Hello from Ronnie & Hank the Cat

[Ronnie]

Hey there! We're new here and had so many questions as we navigate the new journey of feline diabetes! It's great to read so much information and see so many helpful souls out there that love their cats as much as we do!

Hank (9 yo male cat) was just diagnosed with diabetes about a month ago. He wasn't sick and we hadn't really noticed anything wrong besides he had some dry skin and seemed hungrier than usual, which meant keeping me up all hours of the night. He had lost a little weight, but he was using his catio quite a bit and we had scaled back on his free feeding so we didn't think much of that. We had his annual exam and got some blood drawn only to find his glucose was high. The vet recommended a fructosamine test and a few days later...welp, here we are!

We immediately switched his diet to wet food only the day we found out (Wellness Grain Free) and ceased all dry cat food treats - only gets Churus now or freeze dried treats (which he doesn't love those). A week after his diagnosis we finally got his insulin and an appointment to learn how to inject him. Oy. I'm MUCH braver than I would have thought because I have a huge fear of needles and was quite worried, but it's been going well so far. Phew! Thank goodness the syringes are tiny!

I was hoping to hear about people's experience with glucose curves. After 10 days of doing .2 units of Lantus twice a day, the vet wanted us to do a glucose curve at the office. Hank had improved quite a bit even with just the food change, but he is SUPER stressed at the vet so the curve came back high (of course), and he lost an additional 1/2 pound so the vet recommended we up his dose to .3 units and bring him back again for another glucose curve in 2 weeks. I asked about doing the fructosamine test at this appointment just in case and at that point and she said we should hold off.

Fast forward to 2 weeks later, Hank is doing amazing. Hi skin is 90% back to normal, he's eating great, super playful, gained 1/4 of a pound, etc. However, the glucose curve came back high again (maybe even higher than last time which seems weird?) and now the vet wants us to up the insulin to .4 units twice a day and do another curve in the office in 2 weeks. I've asked about doing the fructosamine test (happy to pay for it for my own peace of mind for goodness sakes - not sure how many times I have to ask?!) because he's so stressed at the vet and I just question the curve results. He's doing SO well and his "symptoms" have all but disappeared. I just keep getting "oh we can talk about that down the line" when I bring up the 2-week test instead. Has anyone experienced this?

I'm feeling very frustrated because obviously we all hope our cats go into remission, but I feel like his clinical signs have all resolved with just the .3 units and yet they still want to keep upping his dose. I am worried 1) he may get too much insulin and then we have to deal with a possible emergency and 2) they just want to drag this out even though I'm telling them he is SO stressed there at the vet and I'm certain it's affecting the results. He literally stays in his tiny kennel all day, buried under the blanket, and is yanked out for the prick of his ear several times a day for 10 hours. Can't imagine that would be super stressful!? I have looked into doing the curves at home BUT so much of what I've read is that it too can be inaccurate because you don't get enough blood, the meter isn't accurate, you have to keep retrying by sticking the cat over and over, etc. Just seems like a traumatic experience for all involved there, too.

So all this long-windedness to ask - is this normal? Am I being a helicopter cat mom and over-thinking/over-researching all this? I know I'm not a vet and it's all early stages, but I've had Hank since my partner found him under a stack of pallets at only 6 weeks old. I know my cat and I just wish the vet would listen to me and do the 2-week test so I could know for sure how his glucose is doing.

Anyways, thanks in advance for reading all this and any advice you may have at this early stage!

 

[Larry and Kitties]

During BG curves at the vent can be non-representative of what happens @home since the vet environment frequently raises BG.
Can you test BG@home? Most of us caretakers here do using a human meter.

 

[Hendrick Cuddleclaw]

Hi and welcome to the best place in the entire world to help your boy.

When my buddy Hendrick (seen in the picture there on the left) was diagnosed at 10 years old, the vet said to bring him in for curves just like your vet (and almost every vet). Then I joined this group and I learned SO much. You are 100% correct that most cats test higher at the vet due to stress. Doing a curve at home sounded impossible to me, in fact doing any home testing sounded impossible. But if I can learn how, so can anyone. With helpful tips and tricks from the members here, me and my wife learned how to test Hendrick at home and it didn't bother him at all. Much less than going to the vet!!

Without home testing you don't know for sure that it is safe to give insulin. Human parents would never administer insulin to a diabetic child without first checking the blood glucose level, and neither should pet-parents.

Good job changing the diet. Hendrick didn't like the freeze-dried treats at first but over time he came around and now you would think they are crack cocaine. Using a tasty treat, lots of pets and rubs, singing a little song even -- these are all tactics for home testing. Hendrick got to the point where he would go to the test spot and sit and wait when it was test time. And purr. Anticipating that treat and not worrying about the ear prick one bit!

.2 units is a very small starting dose, can you post the results of the fructosamine test? For your vet to recommend such a small starting dose makes me think the numbers were not that elevated.

 

[squeem3]

I hope you means 0.02 or 2 units of insulin. 0.2 is the same as 20 units which is an overdose for most cats.

There's a Lantus / glargine forum here with tons of info. Read through the stickies at the top to see how to use Lantus. Most people follow the "start low go slow" method.

Bg testing at home is easy once you get the hang of it. Many blood glucose meters only need a 6 ul drop of blood, a teeny amount. Warming the cat's ear really well before pricking helps improve the blood flow so you get blood the first try.

 

[Hendrick Cuddleclaw]

I hope you means 0.02 or 2 units of insulin. 0.2 is the same as 20 units which is an overdose for most cats.

It probably is 2 units, good catch. I was reading it as 2/10ths of a unit. It would make way more sense for the vet to start at 2U, and then want to bump up by a full unit to 3. And now 4!

If it were my cat I definitely would not want to start giving 4U twice a day without LOTS of home testing to make sure kitty doesn't go too low and risk a hypoglycemic episode or worse.

 

[tiffmaxee]

Welcome to LLB. Are you testing at home? The only curve Max had at the vet was the day of his first shot. At first I brought him in for a test around mid cycle every few days. But that too stopped the day I brought my emergency meter in to test it. My vet handed me the needle and I saw how easy it was. From then on all testing was done at home. Cats are often stressed at the vet and the bg rises. Some days do drop there though but not mine. Max would be in the 60’s at home and shoot up at the vet. Your vet is increasing way too fast I think. Do you have copies of the curve results? If so please post them. Another thing to bear in mind is too much insulin can look like too little. When a cat’s bg drops lower than their body is used to they can bounce high.

If you go over to the lantus you can read all about how lantus works. Keep asking questions. There’s a lot to learn.

 

[Ronnie]

During BG curves at the vent can be non-representative of what happens @home since the vet environment frequently raises BG.
Can you test BG@home? Most of us caretakers here do using a human meter.

Thank you for replying! Yes, we have thought about trying that as well and will need to read more about the best monitor to get for accuracy and best methods so we aren't torturing him with several pricks that don't give enough blood.

 

[Ronnie]

Hi and welcome to the best place in the entire world to help your boy.

When my buddy Hendrick (seen in the picture there on the left) was diagnosed at 10 years old, the vet said to bring him in for curves just like your vet (and almost every vet). Then I joined this group and I learned SO much. You are 100% correct that most cats test higher at the vet due to stress. Doing a curve at home sounded impossible to me, in fact doing any home testing sounded impossible. But if I can learn how, so can anyone. With helpful tips and tricks from the members here, me and my wife learned how to test Hendrick at home and it didn't bother him at all. Much less than going to the vet!!

Without home testing you don't know for sure that it is safe to give insulin. Human parents would never administer insulin to a diabetic child without first checking the blood glucose level, and neither should pet-parents.

Good job changing the diet. Hendrick didn't like the freeze-dried treats at first but over time he came around and now you would think they are crack cocaine. Using a tasty treat, lots of pets and rubs, singing a little song even -- these are all tactics for home testing. Hendrick got to the point where he would go to the test spot and sit and wait when it was test time. And purr. Anticipating that treat and not worrying about the ear prick one bit!

.2 units is a very small starting dose, can you post the results of the fructosamine test? For your vet to recommend such a small starting dose makes me think the numbers were not that elevated.

Thank you for the reply! She only did one fructosamine test in the beginning and didn't share the results with us, besides to say "poorly managed" or something like that. As of today, she is still saying that doing that test again at this point isn't worth it because of his numbers in the two curves we have done at the vet so far. Sigh. We did start on 2 units, then she upped it to 3 units two weeks ago, and then yesterday she stated we should do 4 units going forward. We may just have an at-home vet do the fructosamine test as a second opinion and maybe test him at the same time while we are in the process of getting our own monitor and learning all that!

 

[Ronnie]

I hope you means 0.02 or 2 units of insulin. 0.2 is the same as 20 units which is an overdose for most cats.

There's a Lantus / glargine forum here with tons of info. Read through the stickies at the top to see how to use Lantus. Most people follow the "start low go slow" method.

Bg testing at home is easy once you get the hang of it. Many blood glucose meters only need a 6 ul drop of blood, a teeny amount. Warming the cat's ear really well before pricking helps improve the blood flow so you get blood the first try.

Thank you for the info! Yes, my bad - it was 2 units to start, then upped to 3 units after 10 days, and now she wants us to start 4 units after two week being on the 3 units.

 

[Ronnie]

Welcome to LLB. Are you testing at home? The only curve Max had at the vet was the day of his first shot. At first I brought him in for a test around mid cycle every few days. But that too stopped the day I brought my emergency meter in to test it. My vet handed me the needle and I saw how easy it was. From then on all testing was done at home. Cats are often stressed at the vet and the bg rises. Some days do drop there though but not mine. Max would be in the 60’s at home and shoot up at the vet. Your vet is increasing way too fast I think. Do you have copies of the curve results? If so please post them. Another thing to bear in mind is too much insulin can look like too little. When a cat’s bg drops lower than their body is used to they can bounce high.

If you go over to the lantus you can read all about how lantus works. Keep asking questions. There’s a lot to learn.

Thank you! Yes, I did ask for the curve numbers and she just sent them this afternoon with this note: "Hank's glucose numbers were: 366, 490, 588, 433 and 436. Normal glucose numbers in a non-diabetic patient would be below 150. With diabetic cats in a hospital setting, we do take into account a component of stress, but even with stressed kitties the levels should not be over 300 (let alone in the 400-500 range that Hank was at yesterday)."

So, I understand those are high, but I still can't help but wonder if they don't shoot up so high due to stress. That is why I really just wanted the fructosamine test again to gauge it. If it comes back "poorly managed" again then I would happily up the dose to make sure he's getting to where he needs to be. I think I just mainly doubt the results because his symptoms have almost all but disappeared so it's weird to me he could possibly be so high.

I'll definitely read more about the Lantus insulin - thank you!

 

[Ronnie]

It probably is 2 units, good catch. I was reading it as 2/10ths of a unit. It would make way more sense for the vet to start at 2U, and then want to bump up by a full unit to 3. And now 4!

If it were my cat I definitely would not want to start giving 4U twice a day without LOTS of home testing to make sure kitty doesn't go too low and risk a hypoglycemic episode or worse.

Yes, thank you! It was 2 units, I mistyped that. And then up to 3 units after 10 days, and then 4 units after two weeks...We have not started the 4 units because I am a bit hesitant given how well he's doing and worried about pushing it too low.

 

[Wendy&Neko]

If you can learn to home test, which most of us here do, you will find you can save both money and a lot of stress for Hank. I had a non diabetic cat test around 230 at a stressful vet visit, and 53 at home the next day. The vet (not my usual one) tried to tell me my cat was diabetic. Thankfully I was testing my diabetic Neko so it was easy for me to verify the other cat was in fact, not diabetic.

On FDMB, we typically increase doses by 0.25 units at a time. That means using 1/2 unit syringes and eyeballing those quarter unit doses. Most cats are sensitive to small changes.

Hank's glucose numbers were: 366, 490, 588, 433 and 436

Thanks for posting that. Just seeing that, I'm guessing that he was doing what we call bouncing at the vet. Here is the definition:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

This means it's possible that Hank saw a lower number than he's used to at home in the previous day or so. Bounces are very frustrating for us, but perfectly normal, and when they are bouncing when is when doing curves is worthless. Unless I knew how low his current dose is taking him, I would be reluctant to increase at this point.

Also, point of clarification, if you read the yellow starred Sticky Notes at the top of the forum, I think over half of caregivers are following Tight Regulation for dosing, some of which started out follow the Start Low Go Slow method until they got comfortable with testing. The choice of which dosing method people choose is based on your life style and goals for your cat.

 

[Hendrick Cuddleclaw]

..We have not started the 4 units because I am a bit hesitant given how well he's doing and worried about pushing it too low.

I would say your instincts are spot on!! You know your cat better than any vet, I'd say.

And especially without any home testing to know exactly what is going on in that little body, increasing to 4 units could be dangerous. The proven methods that help get kitties regulated, that people here follow, involve increasing or decreasing the dosage based on how low the dose takes the kitty.

So once you have enough test data to see what is going on with the cat's blood glucose on a certain dose, you can make a logical, reasonable and safe decision to increase or decrease the dosage -- and usually in small increments -- .25U at a time.

And then even with that data we recommend that people still always test before giving insulin so you have a pre-shot number and know it's safe to give the insulin.

I'm no expert like Wendy, just a guy who's cat was helped by these wonderful folks and now I try to pay it forward.

 

[Wendy&Neko]

We have no experts here, just laypersons with more or less experience with diabetic cats. We have occasionally had vets on board, but not that I know of right now. Them I would call experts.

 

[Ronnie]

If you can learn to home test, which most of us here do, you will find you can save both money and a lot of stress for Hank. I had a non diabetic cat test around 230 at a stressful vet visit, and 53 at home the next day. The vet (not my usual one) tried to tell me my cat was diabetic. Thankfully I was testing my diabetic Neko so it was easy for me to verify the other cat was in fact, not diabetic.

On FDMB, we typically increase doses by 0.25 units at a time. That means using 1/2 unit syringes and eyeballing those quarter unit doses. Most cats are sensitive to small changes.

Thanks for posting that. Just seeing that, I'm guessing that he was doing what we call bouncing at the vet. Here is the definition:
Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

This means it's possible that Hank saw a lower number than he's used to at home in the previous day or so. Bounces are very frustrating for us, but perfectly normal, and when they are bouncing when is when doing curves is worthless. Unless I knew how low his current dose is taking him, I would be reluctant to increase at this point.

Also, point of clarification, if you read the yellow starred Sticky Notes at the top of the forum, I think over half of caregivers are following Tight Regulation for dosing, some of which started out follow the Start Low Go Slow method until they got comfortable with testing. The choice of which dosing method people choose is based on your life style and goals for your cat.

Wow thank you for all this information. I wish my vet would explain things like this and mention possible causes like this that could spike his tests. From everyone on here so far that has replied (so very grateful to you all!) it sounds like I need to get the at-home meter ASAP and start testing here. I'll explore the site a bit more as I'm sure there is a section on which ones are recommended, but if anyone has a suggestion that is easy for a first-timer that would be amazing. Really, truly appreciate the time you've all taken to reply. Glad I found you!

 

[Ronnie]

I would say your instincts are spot on!! You know your cat better than any vet, I'd say.

And especially without any home testing to know exactly what is going on in that little body, increasing to 4 units could be dangerous. The proven methods that help get kitties regulated, that people here follow, involve increasing or decreasing the dosage based on how low the dose takes the kitty.

So once you have enough test data to see what is going on with the cat's blood glucose on a certain dose, you can make a logical, reasonable and safe decision to increase or decrease the dosage -- and usually in small increments -- .25U at a time.

And then even with that data we recommend that people still always test before giving insulin so you have a pre-shot number and know it's safe to give the insulin.

I'm no expert like Wendy, just a guy who's cat was helped by these wonderful folks and now I try to pay it forward.

Thank you - this all makes so much sense to me but my vet makes me feel like I'm crazy for asking these questions. I really appreciate the time you've taken to reply. Thank you, thank you. I will hopefully be able to pay it forward one day as well after navigating all this.

 

[Wendy&Neko]

Which country are you in? Our suggestions for meter brands vary.

 

[Ronnie]

Which country are you in? Our suggestions for meter brands vary.

Thank you - we're in the U.S. Appreciate any suggestions!

 

[Hendrick Cuddleclaw]

Thank you - we're in the U.S. Appreciate any suggestions!

Probably the most commonly used meter by members here in the US is the Relion which can be purchased at Walmart. Strips are very affordable which is a good feature.

We bought a Caresens+ from Amazon and that worked fine for us, strips were also affordable. There is also a blood ketone meter, the Novamax +, that we used to test for ketones. The Ketone test strips are expensive though, about $2/ea

 

[squeem3]

I use the AccuChek Aviva, a relic from my first diabetic

Since the test strips are the part you need to buy often, most people buy a brand that has affordable test strips and that can be found at any local Human pharmacy for those times when you need to test often and don't have an extra box of test strips on hand because you forgot to place an online order ahead of time (it happens).

 

[Ronnie]

Probably the most commonly used meter by members here in the US is the Relion which can be purchased at Walmart. Strips are very affordable which is a good feature.

We bought a Caresens+ from Amazon and that worked fine for us, strips were also affordable. There is also a blood ketone meter, the Novamax +, that we used to test for ketones. The Ketone test strips are expensive though, about $2/ea

thank you! Is this the correct one? I have read a lot of people use the humans one and just do math to figure out the correct number?

https://www.amazon.com/Blood-Glucos...2lkZ2V0TmFtZT1zcF9waG9uZV9zZWFyY2hfYXRm&psc=1

 

[Ronnie]

I use the AccuChek Aviva, a relic from my first diabetic

Since the test strips are the part you need to buy often, most people buy a brand that has affordable test strips and that can be found at any local Human pharmacy for those times when you need to test often and don't have an extra box of test strips on hand because you forgot to place an online order ahead of time (it happens).

Thank you so much for the suggestion! Definitely a good idea to get one with inexpensive and easy to find strips. Appreciate it!

 

[Sienne and Gabby (GA)]

There's no math involved when using a meter. There's a small difference in the way the numbers are calibrated on a human vs pet meter at the lower range. The range gets bigger as numbers increase. No one has put in the energy to to come up with what the difference would be and I suspect it may rely on some of the mechanics/physics of the meter and that sort of mathematical problem solving is beyond my expertise. (And frankly, this site has been around from before pet-specific meters were a "thing" and no one has attempted to figure this out!!)

In addition, all of our insulin based dosing guidelines were developed using a human meter.

 

[Diane Tyler's Mom GA]

thank you! Is this the corB009LTE0DO
I have read a lot of people use the humans one and just do math to figure out the correct number?

https://www.amazon.com/Blood-Glucos...2lkZ2V0TmFtZT1zcF9waG9uZV9zZWFyY2hfYXRm&psc=1

Yes this one is good, Next time you need more test strips if you have a Walmart by you ,you can just go in and but them , you also want 26 or 28 gauge lancets to start with, most of us test free hand just holding the lancet
The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197

You can get the U-100 syringes with the half unit markings here
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO
Walmart even has them but you have to go into the store to buy them
Either box is fine

:

 

[Ronnie]

So we just tried our first home test with our new meter and it was a big fail. Sigh. We tried using the lancet and just couldn’t get any blood from his ear. Not sure if it’s because we weren’t able to get the right place/vein or if it’s the lancet causing problems. Any suggestions are appreciated! Is the paw actually easier? I saw that as well but ear seems the best?

We watched videos, warmed up his ear, used the light behind the ear to see the vein, and followed the instructions but no luck. I know people mentioned they don’t use the lancet and just do it free hand but the needle is pretty tiny that came with the kit/lancet and I wasn’t sure the gauge. Could that be the issue?
Again so appreciate everyone’s useful help here!

I need to take more time reading through the forum as I’m sure there is a section on this but just am feeling overwhelmed right now so my apologies if I’m posting in the wrong section.

 

[Red & Rover (GA)]

If they are the lancets that came with the device, it is likely the gauge is too small. (The larger the number, the smaller the gauge.) Try a 26g or 28g lancet.
It could also be that you are not poking deep enough.
And don't be discouraged. It took most of us some time to get the hang of things.

 

[Diane Tyler's Mom GA]

So we just tried our first home test with our new meter and it was a big fail. Sigh. We tried using the lancet and just couldn’t get any blood from his ear. Not sure if it’s because we weren’t able to get the right place/vein or if it’s the lancet causing problems. Any suggestions are appreciated! Is the paw actually easier? I saw that as well but ear seems the best?

We watched videos, warmed up his ear, used the light behind the ear to see the vein, and followed the instructions but no luck. I know people mentioned they don’t use the lancet and just do it free hand but the needle is pretty tiny that came with the kit/lancet and I wasn’t sure the gauge. Could that be the issue?
Again so appreciate everyone’s useful help here!

I need to take more time reading through the forum as I’m sure there is a section on this but just am feeling overwhelmed right now so my apologies if I’m posting in the wrong section.

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

Last edited

 

[Hendrick Cuddleclaw]

So we just tried our first home test with our new meter and it was a big fail. Sigh. We tried using the lancet and just couldn’t get any blood from his ear. Not sure if it’s because we weren’t able to get the right place/vein or if it’s the lancet causing problems. Any suggestions are appreciated! Is the paw actually easier? I saw that as well but ear seems the best?

We watched videos, warmed up his ear, used the light behind the ear to see the vein, and followed the instructions but no luck. I know people mentioned they don’t use the lancet and just do it free hand but the needle is pretty tiny that came with the kit/lancet and I wasn’t sure the gauge. Could that be the issue?
Again so appreciate everyone’s useful help here!

I need to take more time reading through the forum as I’m sure there is a section on this but just am feeling overwhelmed right now so my apologies if I’m posting in the wrong section.

Pretty much every single one of us failed our first time, and probably our first few times. And then thought we had the hang of it only to fail again later. There is a bit of a learning curve here, repetition and practice practice practice is key. Don't give up. It is very frustrating and many tears were shed in the beginning as we tried and failed but you can do this!

 

[squeem3]

Does the lancet device have adjustable settings? If it does, try a higher setting.

How are you warming the ear? I could never get the warm washcloth in a baggie method to work. The washcloth got cold within seconds no matter how hot the water I used. What works for many people is what is often referred to as a "rice sock": take an old cotton sock, fill with 1/4 cup or less of uncooked rice (dried beans or peas would work too), tie sock close, toss in microwave, heat until comfortably warm enough to hold in your hand for a minute (time varies so try different times until you find what works). Apply the warm rice sock to the edge of the ear, wrapping it around both sides. Give it a good minute if possible. Hold the rice sock on the inside of the ear while you firmly poke with the lancet on the furry side. The sock provides a firm surface to press the lancet against.

 

[Chrispooky12]

I just wanted to add after warming the ear put a dab of Vaseline on the ear where your going to poke it helps the blood to bead up

 

[Ronnie]

Omigosh everyone is SO helpful on here! My apologies - I went MIA for a bit because I was feeling so overwhelmed and we found out we weren't even giving the correct units - ACK! Long story, but there was some miscommunication along the way with the vet tech on which line to use on the syringe for the 3 units, even after sending a pic questioning what we were giving him. Luckily it was a unit less than we were supposed to be giving, but it set us back a few weeks and it was so discouraging on top of everything else. Our vet wanted us still to go to 4 units even though we had only been giving him 2 units and I pushed back and we went to 3 units only for two more weeks. It really is complicated in the beginning and I have so much respect for you all on here who spend time helping others like me. I feel like you are more helpful than our actual vet!

I do have some good news though, since I last posted we now have Hank stable! He had his last "in-vet" glucose curve yesterday (we decided to do one last one) and all his numbers came back really good, he's gained a pound, and his clinical signs have all disappeared. I now question though if they are too low because he's so stressed while there at the vet and last time (2 weeks ago) they were in the high 400-500 range. Yesterday they were all in the mid 80s which is on the low side of normal. So, we are now back to working on the testing at home because our vet is still saying we should keep him at the 3 units since he is "stable" and still eating, etc. But, I want to be sure we aren't giving him insulin if he no longer needs it. Obviously our goal is to hopefully get him into remission but I feel like perhaps her goal is to just keep him on insulin and she has no interest in doing a fructosamine test to see what his levels have been over the last two weeks (can't tell you how many times I've asked and she says "not needed.")

I'll definitely be taking all the advice for home testing above from everyone - so amazingly helpful! Our needles are 30 gauge so we'll be getting the thicker ones suggested above and trying the different methods of warming up his ear first and making sure we do it manually in the correct spot. I'm sure it will still be trial and error the next few times, but all this advice will make it SO much easier! I can't say this enough, everyone on here really are heroes and true animal lovers which makes my heart so happy in such an overwhelming time.

 

[Ronnie]

I just wanted to add after warming the ear put a dab of Vaseline on the ear where your going to poke it helps the blood to bead up

Sorry for the late response, but thank you! We will definitely try that!

 

[Ronnie]

Does the lancet device have adjustable settings? If it does, try a higher setting.

How are you warming the ear? I could never get the warm washcloth in a baggie method to work. The washcloth got cold within seconds no matter how hot the water I used. What works for many people is what is often referred to as a "rice sock": take an old cotton sock, fill with 1/4 cup or less of uncooked rice (dried beans or peas would work too), tie sock close, toss in microwave, heat until comfortably warm enough to hold in your hand for a minute (time varies so try different times until you find what works). Apply the warm rice sock to the edge of the ear, wrapping it around both sides. Give it a good minute if possible. Hold the rice sock on the inside of the ear while you firmly poke with the lancet on the furry side. The sock provides a firm surface to press the lancet against.

Thank you and sorry for the delayed response! We were originally trying to poke on the inside of the ear after watching some videos, but the vet tech yesterday actually suggested the furry side as well so we were going to try that. I will try the warm sock/rice idea. We hadn't tried that - I did have a warm cloth and just tried rubbing his ear for a bit, too which neither worked well as you mentioned. I appreciate your help!

 

[Ronnie]

Pretty much every single one of us failed our first time, and probably our first few times. And then thought we had the hang of it only to fail again later. There is a bit of a learning curve here, repetition and practice practice practice is key. Don't give up. It is very frustrating and many tears were shed in the beginning as we tried and failed but you can do this!

Sorry for the late reply but I appreciate your kind words! Definitely have shed some tears - you just hate feeling like your traumatizing your poor cat, but also know you are trying to do what is best for him. Such a difficult situation! Finding this forum and all of you wonderful people has been game-changing for us!

 

[Ronnie]

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with
Here is a video one of our members made testing her kitty
She's using a pet meter that has to be coded ,with a human meter you don't have to code it.
So ignore that
I have always used a human meter
VIDEO: How to test your cat's blood sugar

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My apologies for the delayed response but thank you SO much for these detailed instructions! This is so helpful and I plan to watch the video and print these out so we can be reading through it while trying the testing at home again. We got a few pointers from the vet tech yesterday that are in line with all of this so hoping our next attempt is a success and I'll definitely be posting about it here. Really appreciate all of your help. I can't even imagine what I'd do without this forum.

 

[Ronnie]

If they are the lancets that came with the device, it is likely the gauge is too small. (The larger the number, the smaller the gauge.) Try a 26g or 28g lancet.
It could also be that you are not poking deep enough.
And don't be discouraged. It took most of us some time to get the hang of things.

Ahh yes, ours our 30 gauge so I will try to go with the larger ones. Great advice! (Sorry for the delayed response - I went MIA for a bit due to feeling overwhelmed - everyone is just so supportive and helpful on here and I can't tell you how lucky I feel to have found this forum and all the amazing people!)

 

[Red & Rover (GA)]

Look for 26 gauge lancets.

 

[Ronnie]

Look for 26 gauge lancets.

Thank you - I will pick some of those up tomorrow!

 

[Just-As-Appy]

Thank you - I will pick some of those up tomorrow!

Hi Ronnie and welcome. I found a testing routine was useful. Eg. Gather supplies, settle into specific location with cat, test and most importantly give a treat (blood or not). Give insulin.

Before long kitty will come at the appointed time and be waiting for you.

 

[Larry and Kitties]

but the vet tech yesterday actually suggested the furry side as well so we were going to try that.

Also, many of use coat the ear with a thin layer of petrolatum, Vaseline is one name brand. This make the blood bead up on the fur vice the fur absorbing the blood.

 

[squeem3]

I'm pretty sure the furry side of the ear where most people poke to get blood It's easier to access than the non-furry inside of the ear. I think most ear sweet spot pictures show the cat facing the camera with light filtering through from behind the cat to show the ear veins more clearly.

 

[Diane Tyler's Mom GA]

@Ronnie
I see you have your signature already set up.Would you like to set up our Spreadsheet?
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

Here is the link to set up our spreadsheet and it explains how to use it, it's very easy
You can enter your cat's BG numbers so we can follow along and in case you need any advice
There are also 2 dosing methods to follow when using Lantus
They will let you know when an increase or decrease is needed
You can read them, pick one and add it to your signature and your spreadsheet
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Also you can read all the yellow stickys for lantus here
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

Can you add when Hank was diagnosed to your signature and spreadsheet if you plan to set one up

 

[Ronnie]

@Ronnie
I see you have your signature already set up.Would you like to set up our Spreadsheet?
Here is a link helping us to help you link. If you noticed, our members have some basic information about their cat's in their signature. This helps us to not pester you by asking the same questions (your cat's name, insulin type, date of diagnosis, etc.) repeatedly. We also have a link to our spreadsheet in our signature. We are very numbers driven. The spreadsheet is a record of your cat's progress. By linking it in your signature, we can follow along and provide feedback should you need the help

Here is the link to set up our spreadsheet and it explains how to use it, it's very easy
You can enter your cat's BG numbers so we can follow along and in case you need any advice
There are also 2 dosing methods to follow when using Lantus
They will let you know when an increase or decrease is needed
You can read them, pick one and add it to your signature and your spreadsheet
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Also you can read all the yellow stickys for lantus here
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

Can you add when Hank was diagnosed to your signature and spreadsheet if you plan to set one up

Thank you! I do plan to set up a spreadsheet and will try to get that done ASAP! We only finally were able to get a successful home test today - but now we have some issues that I was going to post about and get some advice in the next post.

 

[Ronnie]

*Disclaimer: I will be setting up a spreadsheet now that we have finally been able to home test, just haven't had a chance yet. Sorry I know they are super helpful and will get that done ASAP.

Hello everyone - I just wanted to thank you all for the awesome advice and kind words as we were trying to figure out the home testing! After many, many attempts over the last week, different needles, different techniques, two vet visits (more on that below - would love advice), we FINALLY were able to get a sample today! It was 143 on the ReliOn human meter - I am still unsure of the conversion. I tried looking through the forum and did some Google search and I think it's about 200-220 in cat numbers? Does that sound correct? We will start testing more now that we finally have gotten the hang of it, though I think our cat hates us today after trying 3x during the day! Oh, and could we have elevated the number today by trying three different times and stressing him out a bit?

I was hoping to get advice though because we had to visit the vet twice this weekend due to Hank vomiting and having no appetite out of the blue. We had given him the 3 units in the morning on Friday 3/1 with some food, and then later that day he vomited twice and didn't seem to have an appetite. We called the vet and they had us bring him in. His BG was 110 there, which isn't too bad considering he gets super stressed there and hadn't had any insulin since 5:30 am and it was 4pm. They basically said he looked okay, wasn't hypoglycemic, and sent us home with some appetite stimulant cream to put on his ear, and just told to watch him. We didn't give him insulin that night since his number was normal and he had only eaten a little bit once the meds took affect. Then Saturday morning he still hadn't eaten much so we tried kibble (which he hasn't had since being diagnosed in January) and other high carb treats. He had very little so that worried us and of course we didn't do a shot then either and contacted our vet.

We brought him back for a full exam that day (Saturday). His BG was 121 and they did a full blood draw/urinalysis which we'll get results for on Monday. Since his number was normal at the vet I asked about hypoglycemia (since it could be elevated due to stress) and they weren't concerned about that, told us to watch him, gave him some fluids and an injection of Cerenia, and sent us home with a few Cerenia pills. Fast forward to today (Sunday), he is still not really eating, hasn't been drinking water, but acting fairly normal besides being more mellow/sleepy. With his BG number still not too high (It was 143 so I believe around 200 if our conversion is correct on the home meter) and him not eating, we haven't done another shot of insulin. Is that protocol? I know for beginners they say don't shoot below 200, and when you factor in he hasn't been eating, I just don't feel comfortable giving any. But obviously we don't want him to get super high numbers again either since we only just finally got him stabilized (we thought!)

Really hoping we hear from the vet early tomorrow as these Cerenia pills haven't really done too much to increase his appetite and I will likely have to take him back for more fluids since he's not really drinking anything. Man, you finally feel like you're in a good place and BAM! It's definitely a roller coaster.

 

[squeem3]

There isn't any conversion for Human meters. The number you get is what the cat's blood glucose level is. I think pet meters just read slightly higher.

Stress can elevate numbers but not as bad as if the cat was at the vet office having blood taken by strangers. Cats eventually get used to frequent testing. A treat after a test helps.

Cerenia is an anti-nausea medicine. It doesn't help with appetite. You'll want to ask the vet for an appetite stimulant if your cat continues to not eat. Ask the vet for FortiFlora, too. It's actually a probiotic and not a very good one but it works great to get most inappetant cats to eat because it's too irresistible.