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Carol and Rosie (Beaka)

Carol and Rosie (Beaka)

Member Since 2016
as you all know from my 'testing' thread I have really struggled to get blood from Rosie's ears but I've persevered and I just did it!!! Getting her used to warming them and getting them really warm did the trick if it helps anybody.
BUT now I have another problem, I tested at 2pm 2 hours after eating and her number is 3.2 ( 57.6) is this too low? She is eating at the moment. She had 2 units caninsulin at 8am this morning and due another dose tonight. Should I ring the vet for advice, they have a duty vet on call.
I have thought for a while she may be getting low, she has been on this dose of insulin for 4weeks but I have changed her to a low carb diet (all wet) and got her weight down to normal.
Any advice gratefully received. Thanks xx
 
Sorry, Carol - only just saw this thread.

Can you test Rosie again straight away.

If it's an Alphatrak and the reading is under 70 OR if it's a human meter and the reading is under 50 then give Rosie a little bit of honey/karo/glucose ASAP.

Please advise which meter you are using (and thank the heavens that you managed to get successful tests today).

Please can you post the test result after you've seen to Rosie's immediate safety. I'll keep an eye out for your update.


Mogs
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Hi Carol,

Congrats on getting that test!

How many hours ago did you give the insulin shot? Was that around 7 hours ago? And you got that 3.2 6 hours later? Have you managed to get another test to see whether her blood glucose is rising?
And which glucose meter are you using, 'human' meter or Alphatrak?

With Caninsulin it is quite common to see the lowest number of the cycle at around 4 - 5 hours after the insulin shot. But, as we say around here 'Every Cat Is Different'. ;)
It might be that Rosie's blood glucose dropped lower than the 3.2 earlier on...

It could well be that switching to a lower carb diet has reduced her need for insulin...

How is she doing now?

Eliz
 
Hi Mogs
Thank you for responding. I called the emergency vet and he said to test again in 2hours (only hope I can repeat my success!) as Rosie is acting perfectly normally and has eaten.
I use a human meter accu-chek Aviva.
She seems fine just now.
Thanks
 
AM DOSE - 2 IU Caninsulin @ 08:00.

AMPS - ???
AM+ 6 - 3.2 (58) - 2 hrs postprandial. (Ate after this test - carb level??? home-cooked chicken - low carb.)

...
 
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Hi Eliz
I did the test 6 hours after giving the insulin.

Rosie is fast asleep now, def asleep not comatose...I just checked. I'm watching her like a hawk and hoping I can get another test later. Only Rosie would pull this one on Easter Sunday afternoon!
The vet said I could call him later for advise about tonight's dose of insulin, I'm worrying about that already because I dread doing the wrong thing.
Thank you xx
 
Carol and Rosie (Beaka) said:
Hi Mogs
Thank you for responding. I called the emergency vet and he said to test again in 2hours (only hope I can repeat my success!) as Rosie is acting perfectly normally and has eaten.
I use a human meter accu-chek Aviva.
She seems fine just now.
Thanks
Click to expand...

If it were my cat I would test now. She could be at too low a number without displaying any symptoms.

50 on a human meter is the nominal hypo threshold. Caninsulin has 2 fractions (amorphous and crystalline). The crystalline fraction typically reaches peak effect from +7 hours after the dose was administered. If Rosie is already running in low numbers when the crystalline fraction kicks in it could take her too low. If you test you will know what is happening and Rosie will be safe.


Mogs
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Carol and Rosie (Beaka) said:
I use a human meter accu-chek Aviva.
Click to expand...
Hi Carol,

That 3.2 is fine 'in and of itself'. It's a normal blood glucose number for a cat. But it's not just a matter of 'what the number is' but 'where it's headed'. So, a 3.2 might be a nice number to see at the peak (lowest number) of the insulin cycle. But if seen earlier in the cycle then it would mean that action is needed to be taken in order to stop it from dropping much lower.
Also, in my personal opinion, that is probably too low a number to 'aim' for on Caninsulin. Caninsulin can drop the blood glucose pretty steeply, and that 3.2 doesn't offer much margin for safety. If it were my cat I'd probably not want him dropping much lower than around 5 at the peak of the cycle. And I would reduce the insulin dose in this instance if this were my cat...

Eliz
 
Carol and Rosie (Beaka) said:
Is this how I should have explained?
Click to expand...
Not a worry; it's just something I do when cats are running in low numbers and I'm keeping watch. I have PTSD and my short-term memory doesn't work. I need to gather bits of information and write them down in one place otherwise I haven't a clue where I'm at. When a kitty's running low it's important to keep track of times, test results and what has been fed (carbs and amounts). When I'm on hypo watch I need to keep a running summary of what has been happening so that I can make appropriate suggestions on what to do next. :)


Mogs
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Thank you all so much for your support with this.
I'll keep a close eye on her, test again as soon as I can and keep you posted, especially when it's time for her next dose of insulin! Xx
 
Rosie is asleep ATM and if I wake her up there is no way I will get to test her! As soon as she gets up I will.

Just for interest, I've had a gut feeling for the last few days that either the insulin had got got control or her own insulin was kicking back in because I'd noticed that
She's drinking much less (I monitor her consumption 2xdaily)
She is peeing less
Her demand for food has lessened and she's eating what I would say is normal for her
Her urine stick tests have been consistently low and negative several times
And I've just had a gut feeling about it! xx
 
Again, if she was my cat I would sooner disturb her sleep and make sure she was safe. Saoirse only had one symptomatic hypo. It was in the early days of her treatment on Caninsulin and I wasn't confident enough to go with my research and instead followed her vet's advice to hold her dose when I really, really wanted to reduce it. To just look at Saoirse that night one would think she was just sleeping but when I went to pick her up for her before-bed BG test I discovered she was very lethargic and not properly responsive. That test saved her life.

I'm not implying for one minute that Rosie is in the same state as Saoirse that night but you know that she has been running very low today - in the middle of an insulin cycle- and there are times when testing is more important than interrupting what might just be a cat nap. I hope that doesn't sound harsh (that is not my intention) but I've always been cautious in my approach to insulin treatment and it has served Saoirse well (and at times it has helped other cats here). I would not be doing right by yourself and Rosie if I didn't recommend checking to make sure she's safe.


Mogs
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Critter Mom said:
Again, if she was my cat I would sooner disturb her sleep and make sure she was safe. Saoirse only had one symptomatic hypo. It was in the early days of her treatment on Caninsulin and I wasn't confident enough to go with my research and instead followed her vet's advice to hold her dose when I really, really wanted to reduce it. To just look at Saoirse that night one would think she was just sleeping but when I went to pick her up for her before-bed BG test I discovered she was very lethargic and not properly responsive. That test saved her life.

I'm not implying for one minute that Rosie is in the same state as Saoirse that night but you know that she has been running very low today - in the middle of an insulin cycle- and there are times when testing is more important than interrupting what might just be a cat nap. I hope that doesn't sound harsh (that is not my intention) but I've always been cautious in my approach to insulin treatment and it has served Saoirse well (and at times it has helped other cats here). I would not be doing right by yourself and Rosie if I didn't recommend checking to make sure she's safe.


Mogs
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Click to expand...
Not harsh at all, I can see that you are just concerned for my kitty!
She just got up and after a bit of a tussle and two pricks I managed to test again, 4.6 this time. Is this okay and what should I do about her injection tonight? I'll try to test again before I give it but what should it be then?
Thank you xx
 
Carol and Rosie (Beaka) said:
I managed to test again, 4.6 this time. Is this okay and what should I do about her injection tonight? I'll try to test again before I give it but what should it be then?
Click to expand...
You've done really well to get those tests today, Carol. :bighug:

That 4.6 is very nice.

Regarding this evening; for newcomers to diabetes we recommend that no shot is given if the blood glucose level immediately prior to the shot (what we call the 'pre-shot' test) is below 11 (200).
But even if it is above 11 (200) I would still suggest that you decrease the dose. You could try reducing it by half, to one unit twice a day, and see how that affects Rosie's blood glucose numbers. Or you may just want to decrease by half a unit to 1.5 twice a day. If it were my kitty, and I was still getting to grips with testing, I'd go with the one unit....

It's possible that Rosie's blood glucose numbers could swing up high this evening if it's the case that her body wasn't comfortable with that earlier low number. This is quite common, and we call it 'bouncing'.
When the blood glucose drops lower than the cat's body has got used to it can be triggered into releasing stored glucose (from the liver) into the cat's system. This raises the blood glucose level, sometimes quite dramatically. It's a protection mechanism. And it can also release 'counter-regulatory' hormones, the purpose of which is to try to keep the blood glucose high for a while.
If this happens then please don't worry. The blood glucose will come down again.

Do be sure to reward Rosie for every test, or every attempted test (even if not successful). She may soon come to actually enjoy the tests if she learns that treats are a routine part of it.
And maybe you should reward yourself too! Chocolate and wine are popular around here.... ;)

Eliz
 
Thank you for your helpful advice.

Things not so great now, tried to test Rosie before tonight's insulin but couldn't get blood after two tries and she got angry so I've left it for a while. Rang the vet and told him her last numbers and he advised to miss the dose. She hasn't eaten much and seems a bit sleepy now?
I'm worried though that going from two units to none is too drastic? If I'd just got her on an even keel this is going to mess things up and what if her numbers are high in the night, she was diagnosed when she had ketoacidosis and I'm worried that will happen again without insulin..aarrgghh!
Sorry for all the problems, fussing and moaning I'm doing, I'm just worried Xx
 
The 4.6 that late in a Caninsulin cycle really does add weight to the hypothesis that her current dose is too high after the food change.

With a history of DKA in the mix it does create a worry about skipping doses but as Eliz mentioned above Rosie's BG may bounce after the low numbers today. For the way Caninsulin works it is possible that she may have gone below 50 earlier in the cycle (the amorphous fraction of Caninsulin really kicks in around +3 and you didn't get the test till +6). That might make her a little more sensitive to the insulin. If she has bounced off the low that might be a bit hard on her little body and it's a possible reason for her being a bit sleepier - or she could still be a bit low.

How long is it since she ate?

What did she eat?

At what stage in the insulin cycle did you get the 4.6 reading? (+?? hours)

Do you have any ketone test strips at home? If not, is there a pharmacy where you could pick some up? Testing for ketones would give you more peace of mind about Rosie's status.

BTW when I first started testing Saoirse's ears I was surprised at just how warm I needed to get them before I could get a successful test. Try warming Rosie's ear for what seems like forever and a half - and then warm it a little more to see if that helps.


Mogs
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FWIW, I think your vet is pretty much on the money about whether or not it is safe to give Caninsulin tonight. Many cats run lower during the night than during the day. Also, if you get an elevated preshot test that could be a bounce so it's not very dependable as a guide to what size dose might be safe - especially as you've not got much test data to compare it with.

Also I concur with Eliz's comment earlier about what makes for a fairly safe nadir on Caninsulin: for the way this insulin works nadirs in the 50s are playing with fire - not nearly enough of a safety cushion for the unexpected. If Rosie were my cat I would be looking to reduce the dose. By how much is difficult to judge - again because you don't have much data yet.

.
 
The 4.6 reading was 8 1/2 hours after the caninsulin dose. She ate some chicken then.

She had a bit of treat mackerel after I had tried unsuccessfully to test her and then went back to sleep. In the last half hour she has had about a quarter of s pouch of chicken (much less than she usually has at this time) and is now sitting in the porch looking out at the rain!

I have urine testing strips which test for lots of things including ketones. She won't use special litter so I just wait till she goes and stick the strip in the flow, is that ok?

I'm going to try to test agin tonight but she runs off now when she sees the sock, she hates anything on her ears and even the vet knows not to touch her paws, it's so hard.! What shall I do in the morning if I still can't test? Maybe a trip to the vet even though it is a bank holiday?

Thanks for sticking with me, it's great not to feel alone with it Xx
 
Great news on the ketone front! :) Also, given that the glucose test was also negative that means Rosie has spent a considerable amount of time today at blood glucose levels under the renal threshold. Good news in the grand scheme of things but another reason to be very cautious about how low Caninsulin might take her.

Keep giving Rosie treats when you test. Also maybe take her to the test station just to give her a treat. It might desensitize her to any anxiety she has at the moment about testing. Try to keep a business-like attitude to testing her: if you're anxious she will pick up on it and you'll both end up in a negative feedback loop. Pretend to be confident you're going to get a successful test even if you don't feel that way inside (maybe try singing). It really can make a positive difference to the testing process.

With regard to the morning, if I were in your shoes I would:

1. Try to get a successful blood test.

2. If test is successful contact the vet to discuss dose and also post here for feedback.

3. If test is unsuccessful ring the vet and see if it would be wise to bring Rosie in to get tested there. NB: if you get an elevated reading at the vet it may be influenced by travel/vet stress and also you can't rule out a bounce from the lower numbers from this afternoon so again caution should be exercised when deciding on a dose that is likely to keep Rosie in safe numbers.

4. If you do give insulin tomorrow be prepared to do spot checks of Rosie's BG during the cycle to make sure she doesn't go too low.

5. Make sure you've got a well-stocked hypo toolkit and leave everything easily to hand; saves hunting for stuff should an emergency arise. (I keep all of Saoirse's hypo kit stuff permanently on a small tray on a shelf so that I can just grab it quickly any time Saoirse's BG is trending lower.)


Mogs
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Good morning.

Well Rosie is absolutely refusing to be tested this morning! I haven't given insulin because she had only had 80 mls water overnight (it has been dropping but has been 160) and had two normal size pees. I feel so stressed about the whole thing and wish I could test her but she is fighting me now and can't be tempted with treats as she just refuses them. I will ring the vet shortly (still on emergency as it is a bank holiday) and see what they say. If only I could explain to Rosie that the ordeal of the vet visit is far worse than letting me test her! Xx
 
Sorry for all the messages!
I tested Rosie's urine and it was showing some glucose so I have given her 1u caninsulin. Checked with vet and he is happy with that and says to keep trying to test and let him know result. Don't know how I'm going to do it as she is hissing and growling when I try and would have no hesitation to bite or scratch me, it's so stressful for us both! (I do wear protective fingerless gloves). It would be easier if I had someone to hold her still for me but unfortunately I don't xx
 
Carol and Rosie (Beaka) said:
Checked with vet and he is happy with that and says to keep trying to test and let him know result. Don't know how I'm going to do it as she is hissing and growling when I try and would have no hesitation to bite or scratch me, it's so stressful for us both! (I do wear protective fingerless gloves). It would be easier if I had someone to hold her still for me but unfortunately I don't xx
Click to expand...

Oh, (((Carol))).... Here's a reassuring hug for you :bighug::bighug::bighug:

I thought my cat would be impossible to test because he doesn't like being handled at all. But I found I could crumble a few treats and test him quickly while he was muching on those. And he soon came to ignore the tests and focus on the treats...

I just posted some hometesting tips in someone else's thread, and I've copied/pasted them below in case they may be of help...

- - -

Here are some things that helped me when I started testing:
1. Rewards. Always reward the kitty for any attempted test, whether successful or not. That 'positive reinforcement' really can endear them to the testing process. Some people reward after the test. I crumble a few treats and test my cat while he's eating those. You don't have to give a food treat. Some cats are happy with a cuddle.
2. Warm ears bleed infinitely more easily than cold ones. Massaging the ear briefly can help to improve the circulation to the ear prior to testing. Some people use a pill bottle filled with warm water or a 'rice sock' (sock/fabric filled with a little rice and warmed in the microwave) held against the inside of the ear to warm it.
3. A teensy weensy smear of Vaseline on the outer edge of the ear will help the blood to 'bead up' rather than disappear into the fur.
4. Sometimes two ear pricks close together will produce enough blood for a test where one ear prick might not.
5. Massaging immediately below the ear prick, with finger and thumb, will 'milk' more blood out. (I almost always do this.)
6. Location... I find it much easier to pop the kitty up onto my desk to test him, and the desk lamp helps me see what I'm doing. Some people put the kitty on their lap. You will find what works best for you and your cat.
7. The more relaxed you are about the process, the more relaxed your kitty is likely to be. Cats really pick up on our moods. So, before testing, try a few deep, soothing breaths. And talk to your kitty in a soft, soothing voice....
8. There are a few folks here who find it easier to do tests on their cat's paws rather than the ears. If your kitty turns out to be one of those I'm sure there are paw-testing folks here who can help you with that.

Eliz
 
Hi Eliz
Thank you for your reassurance
Could you tell me what treats you use for your cat please? I'm finding it hard to find low carb treats apart from the freeze dried ones which, being Rosie, she doesn't like! Xx
 
Carol and Rosie (Beaka) said:
I'm finding it hard to find low carb treats apart from the freeze dried ones which, being Rosie, she doesn't like! Xx
Click to expand...
Doh! Bert likes the freeze dried ones....:facepalm: ....However, his tastes do vary. Sometimes he'll eat the chicken ones, sometimes the tuna, sometimes the liver, sometimes the white fish ones.... :rolleyes:

Other things that I sometimes use are little pieces of cooked chicken or canned tuna. And sometimes just a little bit of a favourite canned (or raw) food will do the trick.
Some cats like prawns/shrimps (which have the added advantage of being rich in taurine).

There are a few more treats listed in the second link in my signature below (the post is quite long, so you'll need to scroll down a wee bit...)

What sort of things does Rosie like normally?
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Ah, another thing that you might try is the Webbox sticks (widely available now) which are a slightly moist treat. I get those for my young cats (who go crazy for them) but hadn't thought to try them on Bertie, assuming they'd probably be too high carb. But I just looked at the ingredients/analysis online on the Sainsbury website and it looks like they are low carb (about 8.4% cals from carbs according the data on that website...)...
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Well I used to give her Dreamies (little luxury biscuits) but she doesn't have any of those now! Prawns and tuna bits sound good because she likes fish. I tried some chicken that I cooked but she wouldn't eat it during the procedure and preferred to run off! She did have some afterwards though even though we had failed.
I think if I could get blood quickly and first time we would would manage but it takes so long warming up her ear and then if I have to try twice she just won't have it.

Today I'm just rubbing the lancet pen around her face and putting it on her ear, same with the sock without doing anything. I'm also leaving the meter and all the paraphernalia where she can see it just so she is familiar. Anything is worth a try! Xx
 
Hi Carol (from a wet and windy Surrey!)

Sorry if I'm repeating anything but scrolling through this thread and reading some of your concerns I wondered if the 'rice sock' method of warming the ear could be adapted to make things easier for you... I used to save and wash my own disposable facial wipes and cut them into smallish strips, warmed them by running under hot water, and wrung out - this can be folded over both sides of the ear and is less bulky than a 'sock' with rice or whatever. Just an idea, everything is worth trying to see if it makes life easier!

It looks as if you're doing really well overall so hang in there.

Diana
 
Diana&Tom said:
Hi Carol (from a wet and windy Surrey!)

Sorry if I'm repeating anything but scrolling through this thread and reading some of your concerns I wondered if the 'rice sock' method of warming the ear could be adapted to make things easier for you... I used to save and wash my own disposable facial wipes and cut them into smallish strips, warmed them by running under hot water, and wrung out - this can be folded over both sides of the ear and is less bulky than a 'sock' with rice or whatever. Just an idea, everything is worth trying to see if it makes life easier!

It looks as if you're doing really well overall so hang in there.

Diana
Click to expand...
Thank you and that makes sense so I will try it. I am grateful for any advice as I will try anything to make this work for Rosie! Xx
 
Hi Carol

I use a plastic pipette (3 - 5ml sizes are OK - get 'em on ebay) filled with warm water to heat Saoirse's ear. She really didn't like anything bulky going into her ear, and as for anything wet!?!?!?! :eek:

I hold the pipette against just the side of her ear to warm it up. Here's a picture:

25066851356_93815b83be_c.jpg


If you decide to try this or something similar you need to get the water very warm in order for the heat to conduct through the plastic. Also, if you stand the pipette or similar in a container of warm water it will hold the heat better until you're ready to apply it to the ear.


Mogs
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Critter Mom said:
Hi Carol

I use a plastic pipette (3 - 5ml sizes are OK - get 'em on ebay) filled with warm water to heat Saoirse's ear. She really didn't like anything bulky going into her ear, and as for anything wet!?!?!?! :eek:

I hold the pipette against just the side of her ear to warm it up. Here's a picture:

25066851356_93815b83be_c.jpg


If you decide to try this or something similar you need to get the water very warm in order for the heat to conduct through the plastic. Also, if you stand the pipette or similar in a container of warm water it will hold the heat better until you're ready to apply it to the ear.


Mogs
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Click to expand...
That's a really good idea, thank you! I'm giving us s break from testing for a couple of days because we are so stressed with it, but we will try again xx
 
Never say never, Carol. With all that's going on with Rosie at the moment you need to be conscientious about testing - and it will get easier on both of you with practice. I can really understand and appreciate how lousy things must feel for both of you at the moment but whereas you can't explain to Rosie why it's important to test to keep her safe you can reason with yourself. I dealt with exactly the same struggle you're going through many times in the past, and even the best part of 2 years into the journey sometimes I still wish I didn't have to test Saoirse. At such times I give myself a really good talking to and remind myself of the potential consequences of not testing - they're really not good. It helps to steel my resolve and to force myself to appear outwardly as bright and breezy as I can possibly manage to at test times for her sake, even if I have to fake it big time. It's a small price to pay to keep her safe from hypos and DKA.


Mogs
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It is tough, for sure, but keep at it if you possibly can. If you think about it, you can try to control your own stress, so consider ways to do this. A warm bubble bath, a glass of wine or hot chocolate (whatever floats your boat!) or just some deep breathing exercises to relaxing music. When you feel calmer and more in control, so will your mental/emotional ability to test. And remember what we've said about treats at testing time, for both of you

You'll get there.

Diana
 
Carol and Rosie (Beaka) said:
Hi Eliz
Thank you for your reassurance
Could you tell me what treats you use for your cat please? I'm finding it hard to find low carb treats apart from the freeze dried ones which, being Rosie, she doesn't like! Xx
Click to expand...


For a treat, try some plain tuna, it's nice and smelly so maybe it'll attract her attention and keep her mind off of being poked.
 
Thank you for your responses and help and advice, especially treats for me!

I know how important it is to test and how passionate you all are about it and I couldn't agree with you more. However it was making mine and Rosie's lives a misery and she had started to run away when she saw me and I hated that. I am going very slowly and handling all the testing stuff around her and frequently rubbing her ears but not doing anything, to get her used to it. If we get to do it eventually all well and good but I decided that as she is 15 years old I want us to enjoy what time we have left, be it long or short, and not spend it battling and upsetting each other. I also think that the amount of stress it was causing her would probably affect the results anyway.
Why can't there be a way to test without blood!

I am monitoring her closely, luckily I'm able to be at home a lot. She is drinking much less and her urine sticks are mostly negative so I think we're as okay as we can be. The only hiccup we've had is that today she seems to be off her food. I'm hoping it's just a fur ball as she has been eating grass today! I am reporting and getting feedback from the vet almost daily and I'm only ten minutes away if I need to take her in.

I'll keep posting so you know how we progress and thanks for all the help you've given us so far. Xx
 
I'm sure you know your own cat, Carol, and I suspect that many people would take the same view as you. It does sound as if you have a good handle on things and as long as you are ultra-vigilant and are ready to respond (ie test) if you need to, hopefully all will go well. Carry on rubbing Rosie's ears etc and maybe try to sneak in a quick test at an appropriate point if you can - just the occasional reading will at least give you peace of mind until you both feel more relaxed about things.

Rooting for you!

Diana
 
Hi Carol--your doing great:)
I know how awful it feels when they run from you.... Dre did this a few times.
As you get more comfortable so will your kitty. I am glad you are rubbing the ears and can test if you see the signs of hypo-
We are in your corner:cat:
 
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