Advice/Reassurance

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Today is my Buddy's 6th day on Levemir (I switched from Humulin). I give him one (1) unit 7am/7pm. I currently do not have a ss because I'm having great difficulty in getting enough numbers to even post. I too started (or attempting) the home testing on that day. I do have 2 questions.
#1. Please reassure me that I'm not the only bean who is having trouble getting successful tests in the beginning. What used to be a quiet little home has become one of great anxiety and frustration. I've tried all the techniques, it's just that his squirming makes it difficult to test. Is there anyone out there who could at least reassure me they had the same difficulty in the beginning and it will get easier and that I'm not the only one going thru this. I would greatly appreciate it. But my main concern is ....
#2. Buddy's numbers just keep climbing. Buddy is 8 yrs old, 14 pounds and was diagnosed 11/19/10 with diabetes with a bg of 454. He was placed on Humulin, 3 units 2x/day and was tested one month later and his bg was 127; then was tested a month later and it was 264 and was told to increase Humulin to 4 units. That's when I switched to LEVEMIR. The advicie is to start low/go slow, as stated ablove 1 unit 2x/day). Is it time to increase?

I have been able to get morning pre-shot numbers. Each morning they keep getting higher in the 400's. As I said I started six days ago .... that day his am pre-shot number was 376, the am preshot # has increased everyday since and today his preshot number was 439.
I have been successful in getting tests around noon everyday and those numbers range between 264 and 304. (I have tried at other times during the day but have been uncessessful) At least the times of successful testing has been at the same time during the day.
I eliminated his dry food last weekend and he only eats Fancy Feast "Classic" and his treat at "testing" time is boiled chicken.
Is it time to increase insulin ... if so how much? When his numbers were low using Humulin he was lively and playful. This week he has not been.
(I'm sure the stress of testing hasn't helped either). Please help .... we're heading in the wrong direction.
I love my Buddy and it's just very distressing seeing these higher numbers everyday. Thank you in advance to anyone willing to offer advice.
 
I can't help with dosing as I have never used your insulin.

But I can assure you that you are not the first of us that have had a tough time with those first few home tests. It is very seldom that we get it right the first few weeks. I was lucky with Max because he was my second sugarcat so I had a basic knowledge of what I was doing. But since I adopted Max from this board as a diabetic our first few attempts were still a disaster. He didn't know me, he had no reason to trust this crazy lady that wanted to poke his ear.

So in the very beginning I would wrap him up in a big towel with just his head out. Now I just shake the container of test strips and he jumps up for testing because he knows there is a yummy treat in it for him.

It does get better, but just like every cat is different, every bean is different. You have to find what works for you both. I did find at least with Max, taking the cap off the Lancet pen and only using the spring action to do the poke helped alot because I could see better where I needed to poke. Plus having something firm to poke against, I use his rice sock, for poking against as well as for warming up his ear.

I also found that poking lower on the ear, just right above that double flap near the base was our magic spot.

Mel, Max & the Fur Gang
 
This whole thing is completely overwhelming. Does it help to know that we all felt that way at first? We spent an entire weekend poking poor Oliver before we ever got a drop of blood. It DOES get easier!

There are ways to help with a squirmy cat. We put Oliver down on the couch on a towel next to the arm. We wrapped him up until only his head was showing. I could press him lightly into the arm if he squirmed. Also, if he is moving away (and bleeding), you can get the drop on your fingernail.

Have you posted on the Levemir forum with your dose questions? It is not terribly busy in the middle of the day, but you will get answers in the am and pm. They all use your insulin and can guide you. viewforum.php?f=10

It also is very helpful to have a spreadsheet; it is color coded and makes it easy to see patterns and trends. Setting up a spreadsheet And if you ever get a number that you don't know what to do with, it helps members know your history and guide you. If you are computer savvy, it isn't hard. If you need help, just send me a pm.
 
Also, make sure you reward your cat after every time you test with a low carb treat. Even if you are not successful in getting blood. Soon you cat will associate getting tested means getting a treat and will become more cooperative with you. Also, if you spend a couple minutes gently rubbing the ears along with a few head scritches, that will help get the blood flowing. You cat will think he is getting spoiled with all of the attention. :mrgreen:
 
Hi Bel,

The dosing protocol for Lantus and Levemir is in this link. I know you don't have a bunch of numbers or an online spreadsheet, but I believe you have enough meaningful numbers and enough clinical symptoms to warrant a dose increase to 1.25U.

From the protocol:

* Hold the initial starting dose for 5 - 7 days (10 - 14 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 cycles).

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

Now, for measuring the 1.25U. You have the .5U marked syringes. You are looking to draw a dose so that the needle end of the plunger is halfway between the 1U and the 1.5U marks. It's a judgment call, but drawing what you call 1.25U consistently is the important thing.


It's amazing how a diabetic cat can reduce a grown woman to tears, isn't it? There are few of us here who haven't been in the same spot. I was so frightened to test that it took me two weeks to buy the glucometer. I shook the first few days just holding the lancet device. Sometimes I still do.
 
Just remember, it is vital that you do it! My kittie hated me at first or seemed to and I just did it right now and she was totally cool. I was poking her multiple times to get just 1 good sample and now I'm down to just 1 poke most of the time and it hasn't been that long since i started it. I do believe it will get easier!!! Now I think she realizes that I am just doing it to keep her safe! Everyone here has great info to help you through it too... =.)
 
I'm sorry it is so hard to test Buddy. Oh boy, do I remember those days with BigMac.

I wrote in your other thread and copied it - below. I don't know if any of this will help because you are probably doing most of the tricks already.

I used to dread getting up in the morning because I knew it meant another day of testing and I was having such a hard time. I was annoyed that so many people that said it would get better because it didn't seem to be getting better for me. I know by looking back at my SS when there finally was improvement.

In my case it took getting a meter that needed less blood and setting up a better routine. So many times I would get a drop and then realize I forgot to put the strip in the meter.... or if I put the strip in too soon it would time out. Arrggghhh! (Forgive me if I repeat stuff you've heard a zillion times.) Eventually I learned to lay everything out in order and place the strip lightly in the meter but not so it would turn on. As I warmed the ear and rubbed it to increase the circulation, the meter was ready and loaded, but the strip was NOT pushed it. I would only push the strip in when (or just before) I picked up the lancet device so the meter would be ready when I got the drop. Occasionally I'd still screw it up. But it was better.

I was lucky that I didn't have to do the kitty burrito method, but I was considering it.
Another thing I discovered (eventually) was that besides the warm ear and rubbing - when you do poke- hang on to the ear and "milk" it (if you can) to get that drop to form larger. Giving it a split second extra time really helps so you can get enough blood on the strip. If I moved too fast and didn't let the drop well up enough and tried to get the strip to sip, sometimes the test failed. I had to learn to give it that extra bit of time to make sure it was a well formed drop. It is as if the poke won't bleed immediately and waiting really helps. Unless you hit the vein and then there is PLENTY of blood. It is ok if that happens occasionally, afterwards just press a little longer than usual on the ear where it was poked so it won't be bruised.

That is not easy if your kitty is wiggly and my heart goes out to you. That's why I have to test up on the counter top so I can lean my arms and body over and around BigMac if I need to keep him still. He is good that he doesn't really try to escape, but he wants to shake his head and then I lose the blood drop as it flies across the room. :roll:


CD and BigMac said:
Hi Bel!
I had similar troubles when I first started testing... squirmy cat and a nervous me, made for some tense and upsetting attempts at getting blood. I think my first post here, I mentioned that the only blood I got was from my own fingers.

I just couldn't poke the ear freehand. (I still can't!) I wasn't as quick jabbing as the lancet device and BigMac clearly didn't like it. So I started clicking the device next to his ear without actually poking him. Click - click - click to get him used to the sound as I rubbed his ears. I was trying to condition him. Then someone told me to try really hard to be confident and tell myself "I can DO this." So my cat wouldn't sense my tension. I told myself and my cat... "I am going to do this because it will save your life, BigMac. YES, I am the boss here!"

I am not sure if it helped BigMac, but it sure helped me, hahaha! I still struggled a bit, but it did become easier. Another thing that many people do is to pick one location in your house to always do the tests. Then the kitty becomes used to it and knows he will get a treat when he is at his testing location. I put my cat up on the kitchen island because of the good light and I don't have to bend down. Up on the counter I can get a good grip on him without too much difficulty. These days, BigMac hops up there on his own as soon as I pull out the bar stool. He knows it is time for a treat... and he accepts that he will get a poke.

And one last thing. I use Neosporin ointment with pain reliever on the ear just before I warm it with the rice sock. I put a dab on and gently wipe most of it off leaving a thin film. Sometimes there is too much goop and I use the rice sock to wipe it away more as I warm up his ear. Maybe that helps numb the area a little and the ointment film helps the blood drop bead up just a bit instead of disappearing into the fur.

Sometimes I tested by using the inside of the ear because I had trouble seeing the blood drop with BigMac's dark furry ears.

Oh, I forgot to say... Welcome to FDMB!
Click to expand...
 
Hi Bel,
My Tessie Lou has only been on Lantus for 5 days, but she was started on ProZinc on 11/27/10. After all the reading I've done, I am sure you made the right decision to get Buddy off Humulin and on to Lev. Good for you!

Now, about the testing. To start, my husband and I both had to hold Tessie. It was horrible. I was lucky enough to have a local FDMB member pay me a personal visit and give me a lesson on how to do it. That helped immensely! Still, I had many, many failed attempts. Lots of tears. But, it's getting better! I use a lancing device, cause I couldn't do it freehand. Others swear by freehand. I put Tessie on her warm "woogie" blanket, on the couch, against the arm, and I sit on the other side of her. She kind of sinks down in the blanket. I scritch her and talk soothingly to her. It helps to have a talk with yourself first..."I am doing this for his health. Human diabetics stick themselves all the time. It's not that painful. He will get treats after, etc." Then, take a deep breath and focus on the job at hand.

It has slowly gotten better for me. It will for you, too. You CAN do this! Your love for Buddy will get you through it, and you have all of us to lean on anytime! I'm sending you and Buddy lots of positive vibes and love...

Your fellow newbie,
Sandy
 
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