Big scare last night!

[Little One]

So my 10 year old male cat called Little One was just diagnosed with diabetes a little over one week ago. We suspected it several weeks ago, but our vet tried to control it with diet first with prescription Hills W/D dry (wish I would have found this site sooner). The first visit back after the food change, his bg went down so we went a little longer, but the next visit it was higher than the first. He started us on 2 units of N two times per day (again, i wish i would have found this site sooner). Took him back a week later, but he was still high. We had given him his dosage Friday morning at 7:30am and his appointment was not until 4:30pm. I discuss the wet low carb high protein diet option. He said that it was probably a good idea, but still wanted to up his dosage to three units. He tried to get me to use the W/D wet, but i told him that I would find another set food option. We didn't start the wet food until the next morning and went a head and gave the three units. He ate and then went to the cabinet in or laundry room where he likes to sleep and slept most the morning. We checked on him a few times and he was responsive, but never got up. When it came to feeding time that night we decided to back his dosage off back down to 2. Later that night we found him under my daughters bed, which is very unusual, acting very funny. We was responding to use, but would not come out. Once we pulled him out from under the bed it was pretty clear that he was low. We grabbed our honey and started going to work. We had given him about one tbs but it didn't seem to be working very well. We called the vet and he said we would probably have to give him 4 to 5 tbs get him back up. We finally got his level back up to 474 and he was acting much better, but still not himself. He has been very lethargic today and definitely not himself. We tested his level tonight and it was 373 before feeding.

So now we have no idea what his dosage should be or how to go about determining what it should be.

We did not plan to home test until this happened. I had a meter that I got some time ago to test my level so we tried it out thanks to the web. My test strips had expired, but that is all we had to work with until i can get a script for new ones.

This is obviously all new to us, but we have already learned a lot, but I know we have much more to learn.

Any recommendations/ suggestions / direction would be greatly appreciated.

 

[Sue and Oliver (GA)]

So you know you need to test. Get some current strips and a lancet with 25-28 gauges, not the 31 that most humans use. Get some readings now that you are feeding the wet low carb and see if his numbers are high enough for insulin. (A cat in remission ranges from 40-120 with the majority of the time in double digits, off insulin)

And if he is high enough, I would urge you to get another insulin. N tends to hit hard and fast and that makes it very difficult to regulate with. If your vet won't prescribe Lantus, Levemir or ProZinc, I would start shopping for a new vet. If you want to post your city/state, someone may have ideas for you.

 

[BJM]

Learning to test may save your cat's life; you'll know when it is safe to give insulin, if he's gone too low, or if he's really high.

Humulin N lasts roughly 8 hours in a cat. If you're stuck using this, it can be helpful to pick up the food 3-4 hours before the next test and shot.

Additional tests of urine for ketones, a sign of fat breakdown, can be really important, plus there are some supplemental monitoring tools in my signature link which you may find helpful.

 

[squeem3]

You don't need a prescription to buy test strips. Just go to the pharmacy and buy some more. They may be kept behind the pharmacy counter so ask if you don't see any with the diabetic supplies.

Are you using U100 3/10 cc insulin syringes? Are you measuring the insulin correctly?

1 unit is a typical starting dose for a new diabetic cat. You may want to restart insulin at 1 unit twice a day or even 0.5 units twice a day.

Definitely test blood glucose levels before giving the insulin. It's the only way you know if the blood glucose level is at a safe enough level for insulin to be given, over 200 mg/dl for newbies.

 

[Little One]

Thanks for the feedback so far.

We are trying get our schedule lined out as we have two young kids (7 & 8) and schedule is proving to be tricky.

He is what we are trying.

MORNING
Feed @ 6:30am
Test @ 7:15am (3xx this AM)
Dose if needed based on above test (Gave 1 unit).

He typically eats all of his food at one time, but if he doesn't, we typically leave it out for him to graze on during the day.

MIDDAY
Test @ noon to help develop curve & understanding

EVENING
Feed @ 6:30pm
Test @ 7:15pm
Dose if needed based on above test

We plan to capture a +3, +6 and +9 hour readings as well to help establish our curve.

We are also considering taking him to the vet and have them keep him for the day and help us develop our curve.

TO DO LIST
1. Buy new testing strips
2. Buy smaller lancets
3. Pick up some keato strips
4. Probably many more

QUESTIONS
1. Is it okay to leave food out if he doesn't eat it all?
2. Do I need to get him to the vet pronto to get a +3, +6 & +9 curve?

I have created my ss, but need to better understand how to use it.

I would really like to change to Lantus. I am sure I can talk my vet into making this change for me. I have five pet and take all of them to him so he really likes me if you k.ow what I mean. If I get him to make this change for me then do I have the vet take him for a day to create the curves?

I think that is all for now. This has been very overwhelming so far, but my wife and I are committed to making this work.

Sorry for any mis-spelling. I am doing this from my cell phone @ work.

Thanks for feedback in advance.

 

[hmjohnston]

He is what we are trying.
MORNING
Feed @ 6:30am
Test @ 7:15am (3xx this AM)
Dose if needed based on above test (Gave 1 unit).
He typically eats all of his food at one time, but if he doesn't, we typically leave it out for him to graze on during the day.
MIDDAY
Test @ noon to help develop curve & understanding
EVENING
Feed @ 6:30pm
Test @ 7:15pm
Dose if needed based on above test
We plan to capture a +3, +6 and +9 hour readings as well to help establish our curve.

First- test the BG level THEN feed. If you feed and then test you are getting a food induced number that is not accurate. And dosage for Lantus is actually based on the nadir number- between +5 - 8 #'s- you want to see how far the dose drops him. And you don't want to change it. You keep the same dose, unless they drop too far and hypo, for at least 10 cycles (5 days) or more. But with the information in the SS we can advise you better.

We are also considering taking him to the vet and have them keep him for the day and help us develop our curve.

You are wasting your money doing that. The vet levels will more than likely be influenced by vet stress- levels could be 100+pts higher and so skew the dosing. When you home test it is easier on your pet and it isn't so expensive. What METER do you have? There are some that are great for testing and some that aren't great at all.

TO DO LIST
1. Buy new testing strips
2. Buy smaller lancets
3. Pick up some keato strips
4. Probably many more

larger lancets, smaller numbers... you want 26 or 28 gauge instead of 31. And get the ones you can freehand if you find you don't like or can't use the device.

QUESTIONS
1. Is it okay to leave food out if he doesn't eat it all?

Yes. Most of us free feed during the day. If you are feeding your whole bunch low-carb food you won't have to worry about him getting any contraband. And it is better for the other cats to eat a low-carb wet food anyway. Less chance of FD, lower risk of CKF(D?), and lower crystals and urine problems associated with dry food.

If you are worried about it drying out or being fresh you can add water- we all do, add an ice cube that will melt and water it, freeze it (personal fav) in ice cube trays (mix with water before hand) to set out- thaws out in a few hours easily.

2. Do I need to get him to the vet pronto to get a +3, +6 & +9 curve?

As mentioned above- you can do your own curve at home and can save yourself the money. Any numbers received at the vet- unless he is a REALLY cool cat at the vet and doesn't mind going at all- the numbers will be wrong.

I have created my ss, but need to better understand how to use it.

AMPS and PMPS are AM and PM pre-shot numbers. U- then how many units you gave. Tricky part- +1, +2, +3- these are how many hours after the shot you tested. Since we are all over the world we can't exactly say '7AM' and everyone know what time that was, so we say '+3' and we know you tested 3 hours after the shot. I insert comments so I know if it was done off the shot at 15, 30, 45 minutes, also when I note feeding or any other changes.
This is what we look at when we give dosing advice.

Good luck! It might take a little time to get into the groove but I can test and shoot Sneakers in two minutes now- and she expects it. If I forget something she is looking at me like "WHAT!!!??? No test?" :lol:

 

[Maggies Mom Debby]

MORNING
Feed @ 6:30am
Test @ 7:15am (3xx this AM)
Dose if needed based on above test (Gave 1 unit).

He typically eats all of his food at one time, but if he doesn't, we typically leave it out for him to graze on during the day.

MIDDAY
Test @ noon to help develop curve & understanding

EVENING
Feed @ 6:30pm
Test @ 7:15pm
Dose if needed based on above test

You need to test before you feed him - that 45 minutes between feeding and testing allows the food to hit his bloodstream and effect his blood glucose readings. I would recommend test, feed, shoot. And leaving food out should be fine, even wet food.

 

[Little One]

Why large diameter lancet?

 

[hmjohnston]

It makes a bigger hole at the beginning. After the first box of 100 you should be able to get the higher number (smaller gauge).

The ear has to be 'trained' to bleed and that means a larger needle.

As for the device- Sneakers did not like the clicking by her ear- or the beeping. So I free-hand the lancet, scoop the blood on my fingernail, and test it from there.

 

[Little One]

I am currently using the OneTouch Ultra Mini test meter. We are using the lancets that came with the test meter except we are using them without the gun device. We have not had any real issues getting the ear to bleed. I assume based on what I have read that it is normal to go all the way through the ear when sticking it with the lancet?

Update. We tested during lunch @ approx +5 and he was in the 290 range. Progress.

Plan to test him again before feeding tonight.

 

[squeem3]

The Delica lancets? Those are 33 gauge, too thin to get blood from a cat's eat. Since you are not using the lancet device, you can buy a box of thicker gauge lancets of any brand. 28 gauge is a good size. Here is a lancet gauge chart: http://www.walgreens.com/marketing/library/centers/diabetes/lancets.jsp

The lancet doesn't need to go completely through the ear. Occasionally it happens, though. You just want to poke deep enough to get blood to come out.

Are you warming the ear before poking with the lancet? Warm ear bleed best because of the increased blood flow. A "rice sock" is popular: fill a small cotton sock with uncooked rice or uncooked oatmeal or dried beans/peas (maybe 1/4 to 1/2 cup enough to make an extra large egg-sized ball that fits in your hand), knot the sock close, cut off the excess, toss the rice sock into the microwave and heat until very very warm but not hot (try 10 seconds and adjust time as needed), wrap the warm sock aroud the edge of your cat's ear for a minute if possible, hold the sock under the ear while you poke on the other side.

 

[Little One]

Went to the store tonight to get some new test stips and some ketone stips. The strips for my meter were $30 for 20 so we ended up buying a new ReliOn Micro meter and new stips instead. Tested with it tonight with no issues. We are not having any issues with getting blood from the ear. My wife has gotten pretty good at hitting a good spot. I have done some work on Little One's SS and tried to add a link to my signature line. Got three readings today so plan to get readings as offten as we can for the next couple days.

I do have a new question. Is dry skin pretty normal with this? Little One is really flaking on us if you know what I mean.

Thanks.

 

[Grayson & Lu]

Glad everything seems to be better today... I'm sure you're relieved!

If by dry skin, you mean all over Little One's body, yes - dandruff is usually a sign of the unregulated diabetic. If you mean on the ear where you're testing, that's not uncommon either. Some people use Neosporin w/ pain relief after testing; some people use vaseline before to help the blood bead up. For those of us that have kitty ears that DON'T bleed easily, the size of the lancet is an issue. Sounds like you're one of the lucky ones!

You're doing great so far! ProZinc can be a really good insulin, so if you're seeing a response, you may want to stick with it for a while. Personally I'm glad I started out on ProZinc, as it's much more flexible with your schedule. Unfortunately, Grayson developed a resistance to it, and I had to switch to a longer lasting insulin. If your schedule isn't consistent, PZI might be your best choice.

Lu-Ann