Confused and don't know how to proceed

[Squalliesmom]

Hi. I'm completely new to this so please bear with me if I sound like a nutter. My 16 year old cat was diagnosed with diabetes on Thursday and our vet prescribed two units of insulin every 12 hours (2x daily). My poor, long-suffering kitty is a very good patient, so no problems administering his shots. Today, a few hours after his morning dose, his ears felt hot to touch, and this has come and gone all day. I also thought he seemed to sleep more than he normally does, although when he is awake he is alert, and he's eating just fine. He was also switched yesterday to a new "diabetic" diet. Is it likely that his sleeping more is because of the insulin or insulin/diet change? I am terrified of hypoglycemia and am afraid now to give him his night-time dose of insulin!

 

[Sue and Oliver (GA)]

The best way to know whether he is just sleepy or too low is to test his glucose levels. If you want to know tonight, you could get a meter and lancets and test him. Then you'll know how the dose is working and whether he is safe. Can we help you learn how to test?

 

[Squalliesmom]

Unfortunately I can't get a meter tonight, but will be getting one tomorrow. And yes, please you can definitely help me learn how to test! I did not give him his shot tonight, I thought it better to err on the side of caution. Hope I did the right thing.

 

[Squalliesmom]

The best way to know whether he is just sleepy or too low is to test his glucose levels. If you want to know tonight, you could get a meter and lancets and test him. Then you'll know how the dose is working and whether he is safe. Can we help you learn how to test?

Arghh! Still figuring out how this site works, think I've posted stuff where I didn't mean to.
Unfortunately I can't get a meter tonight, but will get one tomorrow. And yes, please, you can definitely help me learn how o test! I did not give him his shot tonight, figured it was best to err on the side of caution. Hope I did the right thing. I'm going to call his vet first thing in the a.m. and see if she'll check his bg level.

 

[Chris & China (GA)]

Here's a pretty good video on how to home test...there are bunches of them on YouTube

If you live in the US, WalMart has the cheapest meters that a lot of us use called the Relion Confirm or Micro....it's about $15 ...the nice thing about those 2 meters is they use the tiniest blood sample (and I mean you really only need a pin-head sample size) The replacement strips are $35.88 for 100

You'll need a box of lancets (whether you get a lancet device too is up to you)....I just freehand with the lancet so I don't use the device. I feel like I can control where I poke better by freehanding. The lancets you should get should be 25-28gauge lancets (made for "alternate site testing", but they'll make the biggest "hole" until the ears "learn to bleed"). I think I can just look at China's ears now and they'll start bleeding...LOL

A bag of cotton balls or cosmetic pads are great for staunching the blood after poking, and a little Neosporin with Pain Relief ointment can really help too

Here's my "testing tips"

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

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

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

 

[Squalliesmom]

Here's a pretty good video on how to home test...there are bunches of them on YouTube

If you live in the US, WalMart has the cheapest meters that a lot of us use called the Relion Confirm or Micro....it's about $15 ...the nice thing about those 2 meters is they use the tiniest blood sample (and I mean you really only need a pin-head sample size) The replacement strips are $35.88 for 100

You'll need a box of lancets (whether you get a lancet device too is up to you)....I just freehand with the lancet so I don't use the device. I feel like I can control where I poke better by freehanding. The lancets you should get should be 25-28gauge lancets (made for "alternate site testing", but they'll make the biggest "hole" until the ears "learn to bleed"). I think I can just look at China's ears now and they'll start bleeding...LOL

A bag of cotton balls or cosmetic pads are great for staunching the blood after poking, and a little Neosporin with Pain Relief ointment can really help too

Here's my "testing tips"

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

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

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

Here's a pretty good video on how to home test...there are bunches of them on YouTube

If you live in the US, WalMart has the cheapest meters that a lot of us use called the Relion Confirm or Micro....it's about $15 ...the nice thing about those 2 meters is they use the tiniest blood sample (and I mean you really only need a pin-head sample size) The replacement strips are $35.88 for 100

You'll need a box of lancets (whether you get a lancet device too is up to you)....I just freehand with the lancet so I don't use the device. I feel like I can control where I poke better by freehanding. The lancets you should get should be 25-28gauge lancets (made for "alternate site testing", but they'll make the biggest "hole" until the ears "learn to bleed"). I think I can just look at China's ears now and they'll start bleeding...LOL

A bag of cotton balls or cosmetic pads are great for staunching the blood after poking, and a little Neosporin with Pain Relief ointment can really help too

Here's my "testing tips"

It can be really helpful to establish a routine with testing. Pick one spot that you want your "testing spot" to be (I like the kitchen counter because it's got good light and it's at a good height....it also already blocked 2 escape routes due to the wall and the backsplash) It can be anywhere though...a rug on the floor, a table, a particular spot on the couch...wherever is good for you. Take him there as many times a day as you can and just give his ears a quick rub and then he gets a yummy (low carb) treat. Most cats aren't objecting so much with the poking..it's the fooling with their ears they don't like, but once they're desensitized to it and learn to associate a certain place with the treats, they usually start to come when they're called! Or even when they hear us opening the test kit!

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

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

Thank you, invaluable info! And much needed! I'm sure I'll have more questions as we go on.

 

[Sue and Oliver (GA)]

Chris has given you great info on testing. We compiled a bunch of videos and links here also:

http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

For reference, after you get some numbers. Regulation is probably the first goal and we generally consider a cat regulated if they are in the lower to mid 200s at pre shot and in double digits at nadir (around 5-7 hours after the shot). But we don't want to see them below 50 at nadir - that is approaching hypo territory. And we suggest that new diabetics not shoot under 200 until they have enough data to know how their cat might react.

 

[Squalliesmom]

Thanks to everybody for all the helpful advice and info!
Just finished up at the vet's office. He was at 445 when she tested him, that's without a shot last night or this morning. (That's also what he tested at when she first diagnosed him) She gave him a shot of Convenia for a possible UTI, most likely the cause of the hot ears and head. So I'll give him his next shot around 10 p.m. and hope everything will be okay.

 

[BJM]

You'll want to monitor for adverse reactions to the Convenia.

 

[Squalliesmom]

You'll want to monitor for adverse reactions to the Convenia.

He's had Convenia before, and never had a problem with it. Is it an issue now because of the diabetes/insulin? What should I be looking for?

 

[Sue and Oliver (GA)]

Some cats do have issues with it. A vet explains here:

http://www.catinfo.org/?link=convenia

If he has taken it before and had no issues, I would think it is likely he will be fine.

 

[Squalliesmom]

Just a quick update on my Squallie: He went back to the vet on Saturday, his bg was 445 (I had not given him his shot that morning). He has had his shot (2 units of Vetsulin) every hours since, and when the vet checked him again this morning it was still at 445. She increased his insulin to 4 units, and he goes back again this afternoon to be checked again. Poor kitty is really tired of going to the vet!

 

[BJM]

AARRGGHH!!
Insulin doses should be adjusted based on the nadir, the lowest glucose post-shot, not on the pre-shot level! Doing otherwise risks overdosing your cat.
Please try to get tests in the +5 to +7 time period

 

[Sue and Oliver (GA)]

Were you considering home testing? Not only would it be easier on your kitty and your wallet, but it would be safer. If you test at home, you can get more accurate numbers, without the added vet stress that usually increases the levels. And you can test during the cycle to see how the insulin is working - how low it is really taking him.

Doubling the dose is a pretty scary thing to do, especially when you are not yet able to see what is happening. Can we help you learn how to home test?

 

[Squalliesmom]

I think that's why she wants to test him again this afternoon, it'll be about seven hours since he had the morning shot. I need to get a meter and learn to test him myself. If she tests him between seven-eight hours after his shot will that be okay?

 

[Squalliesmom]

Were you considering home testing? Not only would it be easier on your kitty and your wallet, but it would be safer. If you test at home, you can get more accurate numbers, without the added vet stress that usually increases the levels. And you can test during the cycle to see how the insulin is working - how low it is really taking him.

Doubling the dose is a pretty scary thing to do, especially when you are not yet able to see what is happening. Can we help you learn how to home test?

I haven't been able to get a meter, etc for home use yet -I live a bazillion miles away from any shopping centers :-( but am going to get one this week. Yes, I was terrified when she gave him the extra shot this morning! Thank heavens, so far he seems okay.

 

[Sue and Oliver (GA)]

It will be better than nothing, but not as good as your testing at home. Some kitties are 100+ points higher at the vet, and then doses based on those stress influenced numbers are too high once they get home. And you can't be sure his lowest point will be 7-8 hours after the shot. With Vetsulin, it is more likely to be 4-6 hours after the shot. One number, one day, just isn't going to give you the complete picture you can get by testing various times during the cycle, at home.

 

[Squalliesmom]

It seemed kind of odd to me that he has tested 445 each time she has tested him. Wouldn't the numbers fluctuate some?

 

[Sue and Oliver (GA)]

That is a little strange. Another reason to test at home.

No Walmarts close enough? You could buy a brand name meter at any drug store, get a few strips to get you going. Would the vet have a meter you could use for awhile? Would they show you how?

 

[Squalliesmom]

That is a little strange. Another reason to test at home.

No Walmarts close enough? You could buy a brand name meter at any drug store, get a few strips to get you going. Would the vet have a meter you could use for awhile? Would they show you how?

I haven't even mentioned it to her yet, I'm afraid she'll try to shoot down the idea and I don't want to hear it. I will probably mention it on this afternoon's trip, but I am getting a meter, regardless of what she says. It's just too scary, not knowing where his numbers are, and I can't keep running to the vet's twice a day. (Walmart is over an hour away!)

 

[BJM]

Check my signature link Secondary Monitoring Tools for other assessments you can make to evaluate his health. When you get to a pharmacy, pick up some KetoDiaStix for urine testing in addition to a meter. Avoid ones with True in the name as they don't work as well for identifying high numbers in cats.

 

[Squalliesmom]

Check my signature link Secondary Monitoring Tools for other assessments you can make to evaluate his health. When you get to a pharmacy, pick up some KetoDiaStix for urine testing in addition to a meter. Avoid ones with True in the name as they don't work as well for identifying high numbers in cats.

Thank you, great article, very informative! And I will buy some ketone test strips, too.

 

[Squalliesmom]

We just got back from the vet, his bg level was around 360, down from 445 (about seven hours after his last shot. She recommended to keep giving him 4 units 2x daily, and she will check him again on Thursday. I asked about home monitoring, I was pleasantly surprised when she offered to teach me!

 

[BJM]

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as
your name,
cat's name,
date of Dx (diagnosis)
insulin
meter
general location
any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.

 

[Sue and Oliver (GA)]

We just got back from the vet, his bg level was around 360, down from 445 (about seven hours after his last shot. She recommended to keep giving him 4 units 2x daily, and she will check him again on Thursday. I asked about home monitoring, I was pleasantly surprised when she offered to teach me!

That is great! The sooner she can teach you the better.