Introducing Sergei, diagnosed 14 September 2020

Greetings to everyone. My name is Scott. I'm a new member, very newly caring for our beautiful eight-year-old cat, Sergei, who has diabetes. We just received the diagnosis late on Monday and my partner and I are in complete agreement about trying to manage the diabetes in every way we can, but we are both terribly worried because Sergei seems so sick at the moment. We've not yet been able to start with his consistent insulin regime, which is scheduled to begin with his feeding this evening.

My main immediate concern is that Sergei is in such a rough way. Over the last 48 hours he's gone from being a pretty vigorous cat (though not totally asymptomatic—we took him in as soon as it was clear something was not right) to being crashed out in the same position on the sofa, which is really unusual for him. He ate well this morning and I did see him take some water. He is using the litter box too, so that is a good sign. The vet assured us that he is not in ketoacidocis, but I've never seen him in such a sad state (and similarly he's never seen me in such a sad state).

My partner and I are totally inexpert and inexperienced at this, so for the moment we have agreed to follow the vet's recommendations through the early stages and then to adjust our interventions once we have learned enough and have had a chance to see how Sergei tolerates insulin, etc. Can anyone advise us on on how long it will take after starting insulin before we might expect to see some improvement? I feel ill about all of this myself but I'm trying to stay strong for Sergei. Thanks for "listening" and for any thoughts.

 

Welcome to FDMB Scott and Sergei We are glad you found us and YES we can help Sergei. You have landed in a safe place for Sergei!

I think maybe you should start here:
New? How You Can Help Us Help You!

We are dedicated to helping any and all that find these pages.
Can you tell me what type of insulin was superscribed to Serge? We can go from there.

We are a community of cat lovers with one thing in common feline diabetes. Theres a wealth of information here available at your fingertips WITH many people ready willing and able to help you navigate it all.

WELCOME TO OUR FAMILY
jeanne

 

Its going to be ok!

 

Hi Scott
First of all, take a deep breath and relax... You’ve already taken a very big step towards making things better by finding this site - there are people here all over the world with vast experience of managing FD, and we will support you in whatever way you need.

As well as reading the document that Jeanne’s linked above, I suggest having a little look around the site to familiarise yourself with some of the different sub-forums - this is the main health forum and there are others for specific insulins, as well as other topics.

Can you tell us a bit more about yourself? Where in the world are you? What insulin has Sergei been put on, and what dose? Do you know how to test his blood glucose at home so you can check how the insulin is working? What are you feeding him?

That’s probably enough questions for now, sorry about that but it will help us to build up a picture of you and Sergei and how we can best help.

Good luck!

 

Many thanks for those reassuring words and for the link. We are in the Netherlands, so I'm not sure if all of the various brands will be the same. We are starting with the Caninsulin 40IE/ml using the vet pen delivery system. It is supposed to come in today so I don't yet have it on hand (another source of anxiety at the moment and I may have to take Sergei in to the vet this evening for insulin if the pen does not arrive this afternoon). We are starting him at a dose of 2.5, twice a day, 12 hours apart (9:30 / 21:30), 30 minutes after 1/2 can of wet food (Hills Diabetes Care m/d).

 

Ok Scott, that helps. Maybe this will too:

https://www.felinediabetes.com/FDMB/threads/introduction-to-cannisulin-vetsulin-n-nph.231602/

And

https://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

 

How much does Sergei weigh? I have not used Caninsulin/Vetsulin personally, but I believe 2.5U is a large starting dose. I don't know that I'd want to be giving that dose without having some way to monitor what it was doing.

Most of us here home-test blood glucose. It's a great way to not only keep your cat safe and safely adjust dosage, but also it is a tremendous relief to be able to have some way to assess the situation. I think we've all been there, looking at our cat who is obviously feeling poorly, and wishing we knew what was wrong and what we could do to help!

Does home-testing sound like something you would be willing to do?

 

Oh, and I should have said: welcome to the best place you never wanted to be! We are here to help you and your partner and Sergei in any way we can.

 

Thanks Nan! I have a bit of an emergency here so I cant stay but CAN check in

 

Hi Nan, thanks so much, right, so Sergei is 5.5 kilos or 12.13 pounds. The vet said she was dosing him based on his current weight. Strangely I looked at the guidelines and they specify only a max starting dose of 2 (ugh). We gave him that dose yesterday at the vet's office at noon, and he seemed to do fine through the day and into the night. He's had a mixture of moderate carb food and low carb food today. Now I'm starting to see the value of home testing.

I am open to doing home BG testing and I was just watching the link about it. I feel a bit in the difficult position of knowing Sergei needs insulin soon and not having the right supplies for testing just yet. We know we absolutely have to feed him half an hour in advance of giving the insulin and then to monitor him closely, especially from hours 4 to 5 after administration, when he is at most risk of becoming hypoglycaemic. She said BG was off the charts so he was unlikely to go into hypoglycaemia immediately but that we absolutely had to watch him carefully and have food and grape sugar syr

 

Nan’s right, 2.5u is a high starting dose. The manufacturer of Caninsulin says start with 0.25u - 0.5u per kilo of bodyweight, so that’s how most vets work out a starting dose. Many cats’ bg is indeed “off the scale” on diagnosis so vets don’t usually consider hypo as an option.

We usually suggest starting at a dose of 1u - mainly because insulin is a very powerful substance and you don’t want to be risking an overdose. It’s better to monitor blood glucose and see what effect the 1u has, and increase gradually if needed.

It sounds as if the vet has told you the basics of what to do if you spot symptoms of hypo, but ideally of course you want to avoid it in the first place. To be safe, lower the dose and get a blood glucose monitor as soon as possible. Yes, Sergei does need insulin but we have a saying here - better to be too high for a day than too low for a minute.

Many people come here worried about going against their vet’s advice but there is a wealth of experience here than can’t be under-estimated.

 

Hmmm... Most of us use "human" meters to test blood glucose. I am not sure about the situation in the Netherlands, but usually that means you can buy supplies over-the-counter at your neighborhood pharmacy or even a lot of supermarkets and "big box" stores (eg Wal-mart). So you might be able to just pop out and get yourself set up quickly.

The main things you want in a meter are: takes a relatively small droplet of blood and (most important) strips are cheap and easily-available. You will go through more strips than you think, and it really adds up!

Also on your shopping list:

1) lancets to do the poke. Start with the larger size lancets, 26 or 28 gauge (smaller number = larger size).
2) some kind of antibiotic ointment (not cream) to put on the ear afterwards. I usually only did this once at the end of the day's poking, relying on using pressure to stop bleeding and bruising otherwise.

Whoops, gotta run (at work), more later but that should get you started!

 

Don’t want to scare you Scott but it’s worth reading this document, even if you aren’t testing yet:


https://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

 

Hi Scott you are in GOOD HANDS these two ladies are of our very best!

 

THANKS GUYS!

 

I believe you Jt. Should I be concerned about hypoglycaemia over 24 hours since his last insulin?

 

No you should be fine.
Caninsulin has what’s called a ‘fast onset’ - gets to work quickly, in the first couple of hours; an ‘early nadir’ - ie the lowest bg is often seen earlier than is ideal; and a ‘short duration’, eg it typically peters out before the next shot is due.
Basically, Caninsulin was formulated for dogs (the clue is in the name - Canin-sulin) who have a different metabolism from cats and for this reason it doesn’t suit all felines. Only time will tell!

 

Thanks Diana
Scott,
I cannot give dosing advice. I havent had a diabetic kitty in 10 years. Things have changed since back then. I can help you find things and people to come help though. I'll keep tabs on you
just in case

 

Yes Scott you will find that you get replies from various different people here, offering what they can according to their own experience and learning. I think you’ll be absolutely fine - once you’ve got your head around the basics of how it all works, it’s a matter of putting it into practice to your best ability. You will probably always have questions and that’s fine, that’s what this place is all about

 

Hi Scott and welcome. Be assured that all of us can relate to the panic you feel in the beginning, which means we are all eager to help. It DOES become easier with time. And Sergei will start to feel better when his blood sugars come down.

My girl started on 1 unit of Caninsulin (Canada) - because that is what the vet was used to. We did switch to Lantus, a much better insulin for cats, then later Levemir due to some other issues she had going on. Both Lantus and Levemir should be available near you. They are insulins available at human pharmacies so easier to get your hands on. But we inject with syringes, not pens. If your vet said Caninsulin to start, no harm in at least trying how it goes. It does help some cats.

What food is Sergei eating now?

 

This was very persuasive and helpful. I will be a much less stressed person once we get up and running with home testing. I feel like I'm driving blind at the moment. Sergei took his insulin at 21:45 tonight, so I'm going to be right here with him until after its known peak which should be between 1:45 and 2:45 this morning. I doubt I will sleep much after that worrying that somehow hypo can still happen. It would be very helpful to understand the operation of this particular insulin and dose on his particular system, and I know that's where home testing comes in. The vet said we would be beginning that soon. I printed the info in the link in case of any hypo symptoms and have a large supply of grape sugar on hand and ready to go. It was intended as both a symbolic and practical gesture that we stopped by the health food store to buy grape sugar before we went to pick up the insulin prescription.

 

Very good Scott! I believe you will do well. Sergei is lucky to have you as his care giver.

 

Having some good High carb food in your pantry is a good idea also. High carb meaning any cat food that has gravy as an ingredient.

 

Thanks so much Wendy. Your (and everyone's) encouragement is very heartening and much appreciated. We got Sergei through his first unsupervised insulin injection. It was a learning experience and my poor partner stuck himself with the back of the needle when removing it from the pen. We will have already refined our process by the next injection tomorrow morning. I really appreciate everyone's help and encouragement. I know my vet uses other systems to manage FD and the vet said its not a one size fits all situation. If we find this is not working then we can find another alternative. I am already developing reservations about the pen and we will probably switch over the longer haul. They seem to use the pen here as a way get people who would otherwise be intimidated or uncomfortable with the syringes to adhere to a routine.

Regarding food: at the moment we are transitioning Sergei from Hill's I/D (stomach issues) to Hill's Diabetes Care m/d. He also gets a very small amount (20g) of Hill's diabetic m/d dry kibble. Feeding is a difficult issue because he has a sensitive tummy and often vomits, especially if he eats too quickly. So we have to feed him in stages. And there is the panic about whether he has eaten enough to do insulin.

 

Thanks, and fortunately we do. I will make sure to buy some more. It makes total sense.

 

I dont know where you are located but IF you should have any trouble you can come here. We have folks all over the worls so hours are many. If its an emergency add a 911 to your title. That will alert people to come help.

 

I've heard that you can practice giving shots on an orange. Easier than hurting you! I did find syringes quite easy to use, and actually used syringes when my girl was on Caninsulin. It's easier to give partial doses with syringes too.

M/D isn't particularly diabetic food, just maybe lower carb (though not low carb) than i/d.

 

while you are at it we would like you to set up a spreadsheet It will help our advisors track Sergeis bg numbers you can find how to do that here:

FDMB SPREADSHEET INSTRUCTIONS

 

Also do you see the light gray printing at the bottom of everyones posts? Its called your signature. You will need one for yourself here are the instructions on how to set that up:
First you want to go to the dark blue banner at the top of the page all the way to the left your name appears click that and a drop down appears click signature than add your info

• 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.

 

Hi Scott - I'm new here myself (since Friday, I think!) and just wanted to welcome you, and assure you that you're not alone in feeling overwhelmed at first. I used to be a vet tech but in specialty practice, so I have no prior experience in dealing with a FD kitty. For me, when I started reading all the info here and other reputable places, I was very much "OMG this is so much to digest", but after a couple more days, things are starting to settle in my mind and I'm getting a better understanding of where we are today and what will be happening in the next few weeks.

Hang in there!

 

It IS very scary This might be tricky
@Wendy&Neko can guide you
(hope thats ok Wendy)

 

Scott here is the hypo link just in case he goes too low after insulin
How to treat HYPOS - THEY CAN KILL! Print this Out!!

I must leave for the evening
Be SAFE
J.

 

Thanks Jane. These last three days have been a real challenge, from the initial diagnosis which came back at about 5pm on Monday until now, 2:35 am sitting with Sergei making sure he makes it through five hours post insulin, which is happening right now. I've had to just let myself go through the emotions and to try to muster the confidence, reminding myself that I need to keep it together to help Sergei. Tying to gather and process as much information as I can and as quickly as possible is a colossal undertaking. Are you doing testing at home or are the values on your spreadsheet from the vet? I need to get the testing sorted quickly.

 

Thanks you so much. I read it carefully, printed it and will be vigilant about hypo. He's doing okay at five hours post insulin.

 

Deep breath, hold, release, deep breath, hold, release, deep breath, hold, release. Mindfulness breathing can help to reduce the stress of learning to treat your diabetic cat. It certainly helps me to relax a bit.

You can't learn everything about feline diabetes in one or two days, but you sure are trying hard to do that! Kudos to you for all the effort you are putting in to help Sergei.

We'll help you as much as we can. There are a lot of good folks already helping you. @Diana&Tom are even in Europe, but one hour behind your time zone, and in a different country. Perhaps she can suggest some higher carb foods, that are available in the UK and maybe you can find some of these in the Netherlands. I have no idea what higher carb foods may be available over in Europe.

This link takes you to the list of low carb foods, <10% carbs, that can be found in much of Europe. European Cat Food List.

 

Thanks Deb, the European list will be useful reading for Scott.

Scott, many of us buy food (and other pet supplies) from Zooplus - www.zooplus.com

I don’t recall any other members from the Netherlands at present but our real food expert this side of the pond is my fellow UKer @Elizabeth and Bertie who may be able to give you more info.

 

Hi Scott - Wellcome to the forum! I just wanted to give you a newbie perspective. Hercules was diagnosed in July, and like you I was told here is the insulin, follow protocol and come back in a month. oh and by the way, he might have a hypo, which is when you run into A&E.... Of course that was very stresful, as I wasn't even sure if I could recognize the symptoms... Searching for symptoms I found this wonderful forum and I am now a "pro" tester and Hercules comes to his spot to get his blood taken (as in his picture) many times a day.

We have had a few brushes with very low bg, so i second having some honey in the cupboard!

I switched Hercs to Feringa wet food since learning loads from this board. They are german made, and I am pretty sure you might be able to get in the netherlands.
Here is the list of food available in the UK: https://docs.google.com/spreadsheets/d/1J5JpMe6TDXrHq_aTl9hUtHy6Gs9oRBqlz4nPGKxtySA/pubhtml#
Some of it will hopefully also be available to you
Hercs has not thrown up since moving to wet food. So that was a bonus from the diagnosis and the change in food

Last, but not least. It is a wild ride, but much easier with folks here!

 

Any updates, @Sergei ?

 

Thanks and sorry for not posting -- the last 48 hours have been challenging. From insulin fails to missed insulin for vomiting and the rocky road of trying to settle on a strategy, my partner and I are feeling despair. Sergei is alive, so that is a good starting place. He is nowhere near stable. Not even close to a road to stable. I have no numbers to offer except that we lowered him to 1.5 Caninsulin last night because he seemed to be drinking a little less water and seemed more alert. That made me fear that dosing him at 2,5 would lead to a hypo. I think that may have been a mistake. So far the effect of that seems far worse than the 2.5 he was prescribed. With the 2,5 he seemed to show improved alertness and function yesterday. He was a bit floppy but affectionate and communicative. He vomited this morning so we had to skip his insulin which he will next get at 20:30. Today he has retreated, seems wobbly, glassy eyed and slow. I really am trying to keep it together but seeing him in this state has been a lot to try to process. I know Sergei is carrying the burden of this so my emotional ups and downs seem utterly selfish or indulgent. I just don't understand how he's gone downhill so quickly. From diagnosis late Monday to today he is a totally different animal.

 

Tagging some people to come help
@Panic
@Red & Rover (GA)
@JanetNJ

 

Hold on, it is tough to start with.... but it should get better. How is Sergei as a cat, is he very food motivated? Is there something that you can bribe him with to get him more settled for test?
I know my cat is thankfully very accepting of all the prodding, but folks here have a lot of experience with different cats. What is happening during shots? Perhaps someone has encountered the problem and can help?
You can also ask to have a libre monitor placed by the vet? People here don't love it, but it might be the best to start monitoring the situation with one less stress?

 

Have you been able to check for Keytones in Sergei's urine?

 

We'll help get this sorted Scott.

 

So, how many doses has he gotten? Was it:

Thursday morning: 2.5U
Thursday evening: 1.5U
Friday morning: no shot

or did you start Wednesday night and give him two 2.5U shots before reducing to 1.5U? [edit: just found the reference in the thread, looks like you did shoot Wednesday evening]

Has he eaten normally today after the vomiting this morning?

I, too, worry about ketones, based on his symptoms today. If you can pick up some urine testing strips (you should be able to pick them up from a human pharmacy, with the other diabetic supplies) and get a quick test today, that would be great. It's not something you want to let get out of hand.

Tips to catch and test a urine sample

That said, there might be another explanation for Sergei's feeling so poorly today. Some possibilities:

1) the 2.5 dose brought him down to normal numbers (that's why he looked alert, stopped drinking so much, etc.). But once the insulin wore off, he zoomed back up. Human diabetics report that those kinds of rapid swings in blood glucose can leave them feeling awful, and some of our kitties have the same reaction.

2) Some cats just don't feel well in general on Caninsulin-- whatever their BG numbers are, it just doesn't seem to "agree with" them. Not sure if this is the more likely explanation, since he seemed to be feeling a little better after the first dose.

 

While you are waiting for advice Scott heres something you should read, just in case you havent already)
BEGINNER'S GUIDE TO CANINSULIN/VETSULIN

 

Thanks Nan I had all those questions in my head but couldnt transfer them to my fingers. Its early here

 

Sergei is a very smart, affectionate, communicative, and emotional cat. In seven years, I've only ever seen him hiss once and that was at a vet who gave him what they said would be a painful injection of nausea medicine. Apparently they were correct because never a growl or hiss otherwise. I have however seen him pout plenty of times. He's a total sweetheart. So when it comes to insulin and testing, I'm hoping we can keep him that way.

I've been giving him two or three tiny pure meat jerky treats from my specialty pet food store just after insulin. He loves them but he's starting to associate the appearance of them with the injection. He's also starting to avoid my partner, who has been the one giving the injections because I had two consecutive major fails at in the morning yesterday resulting in having to insert twice. The second stick I pulled the pen syringe out a little too quickly as you need three to five seconds for the full dose to be delivered. We decided that my partner would do the insulin for the time being. I think we need to try to introduce Sergei to the pen, to try to condition him to know that it is connected to a set of rituals we follow so that he does not come to avoid my partner or worry it's going to happen at random times.

I tried to extract blood from Sergei's ear yesterday (no training at all but the Vet's office loaned me the equipment after I showed up and expressed concern about all of this) but he cried and looked at me as if I had really hurt him. I may have because he pawed at his ear quite a bit afterwards. I decided I was not going to do that without some training. If I screw it up severely now, I may never get him to cooperate. The vet assures me that we will be doing it soon enough but has asked us to be patient while we deal with this very acute situation.

They have been very supportive but I told them doing this without BG values feels like driving blind. Partner and I are both monitoring Sergei *very* closely day and night. Just after onset Sergei gets very sleepy. I'm perpetually waking him up and making him walk if he seems at all out of it. I don't think we are anywhere near hypo territory, though, because he also gets up and asks for water and wants food. We keep some out just to be safe and if I'm concerned I'll give him 5 to 10g of wet food with some carb content. We take him in on Monday for a first BG test. Right now that's what I'm going to have to settle with because neither of us wants to stress Sergei anymore than he already is at the moment. I'm going to take a big breath and try to relax so that we can just get a routine started. We really are trying. It's just a lot to try to grasp.

 

Not yet. I will talk to the vet's office about it. They checked Tuesday and said that he was not in Ketoacidosis. Not sure how long it takes for it to develop in an animal with uncontrolled high glucose (possibly for months). We have adjusted the diet significantly this week. Sergei almost at target weight already. Just 500g over though I think he's dropped a little this week. We've cut off any treats with high carb content and changed to a lower carb kibble. His main meals are lower carb wet food (Hill's m/d - Diabetes/Weight Management) Do the food changes usually help significantly in real terms over time?

 

This could be him going so low as to affect his movements. Definitely could be hypo. Thats why checking his blood sugar before injection is SO important. We can help you learn to test to where Sergei will be accepting.
Hometesting Links and Tips

 

Keytones can develop over night. This can be serious so you might want to run out to a pharmacy and ask for Urine testing strips in the diabetic section

 

@Wendy&Neko
I agree with @Wendy&Neko,

Not sure if you are reconsidering to change the caninsulin to either Lantus or Levemir. Caninsulin is actually for dogs, (Canine), not for cat (Feline). The only problem- Lantus & Levemir are both very expensive.
But- if Caninsulin works with Sergei --- that is totally fine. According to the research and studies, most cats get remission in those 2 brands. But each cat is different.

Thanks,

Len & Momo

 

Not trying to scare you but they should be part of Sergei's diabetes regimen

 

YES, food changes can have a BIG effect on blood glucose. So much so that I would strongly recommend that you continue feeding at least some high-carb food until you are able to test. We have had cats who go into remission from a diet change alone, and many cats who see BG drop by 5+ mmol/L. Until you are testing to see how Sergei reacts, you don't want to be giving insulin at the same time as withdrawing all carbs.

Another question: was yesterday (when he was looking brighter and drinking less water) the first day on a completely low-carb diet?

 

Adding another question: just realized you say you are feeding a "lower carb kibble". What kibble is that? I was not aware of any truly low-carb kibbles available in Europe-- if there is one, that would be great to know. Alternatively, if it's actually medium- or even high-carb (most kibbles are), that would take away a lot of the fear about the effects of Sergei's diet change.

 

The more I read the more I can see the benefits of Lantus & Levemir. For the moment we are going to continue with the Caninsulin and observe. Our first few days have not been very consistent so we really don't have a complete picture yet of how he will respond.

 

We are transitioning so the lower carb part of the diet is increasing every two days and the higher carb is decreasing. Yesterday was only day 2 so we were still at 3/4 higher carb, 1/4 low carb in the wet food. The dry is supposedly low carb but I've heard it may not be as low carb as it should be. I give him a few grams of higher carb wet food about two hours after insulin and I have supply on hand and will readily use it as needed. I always have some food out after insulin an I mix in some higher carb oral care kibble just to be safe.

 

If possible -- no more dry foods... Dry foods are not meant for diabetic cats - even to those that have no diabetes..

It is a like a trial and error, always learning. I spent tremendous time, researching, reading, joining forums for my Cat to have good numbers... You need a lot of love, patience, prayers, and hard work for your cat to be in a good normal numbers.

And yes... I did. Thank God, and to all the people here. You can read all the posting that each member posted, you will learn from it. I am still learning, and never stop from researching.

From her Dm cat foods.. to Home made foods... all these things... if you have this kind of attitude.. Sergei will be well..

take care and God bless.

 

I'm not sure where the Hill's m/d Diabetes Management ranks on carb scale but that's what they have us transitioning to. Our local specialty meat-based pet food store has what they say is low carb Kibble but I need to investigate that further. They also sell a sort of frozen pure meat food but I have no idea whether that is really no carb or even meets with adequate nutritional guidelines.

 

Scott, I know you know this but the sooner you can get to grips with testing, the better for all of you. Obviously you need to know bg so you know you have a shootable number and keep insulin in Sergei’s system, and monitor as necessary to keep him safe thereafter in the cycle. But you two humans need to know that you’re on the right road, too - you sound super-anxious and distressed and that’s not good. Sergei may well be picking up on this.

So have you watched videos on testing? Have you tried practising on each other? Do you know the importance of the ear being warm? There are lots of little tricks and tips that can help you to master the technique and I think this is your priority. Can you ask the vet or vet tech to help you learn? Even if you have to pay for a “lesson”? I think you’d feel a whole lot better if you know you can check on bg at any time. Hypo is a scary prospect but if you have the ability to check bg and head off an emergency, I think it would take a lot of the terror away for you.

 

DO NOT DO THIS without becoming proficient with home testing FIRST

 

Oh sorry.. is he in hypo? I did not really see his numbers.. If he has hypo, then he needs the Dry (Kibble)... Sorry for the wrong information. Yes, you need it.

He needs to test.

 

Oh sorry.. is he in hypo? I did not really see his numbers.. If he has hypo, then he needs the Dry (Kibble)...

He needs to test the BG.

 

Please read ALL his posts he IS giving kibble

 

Everybody does this differently, but I usually inject Hercules while he is eating... He gets quite engrossed on eating (He is always hungry), and I swear he doesn't seem to notice, or can be bothered to stop eating to see what is happening... Maybe worth a try, in the sense he will be distracted with something else?

I give him treats after he get his Blood glucose tests. My hope is that he associates as "ok, I'll put up with this, because I know afterwords gets better"

BTW, many people here finds it easier to prick the ear with the lancet "free-hand", i.e. without the "poker" thing. I find it very hard to see where it is going or how far is it going. If I just use my hands, I can be more gentle and precise. Along the same lines, I use a syringe to shoot insulin, I think most people here do also? I never used a pen, but it does seem it might give you less control. Shooting with a syringe certainly takes less than 5 seconds.... Also, you can choose the length and thickness of the needle, which may also help.

I had gestational diabetes, and had to prick myself twice a day. I got used to it over time. Cats ears do not have many nerves, so I hear is not bad, but is hard for us to judge. Nevertheless, even if it hurts to test.... the diabetes hurts more in the long run....and you will be able to be more sure that you are providing the right care if you know his BG. It gets easier for you and Sergei with practice, I promisse!

 

Scott, I hope you don't feel like we are nagging you. We know you are doing your best for Sergei-- and you are doing a great job! Your close attention to him is keeping him safe until you get the testing up and running.

Another suggestion for both the testing and the insulin shots: try singing! Cats pick up when we're stressed or nervous, and it makes them stressed and nervous too. That's probably a lot of what is going on here-- believe me, we all know how stressful it is when you first start shooting insulin, especially when you have to shoot blind. The singing is to distract both of you and turn down the stress level-- kind of a "fake it til you make it" thing, even if you feel stressed, it's hard to stay stressed while singing. Silly songs are a bonus.

I also like @Hercule's mum's suggestion to switch to using syringes instead of the pen mechanism. I don't know how your Caninsulin pen is made, but for the Lantus and Levemir pens I'm used to, you can stick a syringe into the spongy tip of the pen cartridge and use it just like a mini-vial. And then just inject it straight in, no having to wait 5 seconds with the needle in the cat! If you ask your vet for U-40 syringes (that is a pet-specific concentration, I think, so it might be harder to find elsewhere) I think you'll find it easier to use.

 

Tagging @Ann & Scatcats She may have some suggestions
hope you dont mind Ann!
Shes in Sweden I dont know if you share the same time zone.

 

As you can tell Scott we are ALL pretty passionate about our cats and their disease. I know its an overwhelming amount of information. Take it as it comes and read. Have your partner read also. This WILL all start making sense and give you the power to take control.
One of the first things I ever learned here is ...

DONT FORGET TO BREATHE.

Take solace in that ,WE ALL have walked in your shoes.
jeanne

 

I used syringes with Caninsulin. We have seen people who used Lantus pens say it seems to sting more than using syringes, so I would definitely see if you can get syringes instead. Remember, they too are single use. @jt and trouble (GA) one of the many reasons I don’t give Caninsulin help. The locum vet said I could reuse syringes up to three times, also said I only needed to worry for the first half hour after the shot about hypos. Our time on Caninsulin was not something to be proud of.

@MamaLovesMomo I don’t know where you live, but in Canada, Lantus and Levemir are more cost effective than Caninsulin,

 

Sorry if I tagged you. When looking for "veterans" to come help I go to the insulin specific forum and see what veteran names are posting. I should have investigated further. My apologies.

Thats scary about the local vet

 

hope everything is ok Scott.

 

I completely agree. I've watched so many videos on those ears and I'm thinking I may try a toe. His ears get so twitchy and he just seems to have a lot of nerve endings in them. Sergei goes in on Monday for his first BG and we will be addressing the issue of testing very seriously then. I was very anxious about giving him caninsulin tonight and got very worried about whether I had fed him enough carb, since we are transitioning to lower carb food. I mixed a slightly more generous portion of the higher carb wet food and added some higher carb kibble to his bowl and made sure that was available for him if he wanted it. Before peak I made sure he ate a little. I also kept grape sugar on hand and have stayed with him monitoring this cycle. He seems to have done okay, he gets a bit sleepy but he did get up and was communicative and he wanted bat at his toy butterfly a little. I feel a little guilty to say it but I was a little relieved this morning that we could not do insulin after Sergei vomited. I really do not like this driving blind into the insulin cycle.

 

Thanks. I'm up with Serg burning the post midnight oil just watching him resting peacefully. We are just coming out of our expected peak (+5.5 hours now). Sergei was communicative and responsive all evening. No disorientation. We've always had a little way of checking in with Sergei when he's sleeping (He's always been a super deep sleeper). If he seems to be sleeping I say his name he taps his tail. He did this during his naps this evening. When he was awake, he even played a little (I was very careful not to overdo it because of the risk of sending him too low) and that gave me some peace and hope at the end of a most tubulent week. Thanks for all of your support.

 

I loved the suggestion of singing and I did it while my partner gave insulin. It went so well. We were all relaxed. Sergei seemed to know it was time and he came and sat with us. I gently rubbed him and sang while m partner gave the injection. It went well. Thanks for that. Also interested in exploring the idea of Lantus which lots of people seem to like. I want Sergei to have a smoother insulin experience. I feel a little worried that the Caninsulin may be a bit intense. Are there increased risks of hitting a vein with the normal syringes?

 

Thats completely understandable. I think with the food you gave he will be ok. But do keep a close eye on him. Youre doing the best you can once you start testing ypu will have more confidence.
have you read this?
Hometesting Links and Tips

For twitchy ears you may just want to start rubbing them just while sitting around get him use to messing with his ears. Every time you make an action give him a treat whether or not you complete an action. YOU WILL DO THIS I have complete confidence in you!

your doing great Scott and your partner too!

 

Are you injecting into his scruff? if so you shouldnt have to worry.

 

LOVE THIS!!!

 

I have to leave and make dinner but there will be more replies so hold on

 

Awwwwww..... I just love the teamwork!

Don't worry about hitting a vein, it's vanishingly unlikely, really.

Lantus is a great insulin, if your vet is open to it, I would definitely switch.

 

I am doing testing at home, but did not start doing that until three days after diagnosis. Only the very first BG level is from the vet office. The first couple days of testing were mostly about me figuring out how to do things. Then I started PSAM and PSPM, and then my vet asked that I do a PSAM and then a second test at 9-10 hours later since in his opinion, that's the most likely time for nadir on basaglar.

You can see that Ragnar's levels have been pretty high. However, he is acting normal other than the increased drinking and peeing, and he's nowhere near being at risk of hypoglycemia right now. My vet prefers to spend at least a week letting the initial dose stabilize since we started low, and then making decisions. So last night I sent him my numbers so far and we agreed to increase his dose today. I'm testing every 3-4 hours today. We'll see how his readings go for the next week and then assess again.

I think it's important not to panic or try to over-analyze every little change in BG if the cat isn't having declines in behavior or attitude, and the vet has started at an appropriate insulin dose. As owners, we want to jump in and fix everything right now, but there's a reason to take things a bit slower in most cases.

 

This is a real step forward. You’re relaxed and Sergei knew it was time for his shot. As well as singing you could have some calming music playing in the background. The point is that Sergei has to feel safe. If you’re anxious and tense, he will wonder what’s going on and be scared, or flinch, or run away. As another member here put it earlier this week - if a doctor or nurse was about to give you an injection and they seemed tense and stressed, would you feel relaxed? - probably not.

The trick will be to apply the same technique when you start testing. Gather the supplies in the same spot each time, all sit together, stroke and talk to Sergei, sing, talk to each other, have some light tv on in the background, whatever... pick up the meter and show it to Sergei, let him sniff it or touch it... carry on stroking him, including his head and ears... make sure the tip of the ear is warm, hold it between your finger and thumb and then do a quick decisive poke with the lancet. Get your reading and tell Sergei what a good boy he is. Ok that’s easier said than done but really that’s all it is and when you’ve done it once or twice you’ll be fine. It really is all about staying calm. Be sure to give Sergei a treat each time so he associates it with a positive experience. And you guys need a reward too each time so that you also start to see the whole thing as just part of your routine.

 

I don't want to raise a controversial subject but I need a general principle about feeding to work from given that the vet has Sergei simultaneously on a high dose of insulin and is changing his diet. She gave us dietary guidelines for feeding the diabetic cat but I'm being pretty liberal at the moment. I've been keeping food out after insulin and even make sure he eats a little every hour, especially approaching peak. I hope this is not the wrong thing. Do I understand correctly that in general food will not result in a drop in BG? Sorry if that seems a stupid question but I do not want to do the wrong thing and I am second guessing myself quite a lot here. We have a peak coming in the next three hours and I just want to keep my boy safe.

 

Hi Scott--

No, I think you're doing exactly the right thing by leaving extra food out and going slowly on the food transition.

Food doesn't drop BG, if anything it can raise it. It raises more with more carbs. What drops BG is removing those carbs from Sergei's diet-- that's why we counsel caution before changing the diet. If insulin is being administered, the diet change can cause a big reduction in insulin needs. The only way to go through the process safely is to be home testing throughout, so that you can monitor how it's going and adjust the dose based on need.

I would just keep doing what you're doing and not change the diet very much at all before you get home testing up and running. Definitely still offer food when insulin is near peak action-- many cats will respond to low BG by seeking out food (instinctively trying to raise BG), it's a nice safety mechanism to have.

 

Nan you are AWESOME!

 

Mornin Scott! How are things going?


well...its morning here

 

Morning / Late afternoon . I finally got a break from being acute care nurse. Partner says things are fine. Sergei has been sleeping a lot but he was before the insulin too, so I’m concerned about all sorts of things. I’ll try to update later. Going to wade through the miasma of Coronavirus in search of glucose meter and the strength and resolve to use it. I need but one drop of lovingly cultivated blood. Any tips on dealing with the fur on his ears. Does the drop easily emerge?

 

Not necessarily, at first (eventually the ears grow some extra capillaries and "learn to bleed"). Start with the larger size lancets (smaller gauge, 26 or 28) to help this.

As for fur, one approach is to first dab a tiny bit of petroleum jelly (brand name Vaseline in the US, not sure what it would be for you guys) on the ears first, wiping off the excess. That will help the blood bead up so you can collect it easily.

Good luck!

 

At first it may be difficult for a drop to come. It takes time for new capillaries to grow. BUT IT IS DOABLE. Dont get discouraged if the first attempt is a failure. Give Sergie his treat and let him go. You can regroup yourself and he can relax some it is imperative to give a treat after each attempt. You want Sergei to associate testing with getting something YUMMY. Remember this takes TIME everyone here has gone through the same thing. Some cats dont fuss at all, some put up a terrific fight (that would be my Trouble he hated testing) The more you desensitize Sergei the easier it will be. You can also smear a tint amount of Vaseline on the spot you are going to prick that way when the blood does come it will pool.

You also want to prick the inside right along the edge of the ear. (some use the outside) the inside tends to have less hair.
I'm going to tag Ale she has a great chart on where to make that prick
@Aleluia Grugru & Minnie
@Nan & Amber (GA)
They both have great charts!

 

We got our drop and it was more difficult for us than it was for him. The reading was also fairly conclusive that he is not even close to hypo at the end of the last insulin cycle and before food. He was at 21,0 which is high but a little lower than the "off the chart" over 25 he showed at the vet, part of which could have been stress. On the upside, I'm less alarmed about giving him insulin at the moment though. Thanks everyone for your support and encouragement for attempting BG testing.

 

Yes!!! You can see now how very important it is to test... you being less alarmed is great progress
And it does get easier.

 

Now my big concern is ketoacidosis. We see the vet on Monday so maybe they will be able to help us assess him. He is very clearly not feeling well. He remains his sweet and loving self though.

 

Very cool Scott! You and Partner are on your way! I dont know if anyone has shared this with you yet but we have a saying here:

Diabetes is not a sprint race. Its a MARATHON. We will help you with anything you need because you ARE part of this global family.

 

you can by urine strips anywhere they sell diabetic supplies. A drugstore or pharmacy should stock them Regular old HUMAN keytosis strips. You collect a clean sample and dip the strip into the sample and it turns color. You match the strip to the guide on the bottle.
There are lots of tips on how to collect a clean sample when you get them just let us know we can walk you through it. (not the sample the process) You dont need a script for them or a vets permission.

 

Thanks and a good idea. I may try to pick some up at a drug store tomorrow.. I’m starting to wonder if there may be an underlying missing piece to this puzzle that we have not yet discovered. Thanks for your wonderful support. Everyone has been a great help. Taking my raw, worn-out self off to bed now.

 

Sleep well my friend!

 

Hi Scott so glad things are moving in the right direction for you all! Well done!

 

The BG test last night allowed everyone to sleep a little easier. I kept an eye on Sergei through the peaks but I was more comfortable just petting him and letting him sleep. I also got a lot more sleep. Partner and I considered Sergei's current physical state and really went over the vet's findings during the last consultation. She noted minor heart murmur not before heard. We also reviewed the literature on diabetes they gave us and looked closely at our cat and what about him has changed in the last few months. We both think it is worth having a discussion with the vet about further investigating the possibility of feline acromegaly in Sergei's case.

 

Acromegaly is not as uncommon as was once thought but is not usually considered a possibility in cats showing high blood glucose until further down the line. Insulin resistance is a frequent symptom, and there are others.
There is a high dose/acro forum here which you may or may not have seen, if you’re interested. It’s always good to be informed but don’t worry yourself unnecessarily at this point.
There are people here with hands-on experience of treating acro (myself included) so if that does turn out to be the case you would still find support here.

 

Thank you for that encouragement. Last night was really the first I had heard of Acro, after my partner said he worries that Sergei may have a pituitary tumor. We looked at our cat very closely for a few minutes and considered some of what we've both previously talked about, the clubbing of his paws, the redistribution of his body mass towards his belly, the weird look he gets in his eyes (I've said to partner many times in last few months that I worry about Sergei's eyesight) and the changes in states of consciousness in him (sometimes he just seems unrousable. Then there are the breathing sounds (I can hear him snoring right now from the other side of the flat), the increasing appetite and weight: he's gone up 100g this week even after cutting his food significantly.

 

It is always a possibility but there are other conditions that show similar issues. There is a test you can run for acro but I don’t think it’s usually done until a cat is shown to need high doses of insulin and as yet, you don’t know.
Studies have been done in recent years to try to learn more about acro. The RVC here in the UK did some trials of treatment I believe. If you run a search for RVC feline acromegaly, a few pages will come up. I know you’re not in the UK but you’d be able to see what treatment has been carried out.
As I said, it’s good to be informed but don’t jump to any conclusions just yet.

 

Sergei had another very down day. He spent the whole day crashed out. Our reading of 21,0 at +10 hours has me very worried. Ptnr and I managed to perk him up a bit toward evening. He sat on my lap and wanted a cuddle. Otherwise very difficult to bring into present tense. He will eat and drink and has output as expected. It's just the limp body, the faraway look in his eyes and the difficulty we have rousing him that is very worrying.

 

This sound like it could be too much insulin are you giving insulin? Something isnt right here . You are administering insulin right?