#DiabeticCatWatch on the Wirral, UK

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Hi Gillian,

If you really want to know what is going on with Kizzy's blood glucose levels hometesting will be the best tool imaginable. So it is well worth sticking with it even if it takes a while to get the hang of things.

The most common mistake I make when testing is not to put sufficient pressure on the underside of the ear (assuming you're pricking the outside?) The lancet needs something to resist otherwise it can just push the ear away rather than prick it. Some folks hold a small piece of tissue or cotton wool against the inside of the ear. I just use my finger (but have got a blood sample from myself that way more than once...;))

Also do ensure that the ear is warm (massaging it gently is helpful) and DO reward Kizzy for every test or attempted test. She will soon learn to see testing in a positive light if she gets a treat or a wee cuddle every time.
You can start out slowly by just setting up the test kit, massaging Kizzy's ear, giving her a treat, and then putting the test kit away. And then you can build on the routine by setting up the kit, massaging her ear and also clicking the lancing device near her ear, then giving a treat. And so on... It can be helpful to always test in the same place at first, ie, on the same table, desk, couch etc. Then, when she gets used to the routine she may come running to that place for her tests! :D

Here's a link to a page of pics and info on hometesting that may be useful. (I learned to test from this page):
http://www.sugarpet.net/bloodtst.html

Just another thought about the increased appetite (in addition to the factors Mel mentioned) any chance Kizzy could be hyperthyroid...?

Eliz
 
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Hi Gillian,

I didn't have any joy trying to test in the ear, it just wasn't happening for us. (Me too tentative, Pedro sensing my hesitation and the whole thing unravelling) However, using Pedro's pads is working a total treat!!

When I used a human glucometer I used the lancet pen that came with it freehand, so without the spring mechanism. Instead I would hold his had and poke him twice usually as the human glucometer needed more blood. A gentle squeeze would bring enough blood to the surface and I could test.

Since we joined the RVC trial we have an alphatrak2 and I am using their lancet pen on the highest setting, it always brings enough blood (the Alphatrak needs less blood) and works well.

Pedro is really very cooperative, so I can hold I'm in my arms on my lap like a baby, 4 paws in the air and take my pick, but I also have developed an iron grip and steely determination not to waste a drop of blood.

Without testing his blood glucose at home you have very little ways of knowing his glucose numbers and you have to either rely on your vets curve (and if they don't recreate how you're feeding or visa versa you will have unreliable data) and of course the secondary monitoring tools.

I just read another thread about someone using an apple to get their head around using the lancet pen.


With regards to feeding schedules, our cats usually got fed twice a day before Pedro was diagnosed, but it wasn't 12 hours apart and we would kinda top them up when they meowed. And meow they did.

Now when we were on CanInsulin we initially stuck to Royal Canin wet food and didn't give more then prescribed, but had an unhappy cat. Reading this board we understood that smaller portions throughout the day would be better, so we spread the feeding out but had a stop at 2 hours before the planned PMPS to make sure we get a clear glucose level.

We are on the RVC trial and a different insulin now, and just yesterday I wrote a post how not keeping to the evening feeding embargo 2 hours before the PMPS appears to be messing with his glucose, bumping it higher unnecessarily, so from here on in I shall stick to that embargo again to see how this hopefully balances out our evening figures.

My experience is minimal in comparison to the peeps of this board, I am only a novice myself but thought I share. ^_^

Mue & Pedro x
 
@tqfan -

Hi Gillian,

Here's a body condition chart so you can assess Kizzy's weight. If you haven't already got one, a basic digital baby scales is invaluable for home weight monitoring. You can pick one up on ebay for twenty-odd quid. Needless to say, if you need to alter the amount of calories Kizzy eats, you need to make sure that you check the insulin dose, doubly so if there is a significant difference in the number of carbohydrates in any different foods you give her. Part of the problem you are experiencing is that Caninsulin is an insulin more suited to dogs. Because dogs in the main tend to be meal-fed, the feed-only-dry-food-twice-a-day-only-at-injection-time protocol tends to suit them. Not so much with cats who prefer grazing (or who may have other health issues such as pancreatitis). I went through the same palavor with the vets when Saoirse was first diagnosed. I chose to fit a treatment plan to my cat, not the other way round. (Saoirse ended up with severe gastric distress for several days and I wasn't having that.) We moved to a new veterinary practice closer to home shortly after Saoirse was diagnosed and they supported feeding a wet, low carb diet. They also worked with me to develop a dose size and mini-meal feeding schedule that kept Saoirse safe through the big Caninsulin drops at onset but where her food was staggered through the day to stop her tum from getting upset and also so she wasn't spending most of the day hungry. It was an improvement of sorts, but she was still not regulated properly on Caninsulin and it made her feel lousy. She felt much better when she was switched to Lantus (and mini-meal feeding works really well with this gentler, longer-acting insulin).

On blood testing, diabetic-friendly treats are a great help. Saoirse's a dream to test, but she gets her treat regardless. I give her Cosma Snackie freeze-dried chicken treats (available online from Zooplus). Eliz has already given you some great tips, inclding a recommendation to support the ear. I fold a sheet of kitchen paper in four and then cut it into 3/4" strips. At test time I curl one of the folded paper strips around my index finger and it makes an ideal cushioned support. Another tip is to warm the ear for longer than you might think necessary. If you persevere for a short while, more capillaries will grow at the test sites and it will become easier and easier to get a blood droplet for testing.

If you can get the home testing down, it will give you so much more information about what's happening with Kizzy's BG. That in turn provide you and your vet with valuable diagnostic information to better determine the reason why Kizzy's so hungry all the time. There are a number of other advantages to home testing: readings won't be influenced by vet stress; it saves money on vet-run curves; most important of all it is the best way to keep Kizzy safe and well because you'll be able to check her overall regulation throughout the day on Caninsulin, catch any unexpected lows, or spot if her numbers are trending upwards. Finally, if Caninsulin is no longer doing a good enough job of keeping Kizzy in good numbers, gathering home BG data can help you build a case to obtain a prescription for a different type of insulin under the drug cascade rules should one be needed.
 
Hi all, thank you for all the replies. sorry for not getting back sooner.

We complained to the vet regarding the glucose curves not being done properly (them not feeding her while doing it), so she was in on Thursday for one, and typically, she did not eat all her breakfast (insulin time feed). so i took the food to the vet, explaining it was her breakfast, and they didn't feed her it then. let's just say a bit of miscommunication and lying went on. when the vet eventually phoned us, she said the curve was acting as it should, but Kizzy's insulin would need increasing (hurrah we thought!). so i asked about the food, and she said she didn't know that it was her breakfast, but she would give her it (as we usually feed her +6 hours after insulin shots). when she phoned later again to tell us we could go get Kizzy, she said she'd nibbled a few bits, but did not eat it all. so i'm not convinced the curve would still show the right numbers. but what do i know?! lol!!
so the increase in insulin was a whole 0.1 unit. from 2.75 to 2.85. smh. so it's bad enough trying to get 0.25, or 0.75 on the syringe gauge, without 0.85 =(

have been looking around for u100 syringes, as they should be easier to read. currently using the Intervet 0.5ml u40 syringe, so i am looking for 0.5ml u100. i think. i found these http://www.vetuk.co.uk/veterinary-s...-microfine-0-5ml-insulin-syringes-u100-p-2568
does anyone have any experience with them? how easy they are to read? just i can't seem to find a photo of the actual syringe, to check myself!

since she is on 2.85 units of u40, i'd have to give her 7.1 units in a u100 syringe. so i'd need to be able to measure the .1 easy, otherwise we'd be as well sticking with the u40 syringes. the 0.5ml u40 syringes go up in increments of 1 unit, but there are no lines to measure 1/4 or 1/2 units, so getting to 0.85 is a nightmare! the vet mentioned a magnifier that comes with them, but ours do not. i have googled them, and the 0.5ml no longer come with a magnifier (as far as i can see). i have seen some 1ml u40 with magnifiers, but i am not sure what the difference is between the 0.5ml and 1.0ml syringes. can anyone advise?

it would be great if we could buy just 1 syringe to test it out!!

Critter mom - the Cosma snackies treats, are these them? http://www.zooplus.co.uk/shop/cats/cat_treats_catnip/cosma_cat_snacks/261318
i noticed they also have the XXL type. would either be okay? and i assume zooplus are the only place that sell these? it would be my luck that we buy loads (think minimum order is about £10) and her not like them, lol!!

we have cut out a small portion of food (12grams dry) from her routine, and today is day 3 of that, and she's been fine, missing that meal. until today. she's been a bit 'hungrier' today. not in that she is eating more, just she is hungry quicker. so from tomorrow, we are putting the meal back in, but amounts will be dropped over the 4 meals, as we think it is best to stick to what she knows, just give her less food.
i would love to switch her to a complete wet food diet, and maybe once we get success with the home testing, it can happen.

thanks again!
 
These are the 0.3ml U-100 syringes with the half-unit markings that many people here use - easier to eyeball odd doses:

http://www.vetuk.co.uk/veterinary-s...rofine-0-3ml-insulin-syringes-u100-demi-p-296

You can order a pack of 10 for just over £2 to try them out. Your vet's advice to get a magnifier is spot-on. I used a jeweller's loupe - cheap 'n' cheerful ones available on ebay. If measuring the 2.85 units of U40 insulin in a U100 syringe, you could aim for what would be referred to here as a "fat 7.0" dose (i.e. a hair's breadth more than the 7 mark) on the U100 syringe).

The link you posted is to the Cosma Snackies that I give Saoirse (and which she lurves). The XXL ones may be a bit big for cats and perhaps get stuck in their teeth (as do some of the larger chunks in the regular size). I break the larger chunks into little bits. I suppose you could do the same with the XXL ones.

If Kizzy is getting hungrier sooner after injection time, it may be that the Caninsulin onset is happening sooner. I used that as a very significant cue to monitor Saoirse more closely and usually to grab a BG check. Sometimes the nadir shifts to an earlier time, too. The 'appetite uptick' was very helpful to me in terms of keeping Saoirse safe during her insulin treatment. Given that you're finding home testing a bit tricky at the moment, monitoring for appetite upticks may be a useful aid to you.
 
The half unit syringes (that Aine gave the link to) are easier to use when it comes to measuring small doses.
Another advantage of these syringes - over the Caninsulin ones - is that they are smaller and the needles are finer.

But not everyone is comfortable using different syringes and a conversion chart. It has to be something you feel OK with doing. (Very useful if you can do it, though...;))
I'm happy to send you 10 x U100's if you want to try them. Just PM me your address.
But if you want to stick with the Caninsulin U40 syringes I think VetUK now do their own version which is a lot cheaper than the brand name ones.

Regarding the Cosma snackies, I think most cats adore these. And big ones can easily be cut up (I recently stocked up on some XL ones cos they were on special offer.)

Eliz
 
U-100 means 100 units per mL.
U-40 means 40 units per mL, or a 40% (ie 0.40) concentration.
Basically, to use the U-100 syringe with a U-40 insulin, multiply the syringe number by 0.4
0.4 * 0.5 = 0.2
0.4 * 1.0 = 0.4
0.4 * 1.5 = 0.6
0.4 * 2.0 = 0.8
0.4 * 2.5 = 1.0

etc.


On a U-100 syringe with half unit tick marks, every tick mark equals 0.2 units of a U-40 insulin.
Thus, a shorter method is to count tick marks and multiply by 0.2.
 
But not everyone is comfortable using different syringes and a conversion chart. It has to be something you feel OK with doing. (Very useful if you can do it, though...;))
I'm happy to send you 10 x U100's if you want to try them. Just PM me your address.
PM sent. Thank you so much for the offer, so very kind of you!

thanks BJM, helpful info, as always =)

thanks Áine, we usually use medicanimal but i'm sure they're all the same!

i'm going to go order Kizzy some Cosma snackies!! i'm sure she'll be thrilled with them =D

thanks again!!
 
Woot for the Snackies! :D

I just had a look at the Medicanimal site for you, Gillian. They only have Caninsulin U40 syringes listed on their website. I normally use animeddirect.co.uk for my internet supplies but they only offer Caninsulin U40 syringes, too.
 
Got the needles from Eliz today, so will try one over the weekend (at next needle change). Since medicanimal and animeddirect don't do them, will just use the vetuk site you posted previously. makes no difference where we get them from, tbh, they all seem like similar sites anyway.

Kizzy has been a lot happier lately, even let a new visitor to the house touch her (she usually hides!) and she even wanted food from him when we had a meal, lol! She is meowing less during the night too, which is also great. So I'm hoping she has turned a corner and that this happy time will continue, and then we can try the home testing again! a happy cat will be a more compliant cat... i hope, lol!!
 
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