BJ's Rough Start

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Mike and Bj

Mike and Bj

Member Since 2012
My buddy BJ is 14 year old fuzzy creamsicle in Washington. I got all the supplies for him, ketostrips, glucometer, etc and gave him his first shot of lantus at noon.

I tested him before the feeding (he was 485) and gave him the (2u) injection a few minutes after his lunch. I'm not entirely confident the needle went in all the way because he was struggling with me. That's stressing me out a bit. I tried to see if his scruff was wet but he was pissed and didn't let me be thourough. That said, I didn't feel anything wet.

The doc said to feed him twice a day, 12 hours apart. For my schedule that's noon and midnight. I plan on checking his BG again around 6pm. He HATED getting his ear pricked. Of course, I botched getting the blood twice which didn't help. So I'm very excited to draw blood again. I did freehand this time but will try the lancing device next time. I practiced using it on myself to see how it worked but I can see how it might be difficult to aim it so precisely on a cat ear.

Any general advice or words of wisdom appreciated.

Thanks,
Mike and BJ
 
Hi and welcome.

We have all had concerns about giving fur shots, don't worry about it and certainly DO NOT give additional insulin. Just wait until the next shot time to give his shots.

As for feeding times, honestly, you can feed him more than every 12 hours. Actually, feeding several small meals/snacks throughout the day is better for treating diabetes than two meals. It's the same for humans, it helps keeps the Bg's more consistent - there are other reasons why, which I'm sure others can elaborate about.

What kind of food are you feeding? If you are using dry/kibbles at all, we strongly recommend removing this completely and feeding a low carb wet food diet only - wet food can be canned or raw.

For more info on the reasons, please check out Dr. Lisa's site www.catinfo.org

And by low carb, we mean less than 10% in carbs - so foods that have gravy, chunks, slices, grilled etc. tend to be high carb (and is good for the hypo kit). Low carb tends to be pates. Check out Janet & Binky's food chart for low carb options:

http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=115

Regarding testing - let's talk about your testing technique. Where are you aiming on the ear?

http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287

Look at this link and the "sweet spot" picture to understand where you want to aim for.

Warming the ear before poking is also a good idea, you can do this by massaging the ear and/or using a warming sock -

To make a sock - take one sock, add 1/4 cup of rice, oatmeal, dry beans, knot the top - put in micro 15-30 seconds until warm to touch, then place and hold behind cat's ear until ear warms up. I also keep it there as a buffer when poking so I don't jab my finger.

The insulin you are using is great - if you haven't already, please visit the lantus board and read up on the handling, storage and how to use the insulin.

I am curious if 2 units is your starting dose. As we typically recommend a starting dose of 1 unit or even 0.5 unit. You can always increase the dose, but you can't remove it once injected.

You mentioned you are in Washington is that state or DC? As we may have members close to you if you ever need in person help.
 
The doc said to start him at 2u. I've read other people saying on here that he should start at 1u as well. I don't really know what to do... I'm scared to go against what the vet said. But it's making me nervous.

Should I ignore what the vet said and drop him to 1u? He was really fantastic with BJ, I don't want to second guess him.

My other main concern is that I'm not sure he got the first shot of insulin in him. Since his next injection is at midnight, I'm worried because if he has problems I'll be asleep. But that is the schedule I'm stuck with. I'm wondering if I should just start over again tomorrow at noon?

We're in Washington State. Also, I did use the sock warmer and got him in the sweet spot. But after pricking him, he wouldn't sit still so it was hard to get the blood on the strip :(
 
The next time, if he moves away, you can get the blood droplet on your fingernail and test from there. The other thing that really helped us at first was to have a large enough lancet - 25-28 gauge works well. The smaller 30-31 guage sold for humans are often too small for cats.

We do have members in Washington State. if you continue to have troubles, post with your city and ask for testing help.
 
Hi Mike! Make sure you associate the ear prick with a treat. That has been key for me. I give a treat whether I am successful in getting blood or not, and only try sticking the ear a couple of times before letting my cat go. That way, she is not overly traumatized by the whole process and now tolerates it pretty well. I was the worst BG tester on the board (took me WEEKS and I tried everything!). I have also had good success using the lancet pen WITHOUT THE CAP. I just insert the lancet, leave the cap off, cock the pen and aim for the sweet spot.

As to the injections, I give them while my cat is eating or enjoying a snack and she doesn't even notice. I do not give them in the scruff as I read that the blood supply is not the best in that area. Make sure you pull up the skin into a triangle-shaped tent...and inject parallel to the cat's body (not straight down), and into the lower half of the "tent." If you inject too high up in the tent, you'll get a fur shot. If you get a fur shot, his fur will smell medicinal -- someone described it as smelling like "bandaids" ...LOL!! Also, make sure you hold the needle with the numbers facing up - so the bevel of the needle is facing the right way (if the bevel of the needle is not pointing the right way, the cat can feel the injection more).

Until you feel confident in getting regular BG readings, I would echo what Hillary said, that a lower dose is typically recommended. My vet wanted to start at 2 units also, but because I was unable to get regular BG readings on my cat at first, we agreed that 1 unit twice a day was a safer number. Better to have too little at first than too much, in my opinion.

Forgot to ask, what is BJ eating? Low carbohydrate, wet food only is recommended by pretty much everyone on this board. Some pets go into remission by a diet change alone (and do not need insulin at all). Even if BJ does not go into remission, his BG numbers will drop (often by 100 points or more) by removing dry food and other high carbohydrate treats. BJ will also need less insulin if he is on an all wet food, low carb diet.

Good luck to you and BJ!!! Keep posting to let us know how things are going!

Melanie
 
Hi, cat friends. Thank you all for the kind replies. My stress level is sky high right now as you can imagine.

Bj's BG was down to approx. 275 at the 6hour mark. I say approx because by the time I got him to settle down the device already shut off before I could properly record it(!).

I will take the advice and drop his second dose of glargine down to 1u at midnight tonight instead of 2u. I hope the vet doesn't yell at me. I have to take Bj back to see him in two weeks to do the curve thing. Or should I just save the money and do it myself? Sigh...

As to what he's eating, well... I just started everything today. It took a week for me to do research and find supplies and get the insulin, etc etc. All I have is 3 prescription cans of diabetic food the vet sold me at $3/can and a similar bag of dry food which I come to find out is crap. So I have enough wet food to last til Tuesday when I will try to hunt down the Fancy Feast Classics at the store. In the future I will see what kind of things that we can cook for him at home. I have no idea what kind of things he could eat though. But I'm not feeding him the dry stuff anymore. He is pretty upset about that already. But I fed him a tablepoonful of wet food after his blood test instead of making him wait until midnight.

Can somebody recommend some cat treats for him that I can find at the grocery store? All I have now is Pounce, I gave him two after his ear prick. He's so mad at me!

Bj says thank you. He wants you to know he has pretty white and orange fur like a creamsicle and that all cats are Royal.
 
He sounds GORGEOUS! See if you can attach a picture (when you get a chance). Unfortunately, the grocery stores don't typically carry much in the form of low carb treats. But if you have a Petco or Petsmart in your town, you might want to try the PureBites freeze dried chicken or turkey treats. They are yummy (or so I've heard) -- two paws up! Also on the food, I think most people here recommend feeding smaller amounts 3 or 4 times a day (experts, please weigh in).

I am very impressed that you have been able to get a blood glucose (BG) reading this soon. A reading of 275 is not bad, and as you start feeding BJ wet food exclusively you will see his numbers drop further. This is why it is good to start low on the Lantus because you really don't know what kind of additional drop in BG you're going to get, just from diet change alone. Many people on this board estimate 100 points lower or more, when you switch from dry to wet.

On the curves: I think you would get a more accurate result if you are able to do the curve at home. Cats experience a lot of stress at the vet's office and this causes their BG readings to be high -- sometimes very high (it's called stress hyperglycemia). This can happen with any cat, not just a diabetic cat. It is stressful going to the vet and this is reflected in their BG readings; consequently, readings at the vet are not a reliable indicator on which to base insulin dose increases. My vet (the 2nd one...had to ditch the first) told me this and recommended I do the curves at home and just send her the info to evaluate.

For example: say you do the curve at the vet, and BJ's low (nadir) readings are in the 400's (partly from stress and partly from diabetes) so the vet thinks he needs 2 units of Lantus based on these high readings; but, then let's say you test him the next day at home and come up with low numbers in the 200's (because he is not stressed). You see? Which is more reliable? So home testing is better (and more accurate) for BJ and a lot better for your wallet too! :)

If your vet is not open to home testing (including curves) and helping you interpret the results by looking at your spreadsheet -- then you may want to look for another vet. That's what I had to do. One of the board members here recommended a great vet in my town who is an expert on Feline Diabetes, and I cannot tell you how happy I am that I switched!

Here's a great reference article for you to read in your spare time (LOL!). For myself, I printed it out and use it as a textbook -- reading a few pages a day as I have time.

There is an interesting passage in this material related to doing curves at home. It says that you don't have to do them all in one day. As long as you keep the cat's food and insulin dosage the same from day to day, you can collect data from multiple days and use this for plotting your curve. This may be especially helpful for beginners who are having difficulty getting several BG readings, all in one day. Here is the link to the article, and an excerpt from it below:
---------

http://felinediabetes.com/dummies

Diabetes in Cats for Beginners:
Glucose curves don't have to be done all in one day. If the insulin and food are held constant, you can spread the testing over several days and wind up with just as accurate a picture -- possibly even more reliable than a day in which he got an ear stick every time he woke up. Also, you can start your curve at any time of day. For example, test at 7 pm and 9 pm Friday, 10 am and noon Saturday, and so on. When you have at least one test for every two-hour block, plot them all on one graph as if they were taken on a single day and in sequence.
Keep in mind that you did not have to interpret blood glucose curves. If you want to do the tests, plot the curves, and take them to your vet for interpretation (some will let you fax the curves), that is just fine.

-------------
 
Hello Mike and BJ,

I'm the one who said if you make a furr shot it smells like bandaids. really cheap plastic ones. :smile:

I'll give you link for the purebites. They do have them at Petsmart.
Here is the best price I've found online.
http://www.entirelypets.com/purebitecats.html

my cat prefers that i stick them in a tiny bit of water and re-hydrate them...
I also use real shrimp. I just cut them up since she has no teeth.
put the pounce away in your hypo kit. You want to gather the stuff you would need in advance and print the instructions of what to do.

Last night was a good example. Could not log on the this website for over 12 hrs.
I would also advise to keep a written notebook so that if you had to , you could re-create your spreadsheet.
computer failure, power outage. Wouldn't we all be lost without our data?


You do not have to get yourself stuck in a midnight/6 am schedule.
Figure out what your optimal time is.
Anytime you need to shift your shot times you need to plan in advance, ( once you get really going with the shots) because you can
shift it in 15 minute increments.
I started at 7 am /7 pm and then realized I'd prefer closer to 8 so I just started changing it by 5 minutes.
Sometimes it takes me longer than that just to get a blood sample.

As for your vet, go with your gut. If you feel more comfortable starting with 1 unit. Say so. You want to find out early if he' going
to help you or hinder you with BJ's progress.
We all walk away from the vets who think they are dictators and expect us to blindly follow their instructions.
That's why we are all here together on this site, to learn and do what's best for our sugarbabies.

But I do understand why some of them are that way.
Unfortunately the majority of pet owners aren't willing to do what we are all doing here.
And the vet sees those people and their pets too.

If you are able to, it is best to feed several small meals a day. It does keep the glucose levels on a more steady keel.
2 times a day creates a feast or famine for their bodies and the glucose levels rise and drop accordingly.
And in the beginning, as you are switching foods, their bodies have been starving so it's okay to give a little extra.
Appetites will normalize after the insulin is received on a regular basis and they adjust to their new diet.
Have you see binky' lists for canned?
http://www.felinediabetes.com/diet.htm
see the binky charts. There are two, old and new.
Most of us try to keep under 10% carbs, and some of us try even lower like 5%.
It's a good idea to print the lists so you have it with you when you shop or what I did was highlight all the one's I wanted to find in
yellow and then made myself a grocery list.

Keep asking questions. It's the best way to learn.
Read other people's posts. It helps to learn with the things that you haven't had to deal with.
Welcome to a great community!
 
Mike:

Don't worry, we ALL had rough starts to this whole FD thing! It does get easier dealing with the testing and shots. And it sounds like you are doing great so far!

1) Low carb treats: When I started testing Pumbaa, I had him sit on my lap in front of the kitchen table, with his front paws resting on the table in front of us. I put smooshed up sardines (human grade, purchased at the grocery store, packed in water with no salt added) in front of him. While he snarfed these up, he ignored me during the testing. Other low carb treats that are easy to create/find include Stella & Chewy's Freeze Dried Raw food (I can't afford to feed my guys this all the time, but they LOVE it for treats), cheddar cheese, Parmesan cheese, baked chicken, cooked hamburger, etc. To me it's easier to always have human-grade high-quality treats on hand than it is finding/ordering overpriced low-carb cat treats.

2) To avoid fur shots, I used a Wahl hair trimmer to buzz off Pumbaa's fur around his flanks and front shoulders, so that I could actually see what I was doing when I was injecting him. The fur grows back quickly, and 3 months later, I'm still buzzing him, because when I don't, it's still too easy to give a fur shot. You can get the Wahl hair trimmers at Sally's Beauty Supply as well as at WalMart, and many other places. It buzzes the fur off without any risk of harming the cat. I can't believe my Pumbaa sits still for this! :)

3) Here's a link to injection site information for cats. The scruff of the neck isn't the best location for insulin.

4) Oh yes! Do all of your blood glucose testing at home, regularly. I know others have already chimed in on the advantages of this. My vet is shocked that Pumbaa allows me to poke his ears as frequently as I do, considering how agitated he was in her office during our initial diagnostic visit.

5) Feeding. Your vet is wrong. Sorry. When Pumbaa was diagnosed, he was eating like the Russian Army 24/7 because he wasn't absorbing any nutrients. Feeding small quantities over the course of the day, or, if BJ is now underweight, just free feeding him as much as he can eat, would be fine. I still free-feed my Pumbaa, but his eating has decreased as the insulin has been working. I now find myself encouraging him to eat when his numbers are dropping.

6) Testing. I have always free-handed the lancet, as I think that gives me more control and doesn't subject Pumbaa to the anticipation of the popping sound. But ECID and some people free hand and some use the lancet device. :)

7) 12-hour shooting times. They all depend on YOUR schedule and what is convenient for you, as well as testing after the shooting times, during critical points in the curve. Six hours after the shot is the common nadir for many cats, not all. At the minimum, I try to do an AM +3, AM +6, AM +9, PMPS, PM +3 and PM +6. But, I am self-employed and work at home, and my Pumbaa has been a diver, so I never know when he's going to appear to have normal numbers and then take a dive to much lower numbers.

I wish you the best of luck dealing with BJ's FD! You sound very dedicated to your little guy! You were smart enough to find these boards, and the people here will help you out, a lot! Even when you just need a hug for all of the new things you are now dealing with! :YMHUG:

Suze
 
Here is a link to a list of diabetic friendly treats:

viewtopic.php?f=3&t=9172

In addition, you can serve him baked chicken, turkey, etc. Even some deli meats and cheeses, but you want to make sure that they don't have flavorings and stuff added to them.

Maui's favorite treat is being brushed. After testing we would have a 5-10 minute brushing session.

If the times of 12/12 don't work for you, you can always change it to times that are more suitable to your schedule.

There are a couple ways to change it -

1) skip a shot and start over at the new time

2) with 30 minute increments slowly over several days change to the new time.


Honestly, considering that you just started this process, I'd opt for 1. IT's quick and easy.

I get the concern about going against the vet. The thing to remember is that YOU are the customer and YOU are in charge of your cat's care. The vet is a consultant who recommends and works for you. Do not be afraid of the vet. (Yes, I went through something similar with my former vet so I know what you are talking about).

Starting at 1 unit, is a safe way to go. And especially if you are going to sleep after shooting, you won't be up to monitor to know if giving 2 units is too much or not.
 
You are doing the right thing starting at 1u. Here's a link to the Lantus dosing protocol: http://www.uq.edu.au/ccah/docs/diabetesinfo/link4.pdf, and the American Animal Hospital Association guidelines: http://www.aahanet.org/PublicDocuments/AAHADiabetesGuidelines.pdf. I would print these out and bring them to your vet, especially if he tries to give you grief starting on the lower dose. The starting dose formula is .25u per kg of ideal weight, so unless your cat is a naturally very large cat (like a maine coon), then 2u is too high a starting dose. Most cats on a low carb canned diet do not need much more than 1u of insulin. Bandit is a 13lb cat, and the most insulin he ever needed was 1.25u.

The vet who diagnosed Bandit was fantastic--she started him on a good insulin (Lantus), told me I had to home test, and handed me a list of low carb commercial canned foods in different price ranges. But...her dosing advice was off. She was having me shoot once a day and had me raise the dose in full unit increments (Lantus should be increased/decreased in .25u-.5u increments, depending on the numbers). So I counted my blessings that she got most everything else right and educated myself so that I could handle Bandit's dosing on my own. It seems like you're experiencing something similar with your vet--he probably is just not aware of the Lantus protocol for cats, which is why I would bring him that document.
 
Hi guys.

Thanks for all the info - I haven't had time to go through all the links yet (but briefly) but I wanted to update and get some advice. I am not a stupid person by any means but I don't process things well under pressure/stress. Which is where I've been at in the last two days.

I think I am messing up so you can smack me if you want.

Instead of 2u at midnight last night I gave him only 1u. Before his noon feeding he was at (496). I panicked and gave him 2u. Then I gave him a very small meal about 4:30p and checked him again at 5:45 and the glucometer said HI which is (>600). So I'm a bit scared. I'm screwing things up!

Based on the info you kind feline friends have provided, I have decided on 1.5u for now unless you guys think that's foolish. Bj was really overweight the past couple years and went through dramatic weight loss the last 3 months or so. At the vet he weighed in at 11 pounds so I'm guessing his normal is around 13. (He's in the big range, not the hugest however. Though I didn't factor his age, he's 14 now.) So 1.5u sounds right according to the chart and it's between what you guys and the vet thinks is right.

I have to run but two more quick questions -
A: What is Nadir
B: Is there a chart around here I can download to record his BG? The one that came with the glucometer sucks.

I said it before but thank you SO MUCH for helping us out
 
Hi Mike! I think the most helpful thing you could do now would be to set up the spreadsheet so everyone can see your numbers. Try not to panic on those preshot readings. They are typically the highest of the day and will dip lowest about 6 hours after you give the shot. You do not base dosage changes on pre-shot readings. You only base dosage changes on the nadir (the low point) which is about 6 hours after you give the shot (though in some cats it is 5 hours or 7 hours after). And you don't make dosage changes frequently based on one or two nadir numbers. Changes are made slowly over time and based on patterns, which the experts on this board will help you identify.

In any case, I think most people here will tell you that you have to maintain consistent dosing for a period of time (like 5 to 7 days) -- particularly in the beginning, before changing it. Lantus creates a "shed" (like a reservoir under the skin) when you first start using it...so initially you are filling up the shed and typically the cat's BG numbers remain high as a result -- because much of the insulin is going into the shed and not into the cat, per se. Within a few days, the shed is filled and you'll see BJ's numbers start to come down as more of the insulin is being used by BJ -- particularly if you have switched to an all wet, low carbohydrate food.

At this point, you should just pick a number (for your dosage) and stick with it (LOL!!), until the experts on the board advise you otherwise. I myself am not an expert, but have ultimate trust and respect in the folks here who are. If you can get your spreadsheet set up soon, that will help them to guide you - step by step. If you need help getting your spreadsheet set up (and you live in the US), just send me a PM and I will set it up for you.

I know it is hard to see high numbers in the beginning and not panic, but that's the way this stuff works. You have to start low and go slow - which is pretty much the opposite of how most guys like to do things (I am reminded of the old tv show "Tool Time"... and Tim's motto of "MORE POWER." LOL!! In this case, more power (insulin) is not the way to go. :)

You're doing great! Try not to stress out. BJ will get through this and so will you. The first month is the hardest..and then everything settles into place. Promise.

Melanie
 
Mike and Bj said:
I am not a stupid person by any means but I don't process things well under pressure/stress. Which is where I've been at in the last two days.

I think I am messing up so you can smack me if you want.
Click to expand...

*LMAO* I so understand! Some people here think I am an idiot (not all, but many) because there is so much to process under the gun! And because I have made decisions I would have made in the business world that don't correlate to an FD cat.

I've been thanking people for hitting me in the head with a 2 x 4 because I needed it. :)

FD is a lot to handle, and it doesn't relate to anything you've learned in work/life about analyzing data and making decisions based on that data. From my perspective, every time I find a pattern in my Pumbaa's data, he changes the pattern. Hope that doesn't happen to you and BJ!

Do set up the spreadsheet so that everyone can see BG test results as well as the shooting times and doses.

Good luck to you and BJ!
Suze
 
As Melanie mentioned, you do not base dosing decisions off the preshots, but rather the lowest number of the cycle (usually somewhere in the middle of the cycle). For example, Bandit's nadir was usually about 6 hrs after the shot, which is pretty common. The preshots are going to be high, especially in the beginning while your cat's body adjusts to the insulin. We call this "bouncing"--his body is so used to high blood sugar, that when you get a normal-ish number mid cycle, his liver will dump glucose into his bloodstream to counteract the "low" blood sugar. Eventually his body will get used to lower blood sugar and stop doing this, and that's usually when cats regulate well. It's very important not to change the dose up an down frequently during this process.

That's why it's important to get at least one daily mid-cycle number along with the preshots. This is how you decide whether to raise/lower/hold your dose.

Lantus must build up a "shed" under the skin before it starts to work on BG. That means it can take up to 3 days to see any action from the Lantus at first, and subsequent dose changes usually don't show up in your numbers for about 24 hours after the change. So you need to be patient with the dose before changing it. Getting to right dose is a marathon, not a sprint. Moving up the dosing scale prematurely will set you back more than taking your time, not to mention it can create a dangerous hypoglycemic situation for your cat. It's better that your cat be too high for a little while, than drop too low for a second. Just make sure you're testing for ketones when he's in these high numbers.

I would continue with the 1u and stick with it for at least three days. If you don't see any mid-cycle numbers below 200, then you would raise the dose by .25-.5u depending on how high his blood sugar is. Here's a post that explains dose adjustments a bit more simply than the document I provided earlier: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581. This dosing protocol has an 84% remission rate in newly diagnosed cats, with better odds of remission the sooner you start it.

If you are confused and unsure what to do with the dose, you can always post here or in the Lantus forums for advice! There's a ton of people that have a lot of experience with this insulin.

And there's always information overload in the beginning with treatment...don't let it get you down! It takes a little while to process everything, especially when it contradicts what your vet is telling you.
 
Alrighty.

Re: Spreadsheet-

I'll get to that as soon as I can get some damn blood out of him. 45 minutes later and 4 pricking attempts and no dice. So I need to review the articles on that. Maybe I'm not keeping the rice sock on long enough. I can't get the lancet to work, with or without the cap, abandoned that and went back to freehand where I am sticking the thing all the way through his ear. I managed to get blood yesterday without the sock but neither that or the sock worked today. So no BG and now it's feed time.

Aaaagh!
 
Are you using the larger size lancets - 25 to 28? Do you have something behind the ear to poke against? Push the lancet firmly against the ear and whatever is behind it.

If you want, let us know where you live and we might have a member nearby. It is so much easier to watch someone do it the first time.
 
Mike and Bj said:
Alrighty.

Re: Spreadsheet-

I'll get to that as soon as I can get some damn blood out of him. 45 minutes later and 4 pricking attempts and no dice. So I need to review the articles on that. Maybe I'm not keeping the rice sock on long enough. I can't get the lancet to work, with or without the cap, abandoned that and went back to freehand where I am sticking the thing all the way through his ear. I managed to get blood yesterday without the sock but neither that or the sock worked today. So no BG and now it's feed time.

Aaaagh!
Click to expand...

Awwww Mike! You are doing great! Sometimes it takes a while for the ear to "learn" to bleed. Until that happens, you just do your best. I know there were some lancet devices that worked well for us, others did not. I always struggled to get blood when using a generic or the relion devices. I loved the one's which came with the contour. Most of those devices have a spot to adjust the depth the lancet will go. I had to start with it on high in the beginning. In time, I had it set to the lowest.

After using the sock, have you tried rubbing his ear to get the blood flowing?

Maybe you can try again in a little bit, if you have time.

And yes...post the city you are in and we can put a shout out to those in your area to come help you. That is how I learned.

It's going to be ok! :mrgreen:
 
Mike and Bj said:
They are 26g Thin.
Click to expand...

The higher the gauge number, the thinner they are, so 26 gauge should be fine.

Instead of holding the rice sock on his ear, try massaging the outer ear with the rice sock. And do try both ears, as Pumbaa's left ear bleeds easier than his right ear, for some reason. Hold the lancet on an angle so you don't poke through the ear. Aim for the outer edge of the ear, between the vein and the edge. You might have to massage the outer ear gently, around where you poked, to get the blood drop to well up. Also, I read that some people do two pokes, right next to each other, to make sure they get blood initially.

Good luck!
 
Also, don't poke to pierce, rather hold the lancet (freehand) at an upward 45 degreeish angle - then poke, you just want to insert a little into the skin. I found this upward angle seems to help -

here is a pick to show you what I mean:

101_0669.jpg


And are you aiming for the sweet spot?

sweetspot.jpg


You may find that if you poke from the back of the ear to the front, it may draw more blood than poking from the inside (front) of ear to back.
 
Are you backing the ear with a tissue or cottonball when you're poking with the lancet? If you're not backing it firmly, the Lancet device will just glance off the ear and not draw blood. That was my biggest problem when I learned! Also, I found bandit's left ear bleeds quite easily, while I'm lucky if I can get blood within 4 or 5 pokes on his right ear.
 
I just bought a lancet device that is turning out to work pretty well.
I , too, was having to try several times because I had one that was too fine a gauge.

I can recommend the Accu-chek Softclix plus.
http://www.diabetessupplies4less.com/acsopllade10.html
You push it once to cock it, and then push it again to lance. I'm on setting 4/12 pressurewise.
I cant freehand at all and my cat got very upset when I tried. I think she prefers the click cause she knows when it's coming.
And it's fast and done. I kinda lean on her so she doesn't leave before I get the sample and i find if I put both hands on each side
of the blood droplet, I can swish back and forth and get it to be a little bigger. Or even stroke the ear under the poked area
and that increases the flow too.

I also noticed someone said shooting on the inside of the ear.
I've been on the ouside and I find the closer I get to the edge ( around the sweet spot area), the better luck I have.
The neosporin ointment ( not cream) helps the blood bead up in a little ball so it's easy for my meter to sip it ( like a straw).

and yes, make sure you are using something on the backside to give resistance when you poke. I was poking my finger on the other side.
 
Been having family drama but I finally got the spreadsheet done and linked to my signature. He is banned from dry food and only getting Fancy Feast Classics and PureBites snacks. Bj LOVES the PureBites treats. That has helped during blood test time. Plus, I use them to lure him when he's not in the mood. Works great.

I've gotten this far but now I realize I don't know what to do with the numbers. Bj is at his lowest (124) pre-shot today. I really didn't expect this to drop so fast and am clueless what to do. I have to go feed him and give him his insulin now...

If I can only manage to get blood one to two times a day, what times would be the best? I've been getting it about an hour before his first shot so far. Be back later.
 
The more experienced members will be by shortly to advise you on dose, but I believe 124 could be a non-diabetic number. We are advised not to shoot insulin below 200 (for inexperienced folks) or below 150 (for the more experienced); so I would recommend you wait for guidance from the experienced members before shooting. :)
 
You're fine, I'd recommend giving the shot, so don't fret. Remember, we don't base doses on just one pre-shot test. So, continue what you are doing and I suggest getting readings at +4, +5, +6, +8 -- as you can only get one test in, in addition to the pre-shot - today start with +4, tomorrow test at +5 and so on.

This will help to see where his low point in the cycle may be.

Also, I see you don't have any tests in at night - are you able to get any additional tests in then? Maybe one before you go to sleep?

And yes, a lower number like 124 is great to see. It's the high normal range, which means he still needs insulin help, but his pancreas is trying to work. With the food change and insulin, he has a good chance of going into remission (OTJ).

But one step at a time. And just a suggestion - you may want to add the insulin name to your spreadsheet - put it with the name is fine. This will make it easier for anyone who looks at it.
 
My bad. If Hillary says your fine, then you are fine. She is very experienced! I was worried because you didn't have any mid-cycle readings to show how low the 1.5 has been taking BJ this last week, so to my untrained eye I thought this could be a problem -- but if Hillary says you're good, then go with her guidance. :)
 
Thank you ladies so much.

I will do as suggested and I will try to get him after his midnight shot as well. Updated database name. He is sleeping right now.

Well enough about Bj already. Please tell us about YOUR beautiful cats!
 
Just to confirm, you are home to watch him right? While maybe not test, you can keep an eye on him?

Melanie, no "my bad" - you are correct in your thinking, as we typically tell people who don't have data or haven't been doing this very long to not shoot under 200 or even 150.

But given some of BJ's higher numbers and the fact that Mike is home with him, I don't think it's wrong to give the insulin - as we all know, it will be the only way to get him off insulin in the long run.

Of course, when you get your first double digits and below 50 reading - that's when the adreline really flows! And 50 or below, qualifies for a dose reduction!
 
Mike: To answer your question, my kitty Ninja is a domestic short hair black female; though she thinks she is an alpha male cat -- so...shhh... don't tell her. She's about 8 years old (adopted her from the Humane Society so I'm not really sure). Her most endearing talent is waking me each morning, precisely 1 hour before the alarm goes off, by slapping me in the face (exactly like the "Simon's Cat" video http://www.simonscat.com/Films/Cat-Man-Do/ -- except that Ninja has never resorted to the use of a baseball bat -- yet).

Show us a picture of your kitty. You can add his pic as an avatar if you'd like, under the User Control Panel at the top of this page. Would be nice to see what he looks like :)
 
Ninja looks so cute. That's such an awesome name too. I have a pic of Bj on disk somewhere... have to search.

Well, I tested him at +4 and he's at (48)BG. I fed him a small meal after. I've been keeping a close eye on him between errands/chores all day. And I'll be home all evening.

Advice?
 
As you can see Maui is also a black DSH. When I adopted her from the shelter, she was very sick with an URI - the shelter told me that they gave her something for it. But when I got her home, I didn't believe them. I took her to my vet and was told that if I hadn't brought her in she would have been dead in a matter of days.

The stupid shelter named her Raven, and I knew that was just a dumb numb and not worthy of this beauty. I waited for her to tell me her name - and she did - she walked into the bathroom and let out the loudest Meow I ever heard. And I asked her if her name was Maui and she said yes.

Maui has had many medical issues, some I now think were possible misdiagnosis from the former vet. But anyway - she was treated for hyperthyroidism, where I almost lost her - as the vet prescribed a too high dose of tapazole. It took several weeks to get her white blood count from near 0 back to normal - the vet wanted to put her down. I nursed her back, with baby food and syringe feeding. Then she got the I131 treatment.

She always had skin issues - itchy, scratchy, burning - and again, the vet treated symptoms only - shampoos, steroids, etc. NEVER did the vet ask what are you feeding. Of course this vet had no idea about the correlation of food and cats, especially dry food.

It wasn't until Maui was diagnosed with FD that I learned about food and that she had a simple food allergy to something in the dry food (no clue what it is), but of course, it was too late, the damage was done - she got diabetes, IBS and while she is in remission, she still has bathroom problems. And yes, the vet told me that we would just have to live with it and I would just have clean her bottom.

It's much better on the wet food diet, but she does get the occasional diarrea that we deal with.
Maui was a dry food addict and in no way wanted anything to do with wet food. I had to teach her to eat it and what a mess that was. I spoon fed her for a couple weeks, until she decided to take that first lick of the spoon. Here is a pic of what she used to look like after a feeding session.

101_0637.jpg


Maui's latest medical issue is that she has degenerative retina myopathy - and is 100% blind. I noticed she was having vision issues, bumping into walls, walking against the walls, etc. And took her to eye specialist. He said, there is and was nothing I could do to prevent or slow it down. It is genetic and happens to some cats.

It took me awhile to adjust to this, but as she may have been blind for almost a year, she already is adjusted. There are some things she doesn't do anymore, but that could be an age thing as well.
(She is 14).
 
Mike and Bj said:
Ninja looks so cute. That's such an awesome name too. I have a pic of Bj on disk somewhere... have to search.

Well, I tested him at +4 and he's at (48)BG. I fed him a small meal after. I've been keeping a close eye on him between errands/chores all day. And I'll be home all evening.

Advice?
Click to expand...


OK - wow! Test him again in 15-20 minutes. Get out your higher carb food - if you have anything with gravy in it, get that out - give him 2 teaspoons of the gravy alone. As you may have to repeat this process several times tonight, we want that 48 to go up and not down, and if you can do it with gravy and food the better.

As we want to avoid a hypo situation.

But guess what, you need to reduce his dose! He just earned a reduction.

So whatever plans you had tonight, can you put them aside as you need to watch BJ and for the next 8 hours, or at least until you get two tests that are rising and not going down.

Does this make sense?

HEre is something to read that will help.

viewtopic.php?f=14&t=1122

This is what we want to avoid - so let's not panic, but let's get prepared.

I'll get more eyes to come here and help out as well.
 
Hi Mike,
Since you don't have a lot to compare to, you don't know where the lantus peaks on BJ and you are at +4.
You will want to watch carefully for any signs of a hypo.

His bg could go lower between now and +6 which is often the lowest number in the 12 hour cycle.


Some cats don't hypo at numbers hovering in the 40's/ 50's and some do. You don't know with yours.
I hope you have syrup, honey available. And a higher carb food available.

Test again, 15 minutes or 20.
and you don't want to stop testing until you have at least 2 consecutive rises in bg number.
 
OK - I just asked for help on the Lantus board - and may I recommend that from here on out, you post over there, as they will be able to guide you with doses going forward.

has it been 15-20 minutes yet?
 
I'm also going to PM you with my phone number so that if you would like to speak live, I'm here and can talk with you tonight and help you through this.

look in the upper left corner for the message.
 
Awww, poor Maui :(

Wow, she is so fortunate to have you in her life! I'm sure it's been super hard for you. Give Maui a scritch for us, please?

The dry food thing has certainly been a wake up call. I heard it wasn't good for cats but I had NO idea how bad. I can't understand how they can sell this stuff.

(Ok, wow I missed a lot of posts I'll go test him again now).
 
Good please test - we need to keep on top of this, to ensure that he doesn't hypo!

And don't feel bad for Maui - she is fine and beautiful and doing well.
 
Hi Mike...I popped over from the Lantus TR ISG.

Here is some information about Handling Low Numbers

We have a saying "lather, rinse, repeat". So that is test, feed, and do it all again depending on numbers. So test, if his number is in the high 40s-60 range, feed a tsp of HC gravy, wait 30 mins and test to see where he is.

Can you give us an update please?

Good job on the SS.

It's probably best to keep this on the board and not over the phone. This is a peer review board and off board advising, even for low numbers, is against the rules.
 
Mike

Saw on the SS that you got a 46; please feed a tsp of HC gravy and retest in 30 minutes....and post. OK? Don't wait an hour to test. We need to get BJ's BG up.
 
He's at (46) and I just let him pork out. He doesn't have any wierd symptoms, seems fine. Will test again in a bit.
 
Mike

The problem with letting him pork out is that you could be dealing with very low numbers for hours and hours. You don't want him to get too full because then you will have to resort to syringing him karo.

I'm concerned because you have very little data on BJ including consistent preshot tests. You should never shoot insulin into a cat that you don't know what the PS is. We also would have had you stall earlier today to see if his +12 number was coming up; we recommend new members do not shoot this low of a number without having a lot of data and knowing what their cat's onset, nadir, and duration is.

Do you know that the %carb of the food is that he ate alot of? Please retest in 30 and post.
 
Hi Mike,
What did you feed him? Don't let him eat too much. You may have to do this for a while, and you need to leave some room in his belly.

Carl
 
hey Mike,
The saying is "Feed the 40s".... when you get a BG in the 40s, it's a good idea to feed a wee bit of high carb food. The small bit, maybe a teaspoonful, should be enough to bring up the BG number in around 20min or so.... but even if the BG does rise, high carb food wears off in an hour or thereabouts, so it's a good idea to test in another 30min and see if BJ is rising, staying put in the 40s, or starts dropping again.

If BJ is not rising, you may want to feed another teaspoonful .... keep in mind that if his numbers don't come up, you don't want to fill up his stomach, OK? The quickest way to bring up numbers would be to just give some of the gravy from the high carb food, but it does not last long in the system, so you have to keep watching his BG.... look for 3 rising numbers, and heading out of the 40s.

Give mostly the gravies, and it will bring up the numbers but not fill him up.
 
Ok,

After getting the 48 reading I gave him his regularly timed small meal afterwards. Then I let him eat a little of his 'old' dry food, it's Whiskas or Friskies. Then a while later he got some more of the dry food. Sorry, I misread and/or didn't see some of the posts in time before letting him pork out. I panicked. Going to test again shortly.
 
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