Frodo, a new diabetic

[Ruth Ann and Frodo]

Frodo is a 15 1/2 yo DSH former feral with some Siamese somewhere in his ancestry. He had been looking poorly for a while and had lost weight before I got him in for testing (Last tests some 8-9 months ago hadn't shown any problems except that he was borderline high on hyper-T tests, and I was rather expecting that that would turn out to be the problem.) Anyway, his BG tested in the mid 400s, so no doubts that he's diabetic.
He was being fed some raw, some canned, and some Origen kibble. Since diagnosis I've mostly been able to keep him away from the kibble (we have other cats and one is a real kibble-head, so I can't just stop it completely), and I'm trying to avoid canned foods with wheat or soy in them, but it isn't a real drastic diet change.
The vet put him on pro-zinc insulin twice a day, and we've been trying to get the dosage right - only started a couple of weeks ago. I think the readings we're getting are still way too high, but the vet doesn't seem to think so. Morning readings were in the 460 neighborhood, and the lowest we've gotten was 279 at 6 hours after the shot this afternoon (current dosage is 2./2. units).
We're also having increasing difficulty getting him to tolerate an ear stick - seems like every one is worse and he struggles so much and actually tried to bite me tonight - something he's never done before. We also should be running some fluids and have had to give up last night because he was struggling so much. I really feel a little discouraged about being able to monitor him, when two of us can't get readings. Not giving up yet, but not very confident either.
Ruth Ann

 

[BJM]

Welcome to FDMB, Ruth Ann, and to the sugar dance. I promise the steps can be learned!

We generally recommend

1) low carb canned or raw foods - see Cat Info for the food list and an explanation of good feline nutrition. I feed all of mine Friskies pates

2) a good long lasting insulin - you have that in ProZinc. And, we have a protocol for using it here.

3) home monitoring - that can be tough for a lot of folks. While you're working on that, see my signature link Secondary Monitoring Tools for some other assessments which may be helpful

 

[phlika29]

Hi welcome to you and frodo

Here is a link to hometesting and hopefully it will give you some tips to make it easier
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

I personally find heating the ear with a rice sock before you test really helps the blood to pool in the ear. Also squeezing/adding pressure to the bit of the ear behind where you poke and also in front of it will help bring the blood to the surface. Always follow with a low carb treat even if it doesn't work.

 

[Deb & Wink]

Sounds like you need to gain some cooperation from your kitty, so here is something to help.

Beyond the How To's of Hometesting, this article on Ear Testing Psychology or how to make your cat more comfortable and accepting of the process, may be helpful to you. It was written by member Kpassa after dealing with her semi-feral kitten Michaelangelo's diabetes diagnosis.

The same methods should help you to give the fluids too.

Condensing that hometesting links and tips post, is this Google document on the Top 29 Ear Testing Tips.

 

[Ruth Ann and Frodo]

Sounds like you need to gain some cooperation from your kitty, so here is something to help.

Beyond the How To's of Hometesting, this article on Ear Testing Psychology or how to make your cat more comfortable and accepting of the process, may be helpful to you. It was written by member Kpassa after dealing with her semi-feral kitten Michaelangelo's diabetes diagnosis.

The same methods should help you to give the fluids too.

Condensing that hometesting links and tips post, is this Google document on the Top 29 Ear Testing Tips.

 

[Ruth Ann and Frodo]

I should have mentioned that we're pretty experienced giving fluids to Frodo's littermate Gandalf, a CKD kitty. But Gandalf has always been rather laid-back, while Frodo is always the nervous one. Gandalf seems to enjoy fluids time - he gets the undivided attention of his two people. But Frodo started fighting the minute he felt the needle - we are using Terumo ultra thin wall needles so he should hardly feel the stick, if it goes in right.
We managed to get three ear sticks in on Frodo yesterday - the last one we did "kitty Burrito"and it went slightly easier. But he wants to move his head the minute he thinks the stick is coming. Not to mention flicking his ear, both to avoid the stick, and while we're getting enough blood out, and waiting the couple seconds after pushing the strip in to the meter.
I'm also not really confident in our vets (a husband/wife team). We know quite a bit about human diabetes since my husband is diabetic. Cats aren't that different, and I just can't see how a reading of 460 or so (human meter) in the morning can possibly be OK for Frodo. I got the impression that the vet is mostly concerned that he not go too low overnight, but the lowest reading we've gotten so far was a 279 5 hours after the morning shot - still lots of room above a possible hypo, even overnight when he likely isn't eating much during the night.
Oh well, back to trying to get Frodo used to "sticks".

 

[Deb & Wink]

Yes, those former feral or semi-feral kitties can be difficult. I fostered and then adopted my semi-feral Dancer from a shelter. At the time she first came to live with me, I was supposed to weigh her twice a week. I remember all the times she was hiding under furniture and I had to sneak up on her and quickly snag her for a weight in.

Hope that Frodo becomes a bit more cooperative. Treats? Is there something he loves like any kind of pure protein or brushing or ear scritches? Perhaps some active playtime before the fluids and/or ear testing will tire him out a bit and get him to be more willing for you to get those ear sticks.

Kibble-head huh? Another member of DFAA (Dry Food Addicts Anonymous) like my Wink. It took patience and persistence and trying almost all these tips and tricks from vet Dr. Lisa Pierson's article on Transitioning Feline Dry Food Addicts to Canned Food to get my sugardude Wink off the high carb dry and onto low carb wet food. Perhaps there are some ideas to help you too.

Nice that you have a bit of experience with diabetes. At least you know some of the basics, good insulin, low carb diet, home testing.

 

[KPassa]

Are you free-handing or using a lancing device? If using a device, you might need to go to a lower setting/depth. You also want to use the lancing device almost like a clicker training tool for dogs. Start clicking the device at random times and tossing treats after. Then start clicking when Frodo does something "good," like sits next to you or eats dinner. He'll soon associate the click-sound with positive experiences.

If free-hand, what's your technique? I don't free-hand, so I can't really give advice, but someone else might be able to chime in with help.

 

[KPassa]

I would also randomly play with Mikey's ears every time he let me get close enough to pet him to de-sensitize him. He still doesn't really like me messing with his left ear, but his right ear is prime real estate.

 

[Ruth Ann and Frodo]

Are you free-handing or using a lancing device? If using a device, you might need to go to a lower setting/depth. You also want to use the lancing device almost like a clicker training tool for dogs. Start clicking the device at random times and tossing treats after. Then start clicking when Frodo does something "good," like sits next to you or eats dinner. He'll soon associate the click-sound with positive experiences.

If free-hand, what's your technique? I don't free-hand, so I can't really give advice, but someone else might be able to chime in with help.

My husband is free-handing the ear stick, while I hold Frodo and try to keep him from moving. I think that may be part of the trouble - husband starts getting himself upset at the first motion or jerk back on Frodo's part, and they feed off of each other's anxiety. Unfortunately I have rheumatoid arthritis and my hands don't work too well, so it's difficult for me to do fine motions. I *am* able to do the insulin shots by myself, since I can do it really quick while holding Frodo on my lap. And Frodo seems not to get upset, although he startles a little at the needle stick. He is quite willing to hang around for the treat afterwards.

 

[KPassa]

I have really shakey hands, which is why I've always used a lancing device. That might be helpful for you to try with testing to see if it makes it easier for you to test. Try practicing on an apple a few times and see if it's something you might be able to do in the future.

For the husband's anxiety, you're right! Cats really feed off our energy levels. I wrote up this document about taking your time and going as slowly as you need to in order to get as comfortable with the process as possible.