Hello! Food and insulin questions

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Chris and Miles

Member Since 2020
Hi all,

I am Chris - this is my first post and I recognize that I know very little. I just got my cat Miles' diagnosis earlier today.

Miles (11, male) was actually showing symptoms of what seem to be two different things; a congestion problem which I didn't think much about, but then I also realized he was overgrooming for some reason (thin fur on his forelegs) and that he had lost weight. He was also sleeping/resting on the floor at the end of the living room instead of jumping up to a perch or the chair or sofa, his favorite areas.

His appetite has been fine and he has been at least as affectionate as ever. Lately he has taken to taking over the top half of my pillow in the morning, which I find awfully cute. At first I thought maybe he was just really bored so I have started putting "cat TV" videos on the TV. He doesn't pay them too much attention but his sister Ella has always been more interested in playing and so on.

My vet connected the overgrooming with his congestion and took some other samples and came back today with the diagnosis of diabetes.

As just a very very first step I got some DM Purina food from the vet. (I have some concerns about this since I now know it is owned by Nestle, but right now... whatever). The cats certainly LOVE it as I knew they would. I have trouble separating Miles and Ella at mealtimes so right now I am just feeding it to them both. Miles seems to be still crying about being fed more - previously I was feeding them a dry food and I hope that I am feeding them enough and he isn't actually hungry.

I am trying to figure out where to order an AlphaTrak (2) from. I think I've seen that there are some other posters here in Ontario - for starters, aside from reordering supplies, where you did you get your machine from?

I haven't put him on insulin yet. Is that wrong!?
And now that I am reading the "new diagnosis" article, my vet didn't say to bring him in again soon. Is THAT a bad sign?

Thanks,
Chris
 
Welcome, waving from the Kawarthas. Feline diabetes is a steep learning curve. We have all been where you are.

My vet connected the overgrooming with his congestion and took some other samples and came back today with the diagnosis of diabetes.

What tests did the vet do? Was it just a glucose test (what the blood sugar was at the time)? Or a fructosamine test (an idea of what the blood sugar has been like the last two weeks)?

I'm not familiar with overgrooming being a symptom of diabetes in cats. I think something else is going on there. Allergies? UTI? Infection? Did the vet say anything about the congestion? More people will respond and chime in on this one.
@Wendy&Neko

As just a very very first step I got some DM Purina food from the vet. (I have some concerns about this since I now know it is owned by Nestle, but right now... whatever). The cats certainly LOVE it as I knew they would. I have trouble separating Miles and Ella at mealtimes so right now I am just feeding it to them both. Miles seems to be still crying about being fed more - previously I was feeding them a dry food and I hope that I am feeding them enough and he isn't actually hungry.

The DM food. There is nothing special about it except the price. Most people here feed Fancy Feast or Friskies pates. There's also some of the Wellness and Tiki. you are looking for carbs under 10%.
Here is a link to a low carb food list put together by a vet. A number of the foods are not available in Canada.
The only dry food in Canada that is low carb is Dr. Elsey's Clean Protein.

An regulated diabetic cat cannot process the nutrients in food properly. Feed him more.

I am trying to figure out where to order an AlphaTrak (2) from. I think I've seen that there are some other posters here in Ontario - for starters, aside from reordering supplies, where you did you get your machine from?
Through your vet or from a place such as https://www.petsdrugmart.ca/en/Product/AlphaTRAK-2-Kit-118745/3108
A forewarning. AlphaTrak strips in Canada are incredibly expensive. $2.00/strip
Most Canadians use a human meter. That is what vets used before the pet meter was invented. A human meter works just fine and even then the strips in Canada are expensive. We can direct you to what works and what won't break the bank. Do you have a relative, friend, or neighbour who is a diabetic? And could you borrow their meter for a day or even a couple of hours to home test? Some cats run higher at the vet.

(Some insulins in Canada such as Lantus are relatively cheap compared to the US.)

I haven't put him on insulin yet. Is that wrong!?
And now that I am reading the "new diagnosis" article, my vet didn't say to bring him in again soon. Is THAT a bad sign?

Very few diabetic cats go into remission just by changing to low carb food. And yes, no follow-up is a bad sign. Can you ask the vet clinic for a copy of the lab work? You are legally entitled to it. The lab work would help us figure out if your cat is diabetic.
 
Hi Red & Rover, thanks for the welcome!

The vet said the overgrooming was actually - I think running his nose because of the congestion or drip. I think those two things are connected and unrelated to the diabetes.

I don't have much more time to answer right now but all I know about the blood work is a general "geriatric blood profile". I will have to ask for a copy of the blood work. They may be overly busy - I had to wait a week for his appointment in the first place. Fortunately it is a very short distance from me.

Any idea what percent more food I should give Miles? What you say explains his weight loss.

PS no, I can't think of anyone I could borrow a device from
 
Right now I'm just waiting over the next two weeks to see if the antibiotics clear up his congestion and hopefully also the overgrooming/loss of fur.

I remember now that the vet talked about the potential for insulin being dangerous if his levels are already high? So maybe she wants me to get the monitoring device first

Ok so plan for today
- call/email vet and ask for lab results (as you say, by email if they can, that'll be fastest)
- find out if they can sell me the device... honestly I have some personal anxiety issues and I don't think I can plunge into trying to figure out what human device to get. If the AlphaTrak works, even if it's expensive, I can afford that I think.
- check to make sure if I understand the vet's position re insulin/followups
- actually I want to know what they weighed him in as, for food calculations, but I don't know how much more to feed him than normal
- need new rubber lids for wet cat food unless mine are up in a cupboard, so that I don't have any smell or drying out issues from partly open cans of food
 
200 strips a month? Gaaah. I guess I don't understand the routine.

I just spoke with someone at the vet's and got his current weight (5.4kg).

Visiting Walmart in person is not an option. If I can order the Relion online that would be fine too.

P.S. I understand the vet's position now: start with putting him on good food and monitor his levels and then decide on insulin or further visits. I guess that makes sense. They are also sending me his lab reports by email.
 
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Hi Chris, welcome to the forum! I am also in Canada. Most people here are from the US and will recommend stuff from Walmart but we can't get the Relion meter here easily.

When I got Dixie diagnosed, I felt pressured to get the Purina DM Dry kibble and Wet food, and also the Alphatrack meter. I actually couldn't find the Alphatrack meter anywhere. I tried to order it from the US but they cancelled the order after a couple of weeks. I then tried to get it from my vet and they said that their supplier didn't have it... I then stressed out for a while and put off researching the "perfect" glucometer. Basically, it ended up with me not testing Dixie for a month :facepalm:. I will try to help you avoid that situation.

Also, I am very glad that I didn't order the Alphatrack meter. The majority of information on this site is calibrated for Human meters (whereas the Alphatrack meter is calibrated for pets). Most spreadsheets I see also use human meters. So don't get too caught up with what your vet says.

I think the best thing for you to do it get a meter right away and learn how to start testing. You will waste a ton of test strips in the beginning while you get the hang of things, so I think it is better to get a meter now rather than wait for an expensive meter.

If you want to get started testing right away and for cheap, then I recommend you get this:
Shipping is around $13 CAD and I have found it is extremely fast (usually a day or two). I am very happy with this site!

So you can basically get the glucometer, 100x test strips, 100x lancets, and a lancing device for just $60.97+tax CAD It will get to you fast and no stress of researching :)

Some optional things you can order are
I use this Bravo glucometer and lancing deving on Dixie (you can check out my spreadsheet). $0.40/strip is a lot nicer than the Alpha track's $2.00/strip! The meter reads slightly higher than some other people's meters on here, and you can see a discussion about it here (but if you are stressed out, please don't read this now! Just get the meter). I don't think this will be a concern for you though if you have a recently diagnosed pet because the numbers will be high anyways.

So yeah, just bite the bullet and spend that $60 bucks now and get the ball rolling. Then get that insulin from the vet. You will be happy that you did! The meter is free so it really isn't a waste at all. Then you can start researching your own meters later on when things are less hectic :) You can even switch to the Alphatrack later if you prefer... but the best thing you can do now is just get started.
 
It is definitely possible to get all the supplies online (I haven't picked up any supplies in person!). If you do get supplies online then make sure that you account for shipping delays. Diabetesexpress.ca has been really good for this, but even then I will still make sure to stock up on test strips. I tried out the One Drop meter, and the shipping was over a week. With the Alphatrack test strips from the states... who knows how long that would have taken! It took weeks for them to tell me that the order was even cancelled.

Regarding your question about 200 test strips... some people (like SashaV and I) test a LOT! This isn't required or anything. I just do it because I work from home and am often up late at night. I also really like gathering data hehe. So that is why I might go through quite a few strips. Don't feel intimidated by it though because you can find a routine and dosing protocol that works for you.

In the beginning, I also went through a lot of strips, but that is because it was tough to get the hang of testing Dixie. To get the cat's BG level, you need to poke their ear with a lancet, then get the blood to bead up, and then bring a test strip to the blood. Stuff can go wrong here, like not getting enough blood, or the blood soaking into the fur. Then you will inevitably bring the test strip to the blood spot that is too small, then the strip doesn't absorb and tada... wasted test strip!

This gets a billion times easier though. I used to microwave a hot rice pack and use it to warm up Dixie's ear, and I would waste a couple strips each time. Now, all I need to do is rub her ear for 15 seconds. And I can even use the smaller lancets (30G which I found for a bit cheaper) because her ear bleeds so well. I only mess up few a few strips a week now!

As far as food goes, I switched from the Purina DM Wet and Dry to the Friskies pate which is also low carb. Specifically, I alternate between Friskies Pate Chicken Dinner and Friskies Pate Turkey & Giblets Dinner. They are $.60/can at my Walmart and I can do grocery pickup to get them. It is also Purina (Nestle), but at least it is cheaper than the Purina DM stuff! (I can't remember... $2.40/can?). Then you can do more research on better food later on. I think the names of the foods differ between the US and Canada, but the Friskies names I just gave you should be the Canadian version.
 
Is there like a reliable way of converting the results from a particular device to the real values? I mean don't those real values have real meaning? :confused: I guess there must be info about this to read.

It is good to know about the procedure for using the lancet. I guess it doesn't hurt too much for the cat? Have you tried giving your cat a (low carb) treat after testing to encourage them to be cooperative?

I have a local pet store which does free delivery, although I don't know if they have any food which is cheap. I don't have a car, so if I can get the food without increasing the size of my grocery shop that will be good. At least they have a website so I can look at the brands of food which have been evaluated for nutritional content and then look at their site to see if they'll probably have it.

I guess I have a question: I understand that I want a low-carb (<10%) high protein food. What is considered "high" protein? 30%? 50%?

And are there any sort of up to date charts of nutritional info, as I see that a lot of the work by Janet & Binky is >10 years old and probably all the product names have changed...?
 
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Is there like a reliable way of converting the results from a particular device to the real values?
Pet meter values are similar to lab analyser values. There's no direct conversion between human meter and pet meter values but the relationship would be more akin to percentage-based than linear, in that at lower numbers the meter readings are closer together but the divergence between readings is very significant at higher 'actual' BG levels.

Instead of trying to convert between the two meter types, one uses the appropriate reference range for the meter being used, e.g.:

Normal feline BG reference range on a meter calibrated for cat blood: 3.9-8.3mmol/L | 70-150mg/dL.

(Note: This is the range my vet provided for use with my Alphatrak. FDMB uses 3.8/68 as the lower bound.)

Normal feline BG reference range on a meter calibrated for human blood: 2.8-6.7mmol/L | 50-120mg/dL.

(This is the range used in FDMB dosing method literature and is based on published studies where human meters were used to measure cat BG levels.)

Feline renal threshold as measured on a meter calibrated for cat blood: c. 14-16mmol/L | c. 250-290mg/dL (varies from cat to cat, range would be lower on human meter).

(The pet meter range is from the online Merck Veterinary Manual.)


Mogs
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I guess it doesn't hurt too much for the cat?
They don't have as many nerve endings at the edge of their ears as humans do in their fingertips.

Have you tried giving your cat a (low carb) treat after testing to encourage them to be cooperative?
Absolutely! Many, many caregivers include a diabetic-friendly treat (e.g. freeze-dried proteins, small pieces of home baked chicken) as part of the testing routine. For cats that aren't as food-motivated, fuss fests or time being groomed are possible alternative rewards.

I have a local pet store which does free delivery, although I don't know if they have any food which is cheap.
If you identify some suitable foods and would be in a position to order by the case, if your local pet shop don't normally stock them perhaps they might consider ordering them in for you as specials? (I'm in the UK and our local pet shop is quite good about stuff like this: it's more business for them.)


Mogs
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Hi Mogs,

Thanks for the wonderfully helpful information. Now I know I can order the equipment with confidence.

Interesting idea about the delivery. I don't know, but it's worth asking. I also might assemble a list of the wet foods they carry and post here to see if anyone is using those.
 
I asked for the lab work - they did send me this.

MilesCamfieldResults - Copy.jpg
 

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Sorry if I'm asking dumb questions, but - I tried to calculate how much food Miles should have (diabetes aside) and came up with about 1 can/day. A vet employee did a lookup of a feeding guide for the food and came back to me with 1.5-2 cans a day. Which is, yeah, a lot expense-wise.

With an all wet-food diet do you find finding them twice a day enough or do you split it into 3 meals?
 
Sorry if I'm asking dumb questions
You are not asking dumb questions! It is great that you are posting here to find more information. I was just reading that it is quite common for diabetic pet owners to not treat their pets or to just stop treatment after a while, which basically is a death sentence. So we are all very happy that you are being proactive in Miles' recovery!

It is good to know about the procedure for using the lancet. I guess it doesn't hurt too much for the cat? Have you tried giving your cat a (low carb) treat after testing to encourage them to be cooperative?
I don't think I am hurting Dixie at all with the pokes. However, people will say here that cats don't like their ears being fiddled with and that is something that you really have to try out yourself to realize what people are talking about :D. Dixie will kinda roll her head into me while I am touching her ears so it can be hard to get a good test in sometimes. If you want to get Miles prepped before you order the test supplies, you can just sit down with him and give him some pats and see if you can gently massage the tip of his ears and then reward him. Try to do it in the same spot of your home each time.

I guess I have a question: I understand that I want a low-carb (<10%) high protein food. What is considered "high" protein? 30%? 50%?
I'm sorry, but I don't know the answer to this one! I am still feeding Dixie the basic Friskies Pate that gets recommended on the forum. As you can see by her spreadsheet, she is doing very well and is now on 0.25 units of insulin. I would eventually like to do research into a higher-quality food for her, but it hasn't been as big a factor for lowering her BG as I had originally thought!

If you want to search the forum, then there is a search bar in the top right. I prefer to use Google to search the forum, so I would google something like "high protein diet site:felinediabetes.com" and then it will combine all the forum searches at the top of the results. If you can't find any good info there, then you can create a new post in the general forum with the question as the title and hopefully some knowledgeable people will stop by!

And are there any sort of up to date charts of nutritional info, as I see that a lot of the work by Janet & Binky is >10 years old and probably all the product names have changed...?
https://catinfo.org/ by Dr. Pierson gets recommended a lot around here. There is a lot of info there though, so I don't think it's necessary to read it all up front. I usually just use the food chart they have which was updated in 2017.

I tried to calculate how much food Miles should have (diabetes aside) and came up with about 1 can/day. A vet employee did a lookup of a feeding guide for the food and came back to me with 1.5-2 cans a day. Which is, yeah, a lot expense-wise.
I found this difficult to figure out as well. When I started feeding Dixie low-carb wet food, I used an online calculator and got ~200 calories a day (she is 10 lbs and didn’t need to gain weight). At the advice of the forum, I increased it to 225 calories a day because unregulated diabetic cats don’t utilize their food very well, so more is better in the early stages. I weight her occasionally by holding her while I step on my scale at home and her weight has been consistent! So it might take you a bit of trial and error to figure out how much to feed. I’d guess that more is better for now, but every cat is different and I’m not sure if your cat has any weight issues!

With an all wet-food diet do you find finding them twice a day enough or do you split it into 3 meals?
I am not sure how relevant my answer will be since you may not need to start on insulin (depending on how the food change goes), and it will depend on the BG data you collect when you can get a glucometer. But in my case, when I started Dixie on insulin I used to just feed her twice a day (vet’s orders), but I also learned from this forum that that can be bad for the pancreas. So I started adding extra meals throughout the day. I eventually picked up a timed feeder which has made this process very easy. Dixie now gets 8 meals a day, and the feeder ensures that she has no food available 2 hours before shot time! I added some pics here if you want to see how you can set things up. When I went back to the vet and told him what I was doing, he said it all made sense and that he was glad I was doing it. It can be annoying how vets are inconsistent with their advice :facepalm:.

I did a lot of research on which timed feeder to buy, and this one came out on top. It seems like everyone on the forum uses it here. It sucks that it is twice the price in Canada, but it is so worth it. Manually giving Dixie her +2 meal and getting up early to remove her food got old fast! I also feel more comfortable knowing that she will have fresh meals available at her nadir (the time when her BG levels get the lowest while she is on insulin).

Here are the Canadian links to the stuff I have:
I have found conflicting research about how many times a day to feed cats. Some say that they should get several small meals a day. But since Dixie is suffering from constipation lately, I found some info online about how bigger meals can encourage them to poop... decisions, decisions :D

@ChrisC did you find a glucometer and test strips that you can get delivered?
 
Hi FarmKitty,

Sorry that's a lot to take in - I'm working from home and have to pay attention to that right now. But I did order the Bravo meter and lancets that you suggested. Thank you!

Cheers,
Chris
 
I asked for the lab work - they did send me this.

View attachment 58698
Yes, it looks like your cat is a candidate for insulin.
If you change the title of this thread, you will get more eyes to look at the lab work.
Go up to the top righthand corner of this thread.
Click on "Thread Tools."
A small box will drop down "Edit Title."
Click on that.
Change the title to something like: Insulin and food questions.

In Canada, Lantus insulin is the best (and least expensive) option.
 
FarmKitty and Red & Rover thank you for your replies. Of course I should have thought of using google search although I think some forums may block it. I just used it to change my name to Chris and Miles. I'll try to get a new picture of Miles and show him to you.

As far as handling ears is concerned I don't anticipate a lot of trouble. My two have always been pretty tolerant even if Miles will push my hand away from his belly. He is sitting next to me on the sofa (I have a bird video on the TV) and he is letting me massage his ears, or finger the tips of his ears, without a squawk.

I should get some new scales because mine broke - I think from leaving bags of litter on top of it.

FarmKitty thanks for telling me about how much you increased Dixie's food by because of the nutrient absorption issue. I will have to recheck but I think that the vet may have suggested too much food. I think I calculated - I think I said - 1 can per day, and now I've gone up to 1.5, and maybe it should be more like 1 and a sixth or something.

The timed feeder is interesting. I suppose you probably have it set for 8 equal intervals so your Dixie can get meals even in the middle of the night? I am a little worried about Ella nabbing his food instead.

(You know what, as far as that congestion thing goes? I may be imagining things, but I think his paws are already starting to look better.)

The food table looks very useful and I also forwarded it to someone else at work with a cat. Much appreciated!
 
Miles is driving me kind of crazy because he loves the food (Purina DM) so much. I fed him a can and a half today - 1/2 can at 7:30, 1:30, and 7:30. That's... almost 300 calories? Maybe I underfed him yesterday (only 1 can, I think). He complained about food frequently at least an hour before feeding time and ... it was really hard. I still feel kind of stressed. I just took some cups to the kitchen and I was afraid he was going to appear and start crying for more. Thank goodness, he didn't. Maybe tomorrow will be betetr.
 
But I did order the Bravo meter and lancets that you suggested.
Awesome! I hope they arrive quickly!

As far as handling ears is concerned I don't anticipate a lot of trouble. My two have always been pretty tolerant even if Miles will push my hand away from his belly. He is sitting next to me on the sofa (I have a bird video on the TV) and he is letting me massage his ears, or finger the tips of his ears, without a squawk.
That is excellent because getting them to tolerate the ear touch is half the battle! Dixie is also very docile and I could touch her ears right from the beginning, but it still took at least a full month of tests before things started to get easier. The main issue is that poking with the lancet will draw such a tiny amount of blood at first. The Bravo meter requires 0.5 uL of blood. There are a few meters that require only 0.3 uL of blood, but their test strips will be at least double the price. At first I tried the lancing device but I didn't really know how to use it, so then I followed what the forum recommends which is just holding the lancet with your hand (and not using the lancing device at all). After a month of this, I went back to the lancing device and haven't looked back! I like the one that comes with the Bravo meter because the part where the needle comes out is transparent so I can line up the device with her ear at the perfect spot each time.

FarmKitty thanks for telling me about how much you increased Dixie's food by because of the nutrient absorption issue. I will have to recheck but I think that the vet may have suggested too much food. I think I calculated - I think I said - 1 can per day, and now I've gone up to 1.5, and maybe it should be more like 1 and a sixth or something.

The timed feeder is interesting. I suppose you probably have it set for 8 equal intervals so your Dixie can get meals even in the middle of the night?
Yeah, I measure out her food in grams, so there is usually always a partially full can in the fridge. I have settled into the routine of giving her:

Set up feeder for the day:
  • AM insulin shot time: 40g
  • AMPS +2: 30g (Dixie hits lowest BG level here)
  • AMPS +4: 20g
  • AMPS +5: 10g
  • AMPS +10: chicken flakes
Set up feeder for evening:
  • PM insulin shot time: 40g
  • PMPS +2: 30g (Dixie hits lowest BG level here)
  • PMPS +4: 20g
  • PMPS +5: 10g
  • PMPS +10: chicken flakes
I have the pet feeder set to turn 8 times in a 24 hour period (and I think it actually supports up to 9 separate times). I have it set to turn at +10 (10 hours after her insulin shot) so that she won't have any food available for 2 hours before her insulin shot. This way, I can ensure that when I test her blood that it won't be temporarily raised from any food. I put a couple of freeze-dried chicken flakes in the feeder because I feel bad it turns and she walks up to an empty dish :p

I am a little worried about Ella nabbing his food instead.
Hmmm that is a good point. I haven't had to deal with that but I bet others on the forum can offer good advice. I have seen this fancy automatic feeder that will only open if it detects a microchip or a collar tag. When I read the PetSafe 5 Automatic Feeder comments on Amazon, some people said that they bought two of them and put them at opposite ends up the house and configure them to go off at the same time. Then their cats would split up to go to them and wouldn't eat each others food. Another option is to get one of the pet feeders that has bigger food slots, put all the food in it for the day and then just set it to turn a couple of hours before insulin shot time. Then your cats can still free feed but won't be influenced at shot time. I have also heard that some people will put their cats in a separate room to feed. But definitely do a search for it on here but it seems like some people have a lot of cats! :D

(You know what, as far as that congestion thing goes? I may be imagining things, but I think his paws are already starting to look better.)
That is so great to hear! Go Miles :cat:

The food table looks very useful and I also forwarded it to someone else at work with a cat. Much appreciated!
I am looking into different food options for Dixie as well and I spent yesterday researching. I found this post that lists the 10% carbs and under foods https://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-less-than-8.94685/. I found it easier to look at than the other big chart. I see what you mean about pricing... I think I spend $24/month right now on food but I looked at some of the Weruva foods and they might run me $150/month (and others $240/month) :nailbiting:. I think I will wait till next month when I get her blood tests so that I can see if she needs any specialty foods (low in phosporous, etc.)

Miles is driving me kind of crazy because he loves the food (Purina DM) so much. I fed him a can and a half today - 1/2 can at 7:30, 1:30, and 7:30. That's... almost 300 calories? Maybe I underfed him yesterday (only 1 can, I think). He complained about food frequently at least an hour before feeding time and ... it was really hard. I still feel kind of stressed. I just took some cups to the kitchen and I was afraid he was going to appear and start crying for more. Thank goodness, he didn't. Maybe tomorrow will be better.
Was Miles free feeding before? Or did he always have set meal times? When Dixie was diagnosed, she had dry food out all the time and would get a bit of wet food twice a day. One day she ate so much dry food that she drank over half a litre of water as welll... When I switched her to only set meal times she would do the same thing as Miles! Begging for food non-stop and going crazy over it. She also loved the Purina DM wet stuff. I think it only took a few weeks for her to adjust to the feeding times though... and we haven't looked back :)

Also, I checked your blood work and the glucose measurements look almost identical to what Dixie's was (her blood glucose was 22.6 and the glucose in her pee was 3+), so I think it is a good idea to mentally prepare for the vet to suggest insulin. I think it is good that your vet is knowledgeable about the difference switching to a low-carb food can make. People here always warn others about how switching to a low-carb food AND adding/increasing insulin could cause the BG a bit too quickly! Do you know how many carbs Miles was getting previously? You mentioned some dry food.
 
Here are some things that you can get started on while waiting for the glucometer to arrive

1. Get helpful supplies for testing
Here are some things that you will want to look into for testing Miles' BG:
  • Hot rice bag (put rice in a clean sock and tie it off)
  • Vaseline to help the blood bead up
  • Headlamp (this was extremely useful for me because I don't have very good natural light in my place)
  • Low-carb treats for after testing, such as freeze-dried chicken treats
  • Container to put everything in
Some people also use some sort of anti-bruising cream (polysporin maybe?), but I don't use it and I don't want to recommend you the wrong thing. I think there is a safe version of it.

The main thing that made a difference for me was the headlamp and the hot rice pack. The vaseline did nothing for me, but others find it very helpful!

The container has also made a huge difference later on. I would shake the container with the lancets and I guess she has associated that noise with a treat now. All I need to do is pick up the container and she will wake up out of a deep sleep and come running for a test :cat:.

test_supplies.jpg

This page goes more in-depth about how to test.

2. Set up your forum signature. This is how people can see important info about Miles at a glance without asking.
  • On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
    • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
    • Add any other text, such as
    • Caregiver & kitty's name (optional)
    • DX: Date
    • Name of Insulin
    • Name of your meter
    • Diet: "LC wet" or "dry food" or "combo"
    • Dosing: TR or SLGS or Custom (if applicable)
    • DKA or other recent health issue (if applicable)
    • Acro, IAA, or Cushings (if applicable)
    • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
    • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.
Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.

3. Set up a spreadsheet to enter Miles' BG numbers into
We use spreadsheets to easily track the blood glucose trends. Everyone uses the same template and colour coding. Here are the instructions to set up the spreadsheet.
The U.S. uses a different measuring system than us, so you will want to use the 'World Spreadsheet Template'. It has two sheets. You will enter the Bravo meter results on the 'World mmol/L' sheet, and then the spreadsheet will automatically convert those values (by multiplying them by 18) to the U.S. system on the US mg/dL sheet.

Most people here seem to use the U.S. mg/dL system. It can be a bit annoying mentally going back and forth between the two systems when you look at other people's spreadsheets. You will get very good at dividing stuff by 18 :D.

Here is a forum post that explains how to read the spreadsheet. You will want to add a link to your spreadsheet in your signature. You can see how I have a link to Dixie's at the bottom of my signature.
 

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Hey,

Sorry for lack of replies. Sorry I'm feeling kind of anxious right now as I write this because I just fed them which means for the previous hour so they were whining about food.

I haven't been free feeding them. I was feeding them twice a day (7:30am and pm) and have now split it to 3/day (those two times and 1:30pm). When I give them the DM it is all gone within 5 minutes. Miles is licking every possible scrap out of both bowls, pushing them around, and it's really distressing to see because I'm doubting myself about how much I am feeding them. I realized that maybe the first day I underfed them so I gave Miles some extra, maybe a mistake because I wasn't thinking about BG (that is blood glucose, right?) - Ella seems more ok with the portion she's getting. But I am literally giving Miles what must be 225 grams/day of the DM.

I was previously feeding them Natural Balance Fat Cat dry food, about 2/3 of a cup a day - Ella is still quite chonky and Miles was as well, before his diabetes developed. I admit it's entirely possible that this is a high carb food - I haven't been able to find out - and that this may have been partly involved in the onset of diabetes. Who knows.

It is encouraging that your Dixie settled down after a few weeks on her new diet. I can only PRAY that Miles does the same.

I understand what you mean about food $. If I were to feed both cats this DM for all the future I think it would cost hundreds of dollars a month. I will have to talk to the pet store tomorrow to find out (a) if they can special order cheaper stuff and (b) if they have any freeze dried treats, as I don't have anything.

I can at least start by trying to feed the two cats at different places in the kitchen, and see if that will happen.

The glucometer has arrived. Do you wash Dixie's ear before taking the sample, like the instructions show for a person?

Oh and I can right now hear two rooms away Miles, poking around in the food bowls for anything left.
 
The glucometer has arrived. Do you wash Dixie's ear before taking the sample, like the instructions show for a person?
Nope! You just need to warm up the ear with a hot pack (you can make the rice + sock one pretty easily and then microwave it). Try taking a flashlight and shining it underneath Miles' ear. You might see some very tiny red capillaries and maybe a bigger red vein. Then apply the hot pack for 30 seconds and shine the flashlight underneath his ear again. You will see that the red veins/capillaries are a lot bigger!

89de2d3ee90e37de809d904f7d41fe2c.jpg
 
Sorry for lack of replies. Sorry I'm feeling kind of anxious right now as I write this because I just fed them which means for the previous hour so they were whining about food.
I haven't noticed any lack of reply! You are being very proactive with all of this. I hope my long replies aren't intimidating. I have just finished my school term so I am on a break and have time :)

When I give them the DM it is all gone within 5 minutes. Miles is licking every possible scrap out of both bowls, pushing them around, and it's really distressing to see because I'm doubting myself about how much I am feeding them.
Honestly Dixie was the same way when I gave her the DM stuff. With her original wet foot (whiskas? can't remember), she would eat maybe half and leave some. When I introduced the DM she LOVED it and would eat it all right away. She took to it so quickly that I didn't properly switch foods (by gradually adding the DM and removing the old food) and she ended up throwing up quite often (maybe because it was new or maybe because she ate so fast), so I had to go back to the old food and slowly made the switch to the DM. She still ate the DM fast when I made the switch and I had to figure out ways to slow her down, such as spreading the food out on a large dinner plate.

I don't think you need to change the food intake based on how fast Miles is eating the food! He is diabetic so he is probably hungry all the time.

You mentioned that Miles lost weight. What did he weigh before? Was he overweight before? I think Dixie was 16lbs and when her diabetes was caught, she was 10 lbs. Since 10lbs looked pretty good on her, I have just been feeding to maintain her 10 lbs. Do you know if Miles is at an ideal weight or not? There are some charts I can send you if you don't know.

if they have any freeze dried treats, as I don't have anything.
I like to use these ones. I tried freeze-dried shrimp but Dixie wouldn't touch it :facepalm:. You can also make your own treats by cooking some chicken and tearing it into smaller pieces.

If you are feeling overwhelmed at the moment, then you might want to stick with the DM stuff for a month or so. I went through 2 cases of the DM stuff with Dixie before I felt comfortable switching to the Friskies Pate. I think your top priority should just be to get into the routine of testing Miles' BG levels and to calculate how many calories Miles needs to be at his ideal weight.
 
Good morning!

The chart is not showing up for me. Would love more information there, particularly if it is based on a skeleton size : weight determination. Miles and his sister Ella look almost alike but Miles is simply bigger. Ella is a sort of "mini-me" :)

Thanks for the treat recommendation! I hadn't thought of dog treats but when the treat is 100% chicken of course that will be just fine.

You are probably right that my top priority should be testing Miles' levels, this is where I feel kind of anxious (which is the sort of thing which makes me procastinate/"choke" on all kinds of things) but I guess I do have everything. I can easily put rice in a sock and tie it - I have a large bean-filled heat pack which might work but might also be too clumsy.

I've decided to make a spreadsheet with the grocery delivery options and to check the store websites to see which one have the Friskies or whatever. Unless my vet comes through with more DM in the next couple of days I am going to be stuck. They promised to get me a case but they haven't called me. I guess I will call them a bit later this morning anyway.

PS I don't know what Miles weighed before - he was overweight but I have a suspicion he might be underweight now, at least just based feeling him to be a bit "bony".
 
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Ok actually that didn't take long, at least to begin with. I just made a list of all the brands of wet food the independent pet store has, and they have both Wellness and Tiki. Wellness is a little cheaper plus the Tiki cans are smaller. That's really good. I can probably find grocery delivery for Friskies (which will have a delivery charge), but for RIGHT NOW I know I can order a bunch of food from them and it's at least a step down in price from DM. That's a pretty good "win" for 8am.
 
I'm glad you are composing a list. Most cats go off the DM quite quickly.
Grocery time slots are hard to come by at the moment. The pet store should carry Friskies.
While there is a grocery delivery charge (I use the $3/$5 curbside pick-up option), if the charge is not geared to the amount of the order, take the opportunity to stock up on your own essentials.
 
Oh yeah, I've also done some grocery deliveries just for myself - would certainly stock up.

Local store carries (no Friskies though):
Pet Mama
Kippy
Almo
Royal Canine
BFF
Merrick
Weruva
Aujou
Petcurean
Boreal
Little Bigpaw
Natural Balance
Tiki
Wellness

Anyway I'm going to drop by their store and arrange delivery - spoke to someone on the phone who didn't seem to get it.

I've ordered some new kitchen scales so I can buy larger cans. In fact the one I ordered goes to 10kg so I should be able to weigh the cats if I cover it with a towel and adjust for it :)
 
The chart is not showing up for me. Would love more information there, particularly if it is based on a skeleton size : weight determination. Miles and his sister Ella look almost alike but Miles is simply bigger. Ella is a sort of "mini-me"
Interesting that the images did not show up... I will attach 2 images right here and you can let me know if you see them:
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Thanks for the treat recommendation! I hadn't thought of dog treats but when the treat is 100% chicken of course that will be just fine.
Yeah! They have a cat version but it just means that the chicken pieces are smaller (and more expensive usually). The freeze dried stuff is really easy to tear apart. If this is a new treat for Miles then maybe save them for only after BG test time (at least while he is learning) so that he is more likely to want the tests!

You are probably right that my top priority should be testing Miles' levels, this is where I feel kind of anxious (which is the sort of thing which makes me procrastinate/"choke" on all kinds of things) but I guess I do have everything. I can easily put rice in a sock and tie it - I have a large bean-filled heat pack which might work but might also be too clumsy.
Just take things one step at a time. Getting Miles regulated is a marathon... not a race! Even if you were doing everything "perfectly", his BG levels could still (and probably will be for a while) stay high! So don't beat yourself up about taking time to adjust to everything. I know it all seems urgent right now, but Miles has had diabetes for a while... yes it is hard on his body, but spending a few weeks adjusting to the news and getting everything in order will be minuscule in the long run. What is important is that you are taking the steps to get where you need to be!

Try mini-steps with the ear testing. First, get that hot rice pack made (the large one you have will probably be too cumbersome!) and heat it up. I only need to heat mine up for 15-20 seconds... it depends on how much rice it in it. Then rub it between your hands to make sure there isn't a super hot part inside. Then, try out the thing I mentioned earlier with the flashlight. Look at his ear with the flashlight pointing from the inside out, and then try heating up his ear and do the same thing. Basically, just explore how his ear looks. Then give him a treat (these can be your old treats if that is all you have right now).

Then, explore how the lancet device works. It has a pull-thing at the end to prime the device, and then a square button to release the device. Try it a few times. Then add it to your routine (without the lancet) after you heat up Miles' ear. Hold the device near him and click it and then reward him. Some cats really hate the noise of the device, so you will need to see if Miles will learn to tolerate it or not.

Just try doing this a few times a day. Ideally, do it in the same spot of the house each time (maybe at one of his beds). Make sure to reward him each time! You don't need to rush to using the lancets and actually testing yet.

Ok actually that didn't take long, at least to begin with. I just made a list of all the brands of wet food the independent pet store has, and they have both Wellness and Tiki. Wellness is a little cheaper plus the Tiki cans are smaller. That's really good. I can probably find grocery delivery for Friskies (which will have a delivery charge), but for RIGHT NOW I know I can order a bunch of food from them and it's at least a step down in price from DM. That's a pretty good "win" for 8am.
Awesome! Glad you found some more economical food choices!
 

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Just trying to figure out where Miles is on that chart. I am confused. Like, pelvic bones visible WHEN exactly? When they say "ribs visible" do they mean individual ribs or the rib cage? Because I would say his individual ribs don't seem to be visible but I can see his pelvic bones from the side.

The other thing is that from above his rib cage appears to be wider than his pelvis.

I think regardless of the feel of his ribs he is probably too thin, but I don't know if he's a 1 or a 3 :(

It's hard to get a focused photo of him from above when he's walking, but I think you can see there his rib cage, waist, and legs.

Part of the confusion is that I think he still has some residual belly fat. The vet said that might actually not be belly fat but long story short, right now, is that it's a confounding factor for me when I try to estimate things.

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Wait wait, pelvic bones not leg bones. Hnm. Anyway here are more pics of Mr Miles

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He stood still long enough for me to take this. Pardon my bare toes!

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I wouod say underweight with score of 2 or three.
How does here head size compared with waist?
My Nala is large chested and small head size. I consider that she is at her ideal weight even though she looks like #3 except she has a small head. compared to the chart in the previous replies.
 
Thank you Larry :) I would say his head is bigger than his waist. I wouldn't say he has a small head.

So then the question is by what % should I increase his food per day? 10%? 20%?
 
So then the question is by what % should I increase his food per day? 10%? 20%?
I couldn't say for sure because I don't have very much experience with cats in general (I've only had Dixie for 5 months). Maybe a good start would be to calculate how much food Miles should have if he was at his ideal weight? Then add some extra to account for the diabetes. Then you can weight him and see if he starts to gain his weight back or not and adjust the food that way.

You want make sure he is not losing anymore weight! Diabetic cats that lose weight are at risk of getting ketones which would require an urgent emergency vet visit. Here is more info on ketones: https://www.felinediabetes.com/ketones.htm. You can quickly test Miles for ketones by buying some ketone urine test strips ($10/100strips), sticking a spoon under him while he pees, and dipping the test strip in the urine.

If you make a new forum post on main feline health forum with a title that specifically mentions the weight thing, then I bet you will get more educated answers about how serious his condition is. Dixie lost quite a bit of weight while unregulated, but she was overweight before :facepalm:. Weight loss is a sign of diabetes, so I bet you will find a lot of others that have dealt with what you are going through. Yes, it may be more expensive at first to give Miles extra cans of food but as he gets regulated, he will gain weight and then need less food! :)
 
Hi FarmKitty and others,

Sorry for sort of vanishing - combination of Christmas (even if not going anywhere/seeing anyone) and my anxiety about trying to use the machine. I finally bit the bullet today and used it on myself and just now tried to use it on Miles. Possibly I didn't put the lancet in right as it was kind of crooked after firing, and I seem to have missed. I had the thing on 3 and maybe I didn't have it right up to Miles' ear. Anyway no blood, but I gave the cats a minnow treat anyway - hopefully to start to build an association.

I have not had much luck getting him accustomed to the hot rice pack. How hot does it need to be, by the way? I was putting mine in the microwave for about 15 seconds and it was warm, not hot, but Miles seems to think it is a toy or in any case something odd - the first time he tried biting it! But I don't have any trouble handling his ears with my *hands* so for the attempt I made this afternoon I just handled his left ear a ton to try to warm it in the palm of my hand.

Feeding has been a little all over the place but I think I'm still feeding him more than plenty (1.5 cans should be close to 300 calories) so I'm not too worried there. I am going to probably try Friskies next because I miscalculated the cost of the current food and it is not really any cheaper than the DM.

I tried to order one set of scales, that came back as "sorry we're out of stock" after a couple of days, so I ordered another one from Canadian Tire.
 
I finally bit the bullet today and used it on myself and just now tried to use it on Miles.
Awesome that you could use it on yourself! It took me months to be able to work up the courage to use it on myself :p. I find it really hurts if I poke my finger and it will be sore the rest of the day, but cat ears have very few nerve endings so it won't be anywhere near the same pain as pricking your finger!

Possibly I didn't put the lancet in right as it was kind of crooked after firing, and I seem to have missed. I had the thing on 3 and maybe I didn't have it right up to Miles' ear.
I'm pretty sure I also used 3 when I first started out, and then I turned it back to 2 when I had more successful pricks. What I do is hold the lancet device device tight to the ear and I line up the hole so that it is about 1/3 of the way off of the ear and 2/3 of the way on the ear (so basically it is around the edge). I only press the 'go' button when the device is tight to the ear, because I have found that if it isn't and I trigger it too soon, then I don't get any blood either.

It is interesting that your lancet was crooked after firing. Was it the needle that was crooked? Or was it the plastic part? I have found that the microlet lancets are a very snug fit in that lancing device so I haven't had any issues with the plastic part being crooked. The needle is also on the thicker side, so it will be harder to bend. I am using cheaper/thinner lancets right now, and they sometimes shoot out of the lancet device, they go in crooked, and if I am not careful about removing the cap then I will often bend the thin needle. Maybe double-check that when you take off the cap off the lancet that the needle is straight. If it is crooked, then reassess the method you use to remove the cap.

My method for setting up the lancet device it to put a fresh lancet into the device and push it all the way to the bottom. Then, I twist off the top of the lancet and throw the cap away. Then put the cap onto the lancet device. When I started out I would always accidentally take the top off the lancet first and then it made it more difficult to get it into the device :rolleyes:.

Also, are you holding anything behind his ears while doing this? I take a single toilet paper square and fold it up so that it is thicker and then wrap it around my index finger a couple of times. Then, I will hold that paper behind the ear and hold the lancet device on top of the ear. The paper is enough to prevent the lancet from going through the ear and pricking my finger (which I haaate ugh). I will see if I can get some pics later on for you.

It took me a while to figure out this process. Originally I held a flashlight underneath the ear and tried to poke with that, but Dixie hated the light for some reason. Then I tried using a small plastic pill container. Then I tried using paper towel. Finally I realize that the toilet paper was enough and that using my finger gave me good flexibility when holding the ear.

Anyway no blood, but I gave the cats a minnow treat anyway - hopefully to start to build an association.
That is good! And every prick will count and make the future ones much easier to bleed :) Also, you can always reset the lancet device and give some more pokes if you are feeling up to it. That is a common occurrence for me!

I have not had much luck getting him accustomed to the hot rice pack. How hot does it need to be, by the way? I was putting mine in the microwave for about 15 seconds and it was warm, not hot, but Miles seems to think it is a toy or in any case something odd - the first time he tried biting it!
I try to heat it up so that I can touch it to the inside of my wrist and not feel any 'hot' pain. I used to just get it warm and then hold it for about 60 seconds, but I remember reading on here that someone said it should be hotter so I started microwaving it for a bit longer. I also eventually reduced the time I held it on her ear to maybe 20 seconds, but that was when her ears learned to bleed more!

But I don't have any trouble handling his ears with my *hands* so for the attempt I made this afternoon I just handled his left ear a ton to try to warm it in the palm of my hand.
That is also a good method, but I feel like it is more advanced. I have only moved to the hand method after testing Dixie for 4 months, and even then it is still hard to get her to bleed sometimes. I feel like I might go back to the hot rice sack method sometimes (or maybe go back to the bigger lancets). So I think you should just try out different methods for a little while and see what works for you. I think some people fill up a little plastic film canister with warm water and use that on the ear to warm it.

Feeding has been a little all over the place but I think I'm still feeding him more than plenty (1.5 cans should be close to 300 calories) so I'm not too worried there. I am going to probably try Friskies next because I miscalculated the cost of the current food and it is not really any cheaper than the DM.
That sounds like a good idea. Food choices are expensive and aren't really the priority right now, so getting the Friskies that are low-carb would be the best bet while you get the testing/insulin under control!
 
I take a single toilet paper square and fold it up so that it is thicker and then wrap it around my index finger a couple of times. Then, I will hold that paper behind the ear and hold the lancet device on top of the ear. The paper is enough to prevent the lancet from going through the ear and pricking my finger (which I haaate ugh).
I use a cotton cosmetic pad. They are thick and thus no need to double/triple up. I then use the pad to compress the spot/absorb the blood.
 
I think some people fill up a little plastic film canister with warm water and use that on the ear to warm it.
I used a 5ml plastic pipette filled with water heated in the microwave to a temperature where you could just about hold your finger in the water without saying, "Ow!" The filled pipette wasn't that hot to the touch due to the plastic's poor thermal conductivity. I'd touch the bulb of the pipette to my wrist to make sure it wasn't too hot before using it to warm Saoirse's ear.


IMG_20160131_152925.jpg



It worked really well for us because Saoirse hated anything going into her ear. She was happy with the pipette because I only needed to hold it in contact with the very edge of her ear to warm it.


Mogs
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Here are some pics to help you out

1. Put lancet into lancing device, take off lancet cap, and then replace lancing device cap. Set device to 2 or 3.
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2. Put flashlight underneath ear. Notice how you can barely see any veins!
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3. Hold hot rice pack (or whatever you got) to ear.
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4. Now shine flashlight under the ear and notice all the veins and capillaries! The dark red spot is a bruise (probably from hitting the vein or missing too many pokes)
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5. Get toilet paper square and fold it up and then wrap it around your finger. You can also use paper towel, cotton ball, or cosmetic cotton pad.
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6. Before you do the next step, put the test strip into the Bravo meter. If it was already in it, then remove it and put it in again. The meter turns off after a few minutes and it is very annoying to have the perfect bead of blood and then the meter turns off midway through! Hold up pad behind ear and hold lancet device in front of ear. With the lancet device held firmly against the ear, you can trigger it and hopefully get some blood. In this pic, the lancet device could probably be held more more towards the edge of the ear (but it was hard to get a clear pic!). You want to avoid hitting that vein that goes around the outside of the ear.
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7. If you get enough blood, then bring the meter up to the blood spot and let the test strip sip it up. Try to keep your cat very steady during this. In this case, the meter didn't get enough blood and I got the error message. I think this would have been enough blood but I was taking photos so it started to absorb into the fur
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8. So I reset the lancet device (just by pulling the back end of it - you don't need a new lancet), get a new test strip and try again! If it has been a long time then you might want to reheat the ear a bit. This time, I got more than enough blood.
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9. A good result! I like to make sure that the blood is enough to fill up the little while square on the Bravo meter strips. You can now either enter the data into the spreadsheet right away, or do it later in a batch (because the meter stores data with the time and date). You can also take the toilet paper and hold it over the poke spot to stop the bleeding and to prevent bruising. Try to hold it for 20 seconds or however long your cat will stand it :)
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10. Reward with treats and chin scratches :cat:
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This way works best for me. When I finish up my big haul of EasyTouch 30G lancets then I think I will switch back to the Microlet 28G ones that you have because they fit the lancet device very nicely and I didn't have anywhere near the same bruising or testing issues that I am seeing now!

If you find that the lancet device doesn't work for you then you can also try going free-hand by just holding the lancet in your hand. That is what we did for the first month because it seems like the common consensus around here is that it is easier. Personally, I had a very difficult time freehanding it (my partner did it all and if I tried then I would scratch her ear with it... it would also freak me out a bit!). The lancet device has been a game changer! You gotta figure out what works for you and your kitty :cat:. Let me know if you can't see the photos in the previous posts or if you want more explanation at a certain step. You got this!!

EDIT: Also, if anyone sees anything wrong with my method then I am very open to criticism! I still find the process difficult sometimes and I'd love to know if there is anything I can change to make the process go smoother :)
 
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Wow, that is some amazing information, thank you FarmKitty, I mean... just incredible. :)

When I had something crooked in the lancet it was the plastic part. I think maybe I hadn't seated it right?

I just tried to get a blood drop again just now but failed. I'm not even sure I'm loading the lancet properly. I'll try to take pictures here. Maybe to begin with I should try freehanding it, or just put the lancet into the device, cap off, as a holder, and try like that. Hm.

Also I understand now that I'm not warming his ear long enough. If you just use your hand, how long do you hold it on the ear for?

PS what about safe disposal of the lancets? I guess they are actually considered biohazardous material or something?
 
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So like this, I'm not even sure if the needle is going beyond the end of the cap or not!? But this does look like FarmKitty's picture.

Before retraction:
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Retracted
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lol Miles is still sniffing around where I gave him his minnow treat :D
 

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That looks like it is seated correctly! You just press the lancet all the way back basically (it will just be plastic on plastic). I know what you mean about wondering if the needle actually goes beyond or not. When I first opened the packaging I had never seen a lancing device before and I thought I was shipped a faulty one hahaha. The needle moves out and back extremely fast so it is pretty much impossible to see it. You could maybe try holding a piece of paper over it and see that it will poke a hole in it. Also, if you tested yourself then you will know that it does poke! The dial will adjust how deep it pokes. I have found that 2 works for me, but when I first started out the 3 worked better (I think).

If the ear isn't warmed up then I doubt you will get any blood. Even now, after testing for months I will poke Dixie and get no blood. It takes more than just 1 poke (especially in the early days). I mean, even when the ear IS warmed up you can still get no blood from a poke. Even so, every poke will contribute to more capillaries being formed and your cat's ears will "learn to bleed".

Also I understand now that I'm not warming his ear long enough. If you just use your hand, how long do you hold it on the ear for?
I don't think you should just hold it, but also rub your fingers on the ear. I only started this after months of testing, so it takes maybe 20 seconds. Maybe you will want to do it for a minute or more? It also depends on how cold your cat is. Sometimes Dixie is by the vents and her ears are freezing and other times her ears are hot all by themselves. Maybe try to get Miles when he is laying in the sun?

Have you tried the flashlight method? That will show you how the ear changes before/after heating. Then you will be able to see if your rubbing has made a difference or not. The flashlight should reveal something like this:

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You want to hit that sweet spot. If you hit the vein (the larger red part), you will likely get blood, however it will then cause bruising which will show up as a darker red splotch on the ear. So you sort of sacrifice easier shots later on for some easy blood now. I was definitely hitting the vein (usually on accident) when I first started though :rolleyes:. It is a frustrating process in the beginning. Remember to hold his ear with the tissue for a little while after poking (I think it prevents bruising).

I don't think you should give up on using another device to heat his ear just yet. Try the hot rice sack more, or see if you can get something to store warm water in to hold to his ear. I just find these methods work soo much better and faster (if Miles can stand it, that is!).

PS what about safe disposal of the lancets? I guess they are actually considered biohazardous material or something?
I haven't quite figured this out myself yet. I have a small needle disposal bin that I got from the vet so I put the lancets in there (without their caps on - I used to recap them but they all fall off eventually and increase the waste). For now, you could find a thick plastic container to put them in (like a plastic milk jug, pop bottle, large yoghurt container, etc. Then you can research how to dispose of them safely in your city later on. Some plaes allow you to just throw them away in a thick plastic container, but others will want you to use the correct needle disposal container and take it to the vet/pharmacist.

lol Miles is still sniffing around where I gave him his minnow treat
That is awesome that he is digging the treats :cat:. Another thing you could do to create a routine is try testing him right before breakfast and dinner. His reward will be to eat his normal meal. This will help because you will need to test at those times anyways when get gets on insulin, and also it reinforces the routine even more. Sometimes, if Dixie doesn't want to eat one of her meals then I will test her and then it will actually trigger her to eat right after :confused:.
 

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