her ear- I do massages even when it's not test time so she doesn't think that is all I want to do with her ears.

Good luck.
 
HI Shai, sorry to hear your having such a rough time with the testing. I also would encourage you to try free handing the lancet. I never could get blood with the pen and my cat would flinch when she heard the click. After the ear is warmed I use a flashlight to see where the veins are and then using just the lancet poke on the outer spot. I will say that even though I've been doing this for 7 months I don't always get it on the first try. I alternate ears so that one doesn't get more sore then the other. So hang in there - I have confidence that you & your baby will get into the groove. Jan
 
Be sure to have something firm behind where you are poking. I used a folded up paper towel half. It made a huge difference when I was testing Maggie.
 
My 2 cents, but I might even try a 26g lancet. At first I got a little blood from Saima's ears with the smaller lancets included with the meter, but at some point it just quit working. When I went to the largest lancet I could find, it worked better. I felt bad because I figured the larger lancet probably hurt more, but it was better than trying repeatedly and getting nothing.

I can definitely sympathize with what you are saying, though. There were many times when I poked and poked and poked, over and over and over again in one sitting, and ended up in tears about 50% of the time. It was awful. I believe it would have gotten better over time, but that's not much comfort when you are already so panicked about a new diagnosis.
 
I echo everything everyone here has already said. You cannot possibly be the worst BG tester because I am!! LOL! Look at my spreadsheet!! I got nothing for the first few weeks and thereafter I got maybe one every other day. But as time went on, like others said, my cat Ninja got better and better (or maybe I was just less stressed). Is it easy now, after a month? NO it is not, but I can definitely see progress and am getting more readings - and I would tell you that it gets a tiny bit easier every day.

I tried the lancet pen, free handing, wrapping up Ninja like a burrito (towel or blanket), chasing her, crying and giving up -- many many many times. I am still trying to improve my technique, because like you, I often do not get blood. My spreadsheet looks like I don't test NInja as often as I should; but I assure you, I do -- I just don't always get blood.

So rely on what the others have said for more advanced technique (I'm going to try some of these suggestions myself); but here are the things that have helped me most so far: 1) using the round cosmetic cotton things. Not sure why, but these really helped me. I put them on the back of Ninja's ear when I am testing, and they provide cushion when using the lancet pen. Before this, I kept sticking myself!! 2) When using the lancet pen, understanding that I had to press down VERY FIRMLY (almost hard) and pressing up from the back with the cotton pad; 3) using a flashlight behind Ninja's ear to help identify the vein (hard to do though if you are doing this by yourself); 4) using the lancet pen WITHOUT the cap. This is kind of like an interim step between free-handing the lancet and using the pen. If you use the pen without the cap, you can better see where you are pointing the lancet (better control); and if you are hesitant to stick your cat (like me), the pen action does it for you. I just cock the pen, position it near but not touching the ear and hit the button. To clarify, if using the cap with the lancet device, you press down firmly (as mentioned in #2 above); but without the cap, you just position it near but not touching the ear 5) using "Neosporin ointment with Pain Relief" -- I put this on Ninja's ear before sticking. It serves three purposes: the ointment causes the blood to form a droplet, rather than spreading out into the hair, it prevents infection and also relieves pain for NInja. Make sure you get the ointment NOT the cream.

I also agree it helps to desensitize the cat to the process. Maybe you could use the lancet pen without a lancet in it -- just so the cat gets used to the clicking sound around her ear. Then apply the ointment, praise and treat (like, all in 2 seconds). This is kind of like "clicker" training. You might also restrict ALL TREATS other than those associated with this testing activity -- so that the only time Fitzel gets a treat is when she allows testing behaviors. Then progress to one stick (whether you get blood or not) and let Fitzel go with a treat. She will come to see that one little stick is no big deal (they say it hurts the cat about as much as a mosquito bite). I think where you lose them is sticking over and over and over.

After a month of chasing Ninja, she will now hop up on the bed for testing. She too purrs (just started that this week), though quite honestly, I get the feeling that it is more self-soothing behavior rather than that she enjoys the process. She sits on the farthest end of the bed with her ears flattened back (like a kid cringing in anticipation of shot); but this is amazing progress from where we've been. If I don't get blood after 2 or 3 tries, she usually jumps down and typically I let her go. I think that if I stress her too badly this will spike her BG and the reading I get from her will be useless anyway (like what happens at the vet) -- so what is being accomplished by that?

As I have told others, I try to view this as a marathon, not a sprint -- and know that I am not going to be perfect at this; some days I will fail completely, and that's ok. I keep trying different methods, and it will come. I agree with Jill that it helps to talk about it. Sometimes in reading the posts, you see others able to test right away and get you get the impression that this comes easily (for everyone but you); and maybe for some it does. But I think there are far more of us who do not succeed right away -- but are afraid to admit that; and maybe some of those people even quit trying seeing themselves as failures. So I applaud your willingness to post about this and to keep trying.

Finally, you didn't mention what meter you are using -- but I have found the Relion Micro from Walmart requires just a tiny drop (I think it is .3) so might want to use a meter that requires something similar. We are all in this together and are here for you!!!

PS: In the beginning, I had more luck testing Ninja if she was sleeping - for some reason, she didn't seem to mind me sticking her ears as she was waking up from a nap.

Melanie
 
What blood glucose meter are you using? Some require a large drop of blood, like 1 ul, which can be difficult to obtain from a cat's ear. A meter that use 0.3 ul of blood is best.

A cat's ear needs to be really really really warm, not just warm. The rice sock is great to warm up ears. Try microwaving it for a couple seconds or so longer than usual. Wrap it around the edge of the ear for a minute if you can. Distract kitty with treats or toys if needed. Hold the rice sock under the ear and give a good firm poke with the lancet device. You should get plenty of blood. If not, adjust the lancet depth to a higher setting and retry. Some brands of lancet devices just don't work well at all. You can try a different one (and get compatible lancets to use) or just freehand the lancet without the device.
 
I just want to say like everyone else, please don't give up!! Things will get better .. take a breather, give kitty extra cuddles and love and reassuring words .. and try, try, try again .. I know even after two years of testing mocha, there were days I couldn't get blood for nothing! It happens, and we do the best we can next time. If you try the lancing pen, something you could try is clicking it all day long .. maybe giving treats when she comes out .. that way she associates the clicking noise, with treats .. just a suggestion .. ((hugs)) hang in there!!
 
Hi Shai,
From what you've said, your using the device that came with the meter. First thing to try would be freehanding the lancet instead. I never even tried the device. Can you hand sew a button or do needlepoint? If so you CAN do this!
I am one of the people mentioned whose cat comes running for tests. Bob hasn't needed insulin for almost a year. I test him at most once a month. If I were to open the drawer where his meter is right now, providing he isn't sound asleep, he would run to me and sit at my feet purring and waiting. It's all about the treat for him. Bob is 100% motivated by shrimp, and that's what he gets after every test. Does he enjoy the process? Not likely. It doesn't hurt him, but it means he has to wait till I do it before he gets his treat, so he puts up with it. He'll sit thru four or five pokes (I've lost the touch for first poke success it seems:-) ) because he associates the ritual with the reward.
At first, it took a few tries every time. I ended up using 26g lancets before I got to the point where I got blood on the first try regularly. Eventually I was able to do it well with the 33g ones that came with the meter as his ears "learned to bleed". I was lucky because he never really fought it, needing only minimal restraint to stop him from shaking his head and the blood flying. I sit crossed legged on the floor with Bob facing away from me, and I use a small cotton ball under the ear both to protect my finger and to hold his ear in place.
One day soon, you'll" get this", Shai. And from then on, it'll be easy, and it will become a very strong bonding experience for you and her. And you will be telling a new person pretty much what I'm telling you today. :-)
Carl
 
((((((((((((all of the amazing people who responded)))))))))))

I ended up falling asleep on the couch waiting for Fitzel to come out. To my amazement and grateful heart she was curled up next to me when I woke up. After our loving up session I got online and found hope, help and kindred spirits. I truly had no idea my hideous experiences were mirrored by anyone else. I so needed to hear all of your trials and travails with bg testing. That each of you who relayed your stories were able to continue and eventually come to a place where you and your kitties found a median that worked for you gives me hope.

All of your suggestions are gratefully accepted. To answer some of the questions: Iive in the San Fernando Valley a suburb of Los Angeles. If anyone is near please give a shout out. I'm not using the lancet or device that came with my meter. (the one touch ultra mini). The lancets which came with it were 31 gauge. I had to purchase another meter to get the larger gauge 28 lancets. I use the ultra mini meter though. I think I've been holding the lancet wrong and will definatetly try a more angled poke. I've been trying straight down. I have tried with the device ( Fitzel doesn't mind the clicking at all) and without. She struggles more when I try to puncture the inside of her ear so I've been working with the backside rim. I do use neosporin ointment to keep any blood out of her fur but there's been no blood of note to worry about.

I will heat the sock up a bit longer and get it really warm. And I will also rub her ears as part of our loving sessions and reserve treats for testing. I have been giving her one or two after each shot. But the shots are not an issue. And I will change what I'm using under her ear for something other than rolled up toilet paper.

We'll try before tonights shot. Your thoughts will be tucked close to my heart. Btw: just for the info - Fitzel is Yiddish for a little bundle of trouble.
Shai
 
You can buy a box of lancets without having to buy a meter. Just look in the diabetes section and you will see them. If you can't find it, just ask the pharmacist to point them out.
 
ohhhhhhhhhhhhhhhhhh, I might know someone that might be able to help :-) whereabouts are you in the valley? how far away would northridge be? let me send my friend a message and point her here in case she can help you at all. her name is Sherry and she's a long time member here who has plenty of experience with diabetic cats and helping people with newly diagnosed kitties learn this testing stuff.

depending on where you are in the valley there might even be others as I know Sherry has helped others in that area over the years. i'm down in orange county/riverside county myself so a ways away but let's see what we can do
 
Hi Shai,

I'm located in northridge and work in chatsworth and am willing to help you with testing issues. I've helped many others here in the SFV and canyon country. You can let me know here on this thread and I will send you a private message (in the upper left hand corner you will see user control panel and messages).

I'll check this thread later this afternoon or when I get home from work.

Sherry
 
Cindy & Sherry - yes! I live in north Hollywood near the 170/5 interchange, just south of coldwater and roscoe.

I do realize I'm on the other side of the valley but I will gladly pay for your gas.

Shai
 
Btw: just for the info - Fitzel is Yiddish for a little bundle of trouble.
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Thanks for explaining, I always enjoy finding out why or how kitties get their names! Has she lived up to it? :smile: Plus, I learned a new word!
Bob was so named because he's just got about a 1" long nubbin of a tail. Not sure why, but out of a litter of five, two had normal tails, and the other three just a nubbin. No idea what Dad or Mom looked like as they were found as newborns with no adult supervision.

Carl
 
Cindy - I spoke to Sherry and she's wonderful. Thank you SO much for alerting her to my woes.

I promised to post tonight after I take a deep breath, re-read everyone's posts, and try once again to test Fitzel.

Fingers are crossed over here.

shai
 
Carl - isn't it weird how kitties usually name themselves and leave it up to us to figure them out.

Yes, Fitzel is just exactly the definition of a little bundle of trouble. It's interesting that Bob is named after his tail. Maybe he has some Manx in him? Fitzel has quite an interesting tail herself. It goes straight up about half the length of her tail, then straight back down, then it makes a sharp turn to the left. It must have been broken like this in the womb, but it is a living tail which she flicks about quite often. However, when she does her tail goes in three different directions - like a pendulum swinging both ways at the same time with the end piece ususally doing it's own thing.

How I do adore her.
Shai
 
pmps - 67!

Thank God and every single one of you who encouraged, cajolled and directed me to a successful testing of Fitzel tonight - insulin at that number, if I had not known her bg was that low, would have been a disaster I don't want to think about. If it wasn't for this board, I might have lost my baby tonight, and it would have been my fault!

She's not showing any signs of hypo, and hasn't today, but she's obviously skirting it. Even though I was successful testing her tonight, there was still trauma/drama. She just finished dins so I'll let her digest and see if I can re-test her in about half an hour. I hope my luck holds.

shai
 
Oh! This makes me so happy to hear! I'm glad that everyones suggestions helped and our encouragements allowed you to hopefully be more stress free. I hope you go in with the same attitude and positiveness in the next testing, but if it doesnt work, please DONT beat yourself up! Try and talk yourself through it and tell yourself you'll just get it next time! This will become easier I promise! I'm so happy for you, I just want to hug you! :)

Remember you can only do your best. I know though, that if anything were to happen to my cat and I felt if I did something or didnt do something it wouldnt have happened, I would blame myself too. I think its normal, but you're trying your absolute best and thats all anyone can ask for!

Now, others can chime in, but I believe 67 is okay. I believe I read somewhere that below 39.6 is when to really worry, but that could have been with cats on Levemir. I'm not sure I know what your baby is on. I try and stay above 54 before I start to panic.

PLEASE keep us updated! :-D
 
Hi Victoria. I haven't been on here too much but I see you are new, too. I just wanted to say that Buttons is so beautiful and I wish you the best, as well :)
 
Shai,
Congrats on the successful test:-) 67 is a wonderful and safe number. With no shot tonight, she should be good. Yes, if possible, you can get another test but her numbers should hold steady or start to rise, not keep falling as long as you aren't adding insulin to her system.
We don't start really sweating unless someone posts a number under 50, but that's easier for me to say. I am not holding the meter showing the 67, and I'm not in the same room as Fitzel. You did well today:-)
Carl
 
toosweetcae said:
Hi Victoria. I haven't been on here too much but I see you are new, too. I just wanted to say that Buttons is so beautiful and I wish you the best, as well :)
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Awe, thank you so much! You're so kind! I wish you all the best too and Caeser is such a lush, and handsome kitty. I just want to snuggle him all over! :-D Please give him some for me?!?
 
Welcome Victoria and Buttons! Thank you for your kindness to Fitzel and me. Thank you to everyone!

I wasn't able to get blood for a retest on Fitzel until +2 - she was 175mg/dl. I felt that was okay enough for me to go to bed.

This morning, though was once again the battle royal. I knew I just HAD to get a reading. No way was I going to shoot or withhold without a reading. After 6 pokes and no blood, I gave her ear a good rip - and yes, finally, blood. Lots of it. It took a few minutes and a good dab of neosporin to stem it. Her reading was amps:259mg/dl. So after I dried more of her blood and my tears I gave her .5u.

I hear that this will get easier and (hopefully) I won't have to slash her poor ears anymore. I'm looking at her right now, lying on our piano and basking in pre-sleep under the ceiling fan. I gave her some baked chicken after the ordeal and her breakfast, which she ate. But her poor little ear is all red and gooey (from the neosporin). Oh, this is so not how I want her (or me) to deal with all the years of her life to come. She's only 12 and I have plans for her 18th b-day. And her 20th, but those are still a bit loose.

Does anyone have a comment on her numbers and the .5u of Lantus I'm giving her? Feeling like I need a wiser opinion than my own.
Shai
 
259 isnt too bad! I dont know anything about Lantus, but I agree .5u seems a good dose just because there is a chance you wont be able to get a mid day test to see where her sugars are. For now, I think our goal is to get enough blood for testing before each shot.

It WILL get easier, and you wont have to rip her ears every time! After all those pokes you do, maybe give her 15 minutes, and try again with the rice sock and every other techniques your using before deciding to rip. Even if she doesnt draw blood, lots of treats and love! I cant imagine what it is doing to your heart, but I'm sure she doesnt have any bad feelings towards you! Eventually she'll understand its an every day thing and that she gets treats afterwards! :)
 
Hi Shai! First, I understand and sympathize with your "battle royale" this morning. It may (and probably will) continue to be challenging for you for a few more weeks, but trust me, within the month it will be "no big deal." I don't know why it is this way...but in reading all the "newbie" posts, that just seems to be the way it happens. Many of us start out chasing our cats around, crying, throwing things and getting nothing but an angry cat in the bargain. But after a few weeks of testing and treating, the cats just seem to magically fall in line -- some faster than others. Unfortunately, I have one of the "slower ones"... or maybe it's just ME! LOL!! I NEVER, NEVER, NEVER thought Ninja would let me test her. Yet today I have tested her 3 times so far (first time I got no blood); and yes, she was purring each time. This will happen for you too! It just takes time (more for some cats than others).

I am guessing Fitzel's 259 reading from this morning may have been elevated from the "Battle Royale" you had with her. Other FDMB members please chime in... do you think that may have contributed? Shai, what were Fitzel's numbers before she was started on insulin (when she was first diagnosed) and what have her numbers been running at home .... since you have been giving her .5 units or even before? I know you don't have a lot of readings, but would be interested in hearing what you have.

I would like to ask the seasoned FDMB members (like Carl, Hillary, Squeem3, etc.) if they think it would be an option for Shai to take things a little slower. That is, if Fitzel's preshot numbers are in the low 200's (guessing) and Shai is only giving him .5 insulin anyway, would it be an option for Shai to take it a little slower with the insulin until she feels more comfortable getting consistent preshot readings -- like maybe practice her BG testing but give no insulin shots for the next week or so (with the option to discontinue if she sees Fitzel's BG start to climb too high)? The majority of Shai's anxiety seems to be around shooting Fitzel with even a small dose of insulin, because his BG numbers do not appear to be that high to begin with (if I am understanding that correctly Shai?); and she is afraid of sending Fitzel into hypo.

Please note that I am NOT RECOMMENDING THIS (just an idea)... I am just asking what the senior members think. Many of us spend weeks or months getting our cat's BG numbers down into the 200-300 range (from the 400's, 500's and 600's) so by that time, we are more practiced in getting the BG readings -- but Shai is fortunate in one way that Fitzel's numbers are comparatively low at the start -- but unfortunate, in that this means Shai does not have the luxury of time to learn and practice without exposing Fitzel to a hypo episode. So just wondering if Fitzel would experience any/much damage to his system if untreated with insulin for a week or two (assuming his numbers are relatively low now) while Shai practices her testing technique? I defer to the senior members on this as they are the most knowledgeable and experienced.

PS: From the Beginner's FAQ section: if BG is below 300 (and nadir near 100), the cat is considered "regulated with good clinical signs and no hypoglycemia;" and "Well regulated" generally below 200-250 and often near 100, no hypoglycemia.
 
Hi Shai,

Congrats on your successful test last night :) I told you you could do it!! This mornings amps could have been from no shot last night and the "Battle Royale" from this morning. If I were you I would stick to the .5 units of Lantus and keep trying to get some more bg readings.( I know easier said than done :)) Please do not hesitate to call me- I'm available 24/7. Once you get your computer back it will be much easier to keep track of her numbers using the spreadsheet we talked about. ((hugs))

Sherry
 
This is directly from the Lantus forum: viewtopic.php?f=9&t=1581

Many Lantus and Levemir users in this forum have been successful following a somewhat modified version of this Tight Regulation Protocol for the last few years. These "general" guidelines are based on anecdotal evidence and personal experiences of laypersons frequenting the forum.

"General" Guidelines:

Hold the initial starting dose for 5 - 7 days (10 - 14 consecutive cycles) unless the numbers tell you otherwise. Kitties experiencing high flat curves or prone to ketones may want to increase the starting dose after 3 days (6 consecutive cycles).

Each subsequent dose is held for a minimum of 3 days (6 consecutive cycles) unless kitty earns a reduction (See: Reducing the dose...).

Adjustments to dose are based on nadirs with only some consideration given to preshot numbers.


Increasing the dose:

Hold the dose for 3 - 5 days (6 - 10 consecutive cycles) if nadirs are less than 200 before increasing the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 200, but less than 300 increase the dose by 0.25 unit.

After 3 days (6 consecutive cycles)... if nadirs are greater than 300 increase the dose by 0.5 unit.


Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

If an attempted reduction fails, go right back up to the last good dose.

Try to go from 0.25u to 0.1u before stopping insulin completely.


Random Notes:

Because of the cumulative nature of Lantus and Levemir:
An early shot = a dose increase.
A late shot = a dose reduction.

A "cycle" refers to the period of time between shots. There are 2 cycles in one day when shooting twice a day.

Sometimes a dose will need to be "fine tuned" by adding some "fat" or "skinny-ing up" the dose.


Now that you started testing and are collecting data, I agree with holding the dose to see how it works for her.
 
Thank you for the tight regulation protocol info. Also to everyone for comments on Fitzel's recent numbers.

When Fitzel was diagnosed she was in the low 400's. (about the 3rd week of June) At this time she was eating dry and wet food. Since then her diet has been modified to all wet food - high protein, low carbs, low fat, moderate Omega 3's.

The bg tests I've done to date are:

The following readings are at 1u Lantus 2x

6-28-12 - (9:28pm) - 249mg/dl
6-29-12 - (9:39am) - 226mg/dl
6-29-12 - (4:17pm) - 45mg/dl - treated with karo on her gums
6-29-12 - (5:30pm) - 135mg/dl

Reduced dose to .5u/per vet instructions

6-30-12 - (9:45am) - 283mg/dl
7-3-12 - (9:35pm) - 225mg/dl
7-5-12 - (3:47pm) - 98mg/dl
7-9-12 - (9:37pm) - 67mg/dl - treated by withholding insulin shot
7-9-12 - (11:49pm) - 175mg/dl
7-10-12 - (9:21am) - 259mg/dl (treated with .5u Lantus)

This brings me current. So, Fitzel went from the low 400's - skipped the 300's altogether - and has been in the mid to high 200's and down as low as 45 on 1u, and 67 on .5u. Her attitude (other than around mommy) is pretty good. She's eating well, her water consumption is normal as are her litter box habits. She dropped down to 6 pounds when first diagnosed, but has returned to 7.9 pounds rather quickly, which is very close to her optimum which is 8 pounds.

At the moment I'm kind of leaning toward keeping her on the half unit unless her numbers are too low like last night. Now that you all can see her history (what there is of it) I look forward to comments and ideas. I know so little here, I'm not sure just how much I should trust my own judgement.

Shai
 
Do you typically give shots around 9am and 9pm? I noticed a lot of your readings were around that time. The experienced members would want to know your shot times. PS: I would kill to have Fitzel's numbers for my cat. My vet said if I can get Ninja's numbers between 100 and 200 most of the time, that that will be ideal. Looks like Fitzel has responded very well to the change in diet. From my perspective, .5 units of Lantus is a pretty small dose (my cat is on 3 units, twice a day). After a time, some cats can be maintained on diet alone (with no insulin) and here's hoping that Fitzel is one of them!! Hopefully, the senior folks here will guide you. There is also a link off of the main page called Insulin Support Groups: viewforum.php?f=5

There is a "tight regulation" Lantus group, a "relaxed regulation" group, etc -- though I am not really sure which you would be following -- since you just started this a couple of weeks ago and Fitzel's numbers are already so low. Maybe others can advise.
 
New Number: 7-10-12 - (5:42pm) - 126mg/dl

I do try to shoot 12 hours apart and somewhere between 9:00 to 9:30 am and pm seem to be the best for me.

Is this not a good schedule? Wondering.

Shai
 
Shai: Here is a link to a preliminary spreadsheet I made up for you, based on the numbers and info you gave. This link will help others to see your BG readings and better advise you. If you want to use this permanently (and update it as you go), just send me a private message (PM button to the right) and I will give you the login info. I just set up a dummy google account for this spreadsheet.

https://docs.google.com/spreadsheet/pub ... utput=html


To allow others to see this spreadsheet (and your updated readings) when you post, you will need to copy the link above and paste it into your signature box (User control link at top of page, tab that says profile, then "edit signature" and paste the link above into that box. You can edit this spreadsheet and change anything that I got wrong. If you want to make up your own spreadsheet, that is cool too. Just disregard the link shown above. Just trying to help you get a jump start and this took only a couple of minutes to make up. :) As a PS: I don't believe you are supposed to shoot if the preshot number is under 200 (others, correct me if I am wrong on this).
 
shai said:
New Number: 7-10-12 - (5:42pm) - 126mg/dl

I do try to shoot 12 hours apart and somewhere between 9:00 to 9:30 am and pm seem to be the best for me.

Is this not a good schedule? Wondering.

Shai
Click to expand...

Your schedule is just fine. If this timing works for you, then it's a good schedule. The intent is to shoot (if you shoot) in 12 hour increments.

When Maui was on insulin, I gave myself a 30 minute window to shoot as well and it worked for us. So, as long as you are consistent you should be fine.

At this moment, I would say to continue with the 0.5 unit dose. I certainly wouldn't raise it any. And it's possibly that very soon, you could start shaving that dose drop by drop.

Also, if you get a low reading again, instead of going for the karo, get a couple cans of high carb food, Fancy Feast makes a gravy lover's which is perfect for this purpose - and what you can do is feed a couple teaspoons of the gravy and you can also mix those teaspoons with a couple spoons of the low carb food you are using.

By using food instead of sugar to raise the bg, you will get the rise you need, with a slower dropping of bg. And using the gravy alone, will also ensure that if you have to repeat this process she will continue to eat and not be stuffed.

Just something to keep in your hypo toolkit.
 
Thank you so much for the spreadsheet!!!!!!

Yes, I want to use this and will soon as my wife has a chance to go through the instructions, hopefully in the next day or so. Unfortunately, I'm on more meds than Fitzel and this is a bit beyond my brain's current capabilities.

I do have tonight's pre-shot number: 7-10-12 - (9:38pm) - 229mg/dl - I gave her .25u of insulin (or as close as I could get to that)

I'm hoping this was the right decision to lower her dose. With the 67 last night and the low 100's this afternoon, I don't want to chance pushing her into a hypo event. Thank you for the suggestions re:food for low numbers as opposed to going straight for the karo. I put your food suggestions on our kitty shopping list. (yes, they have their own)

But, I'm sliding back into despairing over the tests. In order to get her ears to bleed I have to do such damage to them. I just can't imagine doing this for any length of time. Tonight the blood from her ear dribbled into the fur by her neck. I cleaned her up, held her ear and she's so demoralized by all this she just lay there, allowing this. When I let her loose she still just layed there. I gave her lots of loving but she neither responded in her usual manner nor did she shun me. Maybe this is better than her growling and trying to pull away, but it breaks my heart to see her lose her spirit.

Right now, she's on my desk, leaning against the computer as I'm typing. Her ears are still red/brown, from dried blood and she'll have scars where I've stabbed her. I wish I had the skills to get a pic of her into the computer so I could show you what a beautiful kitty she is even with the damage to her ears. She's a combination black tortie/calico. With just enough white and orange to compete with the black splotches. Well, someday I'll figure out how to add her pic to my posts.
Shai
 
Oh, I forgot to say thanks for the comments on our schedule and her numbers.

The information you all share is priceless to me and gives me a bit of confidence in making decisions on Fitzel's behalf.
Shai
 
No problem. I updated the spreadsheet with your most recent results. Here is the link if anyone wants to view:

https://docs.google.com/spreadsheet/ccc ... li=1#gid=0

Send me a private message (PM button on right) if you want more instructions on how to add this link to your signature line (so it follows you every time you post). It's easy.

Don't despair about the testing. It does get easier with time. Fitzel is on such a small amount of Lantus now (.25) and her numbers are not that elevated (probably even lower than posted due to the stress you have experienced with testing her) -- so the good news is that (from the way I read the beginners FAQ) Fitzel is already in the "well regulated" numbers (less than 250, even at preshot) so, other than her ears, little damage is being done to her body. Her spirit will come back. You have been at this a very short time, so don't beat yourself up about not being perfect. No one is. You just do the best you can do, make judgements you feel are right for yourself and your cat, and don't try to rush. Fitzel will be fine regardless, and so will you. ((((((((Hugs)))))))))

:)
 
Please refer to the lantus protocol again:

Reducing the dose:

If kitty drops below 40 (long term diabetic) or 50 (newly diagnosed diabetic) reduce the dose by 0.25 unit. If kitty has a history of not holding reductions well or if reductions are close together... sneak the dose down by shaving the dose rather than reducing by a full quarter unit. Alternatively, at each newly reduced dose... try to make sure kitty maintains numbers in the normal range for seven days before reducing the dose further.

For a reading of 67, personally, I would have said hold the dose as is. Now that you did drop it, let's see how that works for the next few days. If her numbers rise too much, then you can always increase the dose.

Regarding her ears: make sure you put neosporin on her ears AFTER you test.

Another ear testing tip that you may find helpful is to use vaseline (petroleum jelly) on the ear before you poke, this way, when you do poke whatever blood you get will bead onto the jelly and you can sip/test from that. The jelly won't affect the bg.

Where on the ear are you poking? If you are poking high up on the ear edge, you may want to try poking lower down. Here is a pic of the "sweet spot" and if this isn't working, try lower down on the ear.

sweetspot.jpg


Are you "milking" the ear after you poke? This is a technique that you take the ear and mush it together - think about how you would pop a pimple. this will also help the blood to flow.
 
Shai,
I'm not sure which videos you have watched for home testing, but this is one of the better ones I've seen. Especially for the "milking the ear" part that Hillary mentioned which is about a minute and a half into the video.

http://www.youtube.com/watch?v=_zE12-4fVn8

Carl
 
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