Help - lot's of questions now

Status
Not open for further replies.
S

stacysclass

Member Since 2014
Sweetie was diagnosed 3 days ago as diabetic. They had no cat BG monitors in stock (which now I am glad after all the research I have done I see I can save $ by using a human one). His levels were 545 at the dr. office 3 days ago. They gave him fluids and I have switched to the all wet can food diet. I do have a monitor here that I have tried to use. It is called Accu-Check Aviva but every time a code E-6 keeps coming up. So I looked up the code and it says "Blood was already put on the test strip...." which is not so. I was hoping to use this monitor because it was free but I see a lot of you use the Walmart brand one (Relion) Is that monitor easier to use?
I just don't want to do something wrong. This is all new to me. I actually thought I had all of this under wraps because of all the research I have done but now I am full of questions.

1.Sweetie needs to gain weight. How much can food should he eat (I'd like to feed him twice daily)? Also, could I give him a little bit of dry food every now and again? Or stay completely away from dry?
2. Do you only test BG levels twice daily right before food?
3. At this point do I just continue giving Sweetie 1 unit twice a day even though I have not done any testing on BG levels yet?
4. What is I miss a does of insulin? Do I give it anyway or wait until next dosing time?
5. How will you know if your cat does go into remission?
6. Anyone else tried the Accu-Check Aviva before? If so, what could I be doing wrong?
 
Hi, quick answer about the Accucheck Aviva,

Yes, some do use it here (and it's quite popular here in the UK).
Does your meter have test/control solution with it that you could use to see if the meter is working OK with that?
 
1.Sweetie needs to gain weight. How much can food should he eat (I'd like to feed him twice daily)? Also, could I give him a little bit of dry food every now and again? Or stay completely away from dry?
Click to expand...
a. One formula for estimating how much food to feed is body weight times 15-20 calories per pound. Most diabetic cats may need up to 50% more food in the beginning, because they can't process it properly without the right balance of insulin.
b.More than twice a day for feeding would help to spread out the load on the pancreas, and help to even out the BG levels. Mini-meals are highly recommended.
c. Most of the dry foods are simply too high in carbs. Also, our sugar kitties need the extra water they can get from the wet foods, to keep their kidneys healthy, to keep them hydrated with all that excess peeing they do, to keep the urinary tract flushed out especially when they are above renal threshold and are excreting excess glucose in the urine, providing a nutrient rich environment for bacteria and infection.


2. Do you only test BG levels twice daily right before food?
Click to expand...
The most important tests are before you give the insulin. That should also be 2 hours without any food. Next, and these other tests we expect to be food influenced so ok if your cat has eaten already, testing during the middle of the insulin cycle will tell you how low your cat is dropping on this dose. Depending on what insulin you are using, that can vary but is usually around the +4 to +7 time frame. You also want to determine the duration of the insulin, so you'll want to do some testing later in the cycle.

3. At this point do I just continue giving Sweetie 1 unit twice a day even though I have not done any testing on BG levels yet?
Click to expand...
We think one of the safest things we can do for our extra sweet kitties is to test before each and every shot. That is so that you do not give any insulin if the BG levels are too low.

4. What is I miss a does of insulin? Do I give it anyway or wait until next dosing time?
Click to expand...
It depends on your schedule and the insulin you are using. If you are able to adjust your schedule so you can give it 12 hours later, then it may be ok to go ahead and dose.

Never ever give another shot if you think you have missed the injection with a "fur shot". Better too high for a day, than too low for a moment.

5. How will you know if your cat does go into remission?
Click to expand...
You know your cat may be headed for remission when the BG numbers get so much better, consistently under 100 and you need to keep dropping the dose so your kitty doesn't have a hypoglycemic episode.

You could look at my sugardude Wink's SS for an example. Or Shawna and Davidson over in Lantus TR are doing fantastic right now, lowering that dose and although not in remission yet, it certainly looks like Davidson will be headed there. Here is the link toDavidson's SS.

6. Anyone else tried the Accu-Check Aviva before? If so, what could I be doing wrong
Click to expand...
Are you putting the test strip all the way in? Does the meter time out before you get any blood? Do you wash and dry your hands well before using the meter so you aren't transferring anything from your hands?
 
Yes the meter does time out before I get blood..... what do I do when that happens? I was just pushing the power button back on. Is that wrong? Sweetie is on the Vetsulin 40U 1 unit twice a day.
 
Good morning and welcome. Firstly, take a deep breath. You are doing great. I will give you a few answers, and I am sure others will chime in soon as well.

A few questions.... what food are you feeding now?
how long has kitty been on it?
How old is kitty, and what does he weigh?


Your questions:
1.
Sweetie needs to gain weight. How much can food should he eat (I'd like to feed him twice daily)? Also, could I give him a little bit of dry food every now and again? Or stay completely away from dry?
Click to expand...

Assuming you are feeding a very low carb food (please confirm what you are giving him) he can have as much as he wants at this point. He needs to eat, its very important, because while his BG is high, he cant use that glucose for energy. The body will metabolize body fat for energy instead. That is why undiagnosed diabetic cats eat like crazy but continue to get thinner. Frequent small meals are best.

No dry food. Many cats dont get enough water, wet food helps with that. Dry food also has a lot of carbs to literally form the pellets.

2. Do you only test BG levels twice daily right before food?
Click to expand...

Twice daily testing before shooting insulin is a bare minimum. This is because you never want to give insulin if the pre-shot numbers (known here as AMPS and PMPS) are too low to safely do so. You will want to do more tests than that, however, as it is important to know how low Sweetie goes during the 12 hour cycle. The lowest point in the cycle is called the nadir, and that is really the most important number of all. You want it to go low, but not too low.

3. At this point do I just continue giving Sweetie 1 unit twice a day even though I have not done any testing on BG levels yet?
Click to expand...

If he was on dry food with lots of carbs before, and you have changed to a good low carb food, that in itself might drop his levels significantly. Secondly, the BG spikes from stress for many cats when they go to the vet, so that too added to that over 500 number the vet got. Shooting blind (without testing) can be dangerous. I would like to see you get a few tests in so we know what we are working with as soon as you can manage it.

4. What is I miss a does of insulin? Do I give it anyway or wait until ne
Click to expand...
xt dosing time?

What insulin are you giving him?? Once we know that, we can give more info regarding dosing and administration
5. How will you know if your cat does go into remission?
Click to expand...

Once your cat has gotten down to a very low dose and it becomes hard to give any insulin without them going too low, you go ahead and withhold insulin, know here as a OTJ (off the juice) trial and see how kitty does on his own. My Sammy is on Day 13 on her trial. All going well in the next 24 hours, she will be declared in remission tomorrow. Click on the link to her spreadsheet in my signature and you will be able to see how her numbers changed until we could go off altogether.

6. Anyone else tried the Accu-Check Aviva before? If so, what could I be doing wrong?
Click to expand...

Not familliar with that meter, but I have a question... how old are the strips??? have they been stored in a cool dark place, with the lid firmly closed. Strips left open to the air lose their effectiveness quickly.
 
One more thing to check on that Aviva meter. According to the online instruction manual I looked up, you need to code in a "code key", which is a separate little test strip that comes with each box of strips. You need to change that little "code key" strip each time you open a new box of strips. Does your instruction manual for the meter talk about how to code your meter?

Many human glucometers do not require coding. The Relion Confirm, Relion Micro and Relion Prime do not require coding, so yes, they are a bit simpler to use. The Confirm and Micro need a tiny 3 microliter blood drop, about the size of the head of a pin. The Prime needs a 5 microliter blood drop and can be a bit trickier to use at first until you get more experienced at getting that blood drop.

If it times out on you, I do believe you need to pull out the test strip, turn back on and then reinsert the test strip.
 
Sweetie used to weigh 11lbs., 3 days ago he was down to 6lbs.I gradually realized something was wrong with him. So I need him to gain his weight back. He is 11 years old and has not had any other health issues before. Just 3 days ago I started him on the Friskies Pate can food and right now I am doing one full can twice a day. Sometimes he does not eat all of it, sometimes he does.

As far as the strips go.... they do not expire until December 2014 and I opened the box myself, so I know they are good. I did get the key code from the box and installed it to the meter. My sister in law has a diabetic child who uses all this stuff & she offered an extra meter with strips and lancets. I just feel awful pricking him and then the meter doesn't work. It does not seem to hurt him but after minutes and minutes of holding him in my lap with the cotton ball and trying to get blood..... he gets aggravated. Then I feel awful when after all of that, I do not have a reading!? This morning was my second time trying to get a reading. It takes me quite a few pricks before I get any blood and yes I have read how to do it with the cotton ball and flashlight. As far as someone else's question about test control solution with the meter.... no I do not have that and know nothing about that. Maybe I could try it on myself and see what happens.
Thank you all for your help!!!
 
OKAY..... I tried the meter on myself and it works. So I was determined to get a reading on Sweetie. He had his last does on Vetsulin at 8:00pm last night. His reading right now at 1:50pm today is 294. I missed his dose this morning at 8:00 and wanted to see what his reading was anyways so I thought I would wait until giving him his next dose of insulin again until tonight at 8:00pm. I am glad I got the meter working! It was taking me too long to get blood and the meter would cut off was the issue.
 
Oh, well done, you! :thumbup

I just realised that Sweetie was only diagnosed 3 days ago. I'm quite amazed at how much you've achieved in such a short time; especially given how overwhelming a diagnosis of feline diabetes can be. Some folks are knocked sideways by the diagnosis and can take a little while to 'find their feet' again. You're doing a brilliant job for Sweetie.
Please don't feel though that you have to do everything all at once. And remember to breathe.... (Oh, chocolate is good too. We definitely recommend chocolate (for you, not the cat... ;-) )

Would you like to tell us your name?

Eliz
 
Eliz, thanks so much for the support! My name is Stacy and I was overwhelmed by the diagnosis at first but then realized I have to research, find what works and get on with it. I also have 4 young children (ages 3 - 10) so I was praying I could manage all of this having a full plate as it is. I am excited that I know how to work the BG monitor now!!!!! I was so worried about that. That part is a relief. Now I will start writing down his readings and go from there....
 
I too am a newbie, My baby boy was diagnosed just this month and with the help of this forum my kitty is already in remission! You asked how you will know if your cat is in remission. If your home BG meter readings are between 40-150 daily for two weeks they consider that remission.

I too feed Friskies Pate Classics (Some here have said make sure its not the "in gravy" and "special diet" cans) because they have higher carbs. My Vet basically calls it C-atkins. NEVER feed dry food or treats to the cat. Most here have told me that over and over.

My cat also lost a drastic amount of weight and the Vet wanted me to a) stop the weight loss b) have him gain but not gain too much bc that also affects glucose levels.

I was told by my vet that Tubz can eat as much canned cat food as he wants. If you cant be home throughout the day you can freeze some of the canned food and put it out with his morning meal so that he can eat through out the day as it thaws.I have also noticed that if I add a little water to the wet food which i first give it to him that if he doesnt eat it all it will remain moist and he will snack on it through out the day. Do you have other cats in the house as well? and if so are they eating dry food? Make sure your cat can not access any dry food.

I just like you had so many questions about home monitoring. I purchased the Relion Micro- which needs very little blood and it doesnt time out. I was testing 4 times a day at first (making sure to keep a log) Relion also doesnt require coding. Once you put the test strip in it does all the work for you.

IF YOU MISS A DOSE...just skip it and give him his next one. This was the number one question I asked my vet. He said it is always better to skip than to give too often.

How much water is sweetie drinking? How often is sweetie urinating? This was the first thing that changed for Tubz. Within 48 hours of just switching him to canned food he stopped drinking water all day and stopped flooding the litter box which is a sign things are getting better.

I have not read everyone elses comments fully but in case someone else has not said it " NEVER DOSE KITTY if they are not eating"

Good luck! You can do it. You are already doing your homework which puts you ahead of the game.
 
Just a minor correction to what Heather wrote. The Friskies pates Special Diet foods are ok for our diabetic cats, except for the Sliced Chicken in Gravy flavor which is high in carbs, at 15%. I feed my sugardude the Friskies Special Diet Turkey and Giblet flavor which is 5% carbs.
 
Well, on my very first stick of Sweetie I was able to get blood this morning! I was soooo happy! :-D THEN the monitor read code E-9!!!!! I could have thrown it out of the window or stomped on it. :-x OMG!! So I had to run upstairs get online and read the code which meant "low battery". Needless to say after a battery change I got a reading this morning at 294, same as yesterday. At what point do I decide his Vetsulin needs to be increased? I do plan to test his BG a couple more times today since giving him the I unit of Vetsulin this morning to check on his levels. So I will see how he is doing.

Chuchunga - In response to your post....First, thank you for your support. After Sweetie got fluids from the Vet. and we got home with the Vetsulin he does seem better. No, he is not drinking as much as before at all and the litter box doesn't have mounds of urine in it either, so I know that is good. Yes, I do have one other cat whom is obese so I have also switched her to the can wet food as well. When you say remission and the readings are to be between 40 - 150 daily for 2 weeks.... does that mean with no insulin? Like how does that work?
 
First of all, welcome to the Vampire Club! with your successful first poke of your kitty Sweetie. It will get easier as time goes on.

Sorry you are having so many problems with your meter. Perhaps, print out the page with the error codes from the on-line instruction manual and keep them with your meter? That way, you won't have to go scrambling to find out what the error means.

Vetsulin is one of the shorter acting insulins, with usually no overlap into the next 12 hour cycle. It's what we refer to as an "in and out" insulin. That means the dosing is based more on the pre-shot BG levels, but you also need to know how low any particular dose will take Sweetie. Testing in the middle of the cycle will be helpful to determine that and lets us know if this dose is enough, too much or not enough for him.

I'd give it a couple of days, unless he drops low, under 100. With an insulin like Vetsulin, you don't want to push the cats into really low numbers until you learn more on how your cat reacts to a dose.

If you could set up a spreadsheet (SS) and link it to your signature, it would give us a better handle on how Sweetie is doing on his dose and you can share it with your vet. We have this standardized SS in Google that you can copy and start to track the numbers. Instructions on setting one up for yourself are here. You'll need to change the Share options to "anyone with the link" to give us read only access. A notebook to track the progress is a good idea too, in case you lose internet access.

You certainly have your hands full with not only a new sugarkitty, but 4 young children. Bless you for learning all you can to help Sweetie with everything else you have going on in your life.
 
I have been out of the loop for a while as our sweet Smokey passed away in Dec 2012, but we used the Aviva for the years we tested her. I loved our Aviva, tried a few others at times and just didn't like them as much.

When the meter shuts off because you did not get the blood on the strip fast enough, don't just press the power button, pull the strip out and re-seat it into the meter to get it to turn back on. If you turn the meter on with a strip in it, it won't recognize the strip correctly and will think it is used. Pull the strip back out, slide it in, and wait for it to start flashing that blood drop symbol that it is ready for blood. If you typically need more time that the meter gives you, some people found it worked to put the strip into the meter partway, but not far enough to turn it on. Once you have the poke, you are able to use one hand to finish seating the strip into the meter and turn it on. Always wait for the symbol that the meter is ready, if you put blood on the strip before it is flashing that symbol, it will give you the E-6 error code. Always handle the strip on the parts that don't take blood or go into the meter.

Not sure what the E-9 code was. When you get blood, make sure you sip it up the strip from the tip,don't lay the strip into the blood. Just poke the end into the very top of your blood spot and the strip will sip up what it needs. Too much blood and blood on top of the strip instead of sipped up can cause an error and that could be what you were getting with E-9.

Until you get the hang of it all, some people found it easier to get the blood of the kitty's ear onto something else and then sip it onto the meter strip from there. That way you aren't need to deal with managing the strip into the meter, the meter's timing, and the kitty all at once.

Good luck! It might feel like it is a fussy meter at first, but it is a great meter to use IMO.
 
Hi Stacy,

I have been reading my Juno's BG since he was diagnosed two months ago with the Accu-Check Aviva reader. In the beginning I had lots of problems reading his blood. Every time I needed to poke his ear I would get either an E-4, E-6 or E-7 error. In my case, the problem is usually either because there's too little blood or too much blood in the strip. I would start getting very nervous, and Juno started to get even more impatient. It was a nightmare to get blood from his ear. I still get occasionally some reading error, after 2 months of practice. Last week I wasted 7 or 8 strips just for one reading, but I'm way better now with the BG reading. Juno is also behaving very nicely to the poking and his ears are not looking as bad as they were in the beginning.

You will get better with practice.

Cristina
 
You can scoop up the droplet on a clean fingernail and test it off your nail.
 
BJM said:
You can scoop up the droplet on a clean fingernail and test it off your nail.
Click to expand...

I too have done this. Some times I get a great drop of blood and he wants to shake his head before I can even reach for the meter. So I just scoop it off on my nail and test it on the meter.

And to answer your question about remission- Yes 2 weeks no insulin in the 40-150 range on your home meter. You can always take your meter in to the vets office and compare it to the meter your vet has. Many people here recommended this to me. Then you can tell how "off" your home meter is to the vets meter. According to what I have read- ALL home meters read different than pet meters but once you know how "off" they are you can build a baseline. Mine was about 58% off from the vets meter. So if my home meter read 150 his REAL BG was 237. Please note: I was on a different insulin than you use, and a different meter than you are using. But I found comfort in comparing my meter to the vets meter so that I knew the accuracy of my home meter.

When is your first blood curve? You will know after that how well his body is reacting and weather or not to increase the dose. Has your vet told you to increase the dose on your own?
 
My Vet. just gave me the insulin an said I SHOULD be home testing but regardless bring Sweetie back in 3 weeks. He did not mention whether or not I could try my own dosing.... but I have seen on here many people have done it. I do not want to do the curve test at the office because he hates going to the vet.'s and I know levels will be extra high so I don't see the point. So I would like to do it here (possibly tomorrow) and then go and compare that to the vet'.s. But as someone else wrote on here... I plan to take my glucose monitor in there as well to compare it with the Dr.'s.
 
Human vs pet meters have varying amounts of difference depending on the general level.

At low numbers, pet specific meters may read, on average, about 30% higher than human glucometers.
At high numbers, pet specific meters may read, on average, about 40% higher than a human glucometer.


When I note on average, this means if you take a bunch of different human glucometers and compare their results to a pet-specific meter, you then average these together. That means some will be higher and some will be lower. That's how averages work.
 
I found the Aviva to be not too far off from our vet's meter (less than 15% variance at any time I can remember). Our main meter we tested at the vets on a couple of occasions on the same blood drop, my spare meters I'd test just before or after taking her (we almost never tested her BG at the vet unless we were getting bloodwork done so the comparison is a little off because it is our meter on a drop vs vein draw testing there). I'd get similar variances testing 15 minutes apart at home with the same meter.
 
Hiya,

Just want to say that I think you're doing a great job. Sweetie is lucky to have you as a caregiver!
Are you able to tell us your name?

Eliz
 
Since you just got the insulin form your vet and have only started to give that to your kitty a curve at this point will not provide much useful information. It will take a bit of time to see how the insulin is affecting Sweetie. Doing a curve at home is a great idea, less stressful environment and easier on your wallet too!

Instead of a curve right now, for now, I'd recommend testing before every insulin shot so you know Sweetie's BG is not too low to shoot. We set that shoot/no shoot bar at 200 over here in the Feline Health forum. As time goes on, and you learn how your cat reacts to the insulin, you can gradually lower that shoot/no shoot threshold.

Other good tests to get are somewhere in the middle of the cycle. That is usually somewhere in the +4 to +7 hour timeframe after you have given the shot. These mid-cycle tests will help you to determine the nadir or lowest point that the insulin takes your cat. It's also sometimes call the peak, because it is the time of the peak action for the insulin.

I'd give it at least 4-5 days or even a week before you do a curve. That curve would be testing every 2 hours for the 12 hour cycle. Some people here never do curves, but they get more random tests during the cycle to gather more data on how their cat is doing.

I know you are horribly busy, with 4 your children and all, but taking 5-10 minutes to set up our standardized, color coded spreadsheet would be really helpful as a way to track the BG readings, doses of insulin, notes on how well your cat is eating, etc. You could also share it with your vet and we'd love to be able to see how Sweetie is progressing. Instructions on the spreadsheet setup are here, from over in the Tech Support forum here.
 
So I have completed the SS on Sweetie. I know it does not contain a lot of numbers right now but it is a start. I actually tested him throughout the day today. Any thoughts on his levels? Comments appreciated. thanks!
 
Thank you so much for setting up that SS (spreadsheet)! It really does help us to see what is going on with Sweetie.

We can see that the insulin is managing to lower Sweeties BG levels. Maybe not as much as we want, but it's a start. Have you shared some of these BG readings with your vet? Does the vet want to increase the dose a bit? I think you may need to increase, but only a tiny bit for now, maybe only 0.25U to 0.5U.

Do try to keep getting those pre-shot tests every cycle. They are probably the most important ones you can get. That's because we don't want to have you give your cat insulin if the pre-shot test is too low. Here in the Feline Health forum, we set that shoot/no shoot number at 200. As you gather more data, you can gradually that number. "Better too high for a day, than too low for a moment."

Would it be possible to get at least one test in during the evening cycle? Many cats go lower at night so we like to see this if we can. Also, if you are testing only during the morning cycle, you only have half your data. A good time to try to get this test would be just before you go to bed. Do you think this would be possible for you to do, that "one last test before you go to bed" test?

As a busy mom, you need to let us know what is and what is not possible for you to do. Please, keep asking questions and let us know if something isn't working for you or if anything we suggest won't work for your schedule. We'll try to come up with other ideas for you to try.

How is Sweetie doing otherwise? How is his appetite and the 5 P's (peeing, pooping, preening, playing, purring). Have you seen some improvement in his litter box habits, less peeing? Is his appetite getting less ravenous or is he still pigging out at meals?

ETA: Would you please add the meter you are using to your signature? That would be helpful to see at the bottom of your posts.
 
They aren't horrible numbers. Gracie routinely starts near 300 and drops down between shots.

That said, with Vetsulin, you are seeing that the probable nadir is around +4 to +5 hours after the shot. You do have some room to increase - eyeball 1.25 units for the next shot.
 
To answer some questions.... no, I have not shared the readings with my Vet. In fact I will be looking for a new Vet. The one that diagnosed Sweetie does not agree in using the human glucose monitor and after all of my research I think he could have offered other suggestions in helping me with Sweetie.
I also thought maybe Sweetie could be increased a bit. I could try to get a few night readings, so I will work on that as well. Yes, Sweetie is doing much better! He comes running out when I walk by, tons less urine in litter box, he is drinking less (a lot less) and he seems like he is really getting back to his old self. He is not pigging out as much on the food. I am using the Accu-check Aviva meter and I will add that to my signature. Thank you for the replies and advice, this site helps out soooooo much!!!! :-D ~Stacy
 
Welcome to the board!

I am glad he is feeling better but he is still looking high at preshot. Can you get some mid cycle tests on this dose? Maybe one around +5 during the day and another just before bed? Many cats go lower at night than during the day... And We want to check he isn't dropping too low before considering a dose increase. With any insulin, dose changes are mainly based on the nadir, or low point of the day which on your insulin is around +5.


And you also want to wait 3 days on any dose to check for bounces before making a change.



Wendy
 
Status
Not open for further replies.
Back
Top