Is a "curve" at the vet's office really essential?

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Mashyspringle

Member Since 2014
Hello, I'm new and have already posted once today. Encouraged by the thoughtful replies so far, I though I would risk another question. My cat is Stella. She was diagnosed less than 2 weeks ago and we have started her on 1ml of Lantus twice daily. We have also found a wet food that she likes called Royal Canin Diabetic. She now prefers it over the Royal Canin Diabetic kibble.

In the past few days, her behavior has changed. I called the vet and left a message but it has been two days now and no response. Stella is lethargic, sleeps constantly--more than ever before. She drinks very little water now and doesn't pee much. The one pee she had last night was on the floor in spite of 3 pristine cat boxes! In the past she has been a voracious eater, drinker and peeler. She also continue to lose weight, although very slowly. I've been able to get two readings from her--one was 440 and the next one (two days later) was 270.

She is scheduled to go in for a 12 hour blood glucose curve at the vets office. She hates the vet's office and I can almost guarantee it will be a stressful day for her. I am just learning to test her blood (quite a challenge for both of us), but I would much rather conquer this testing at home than take her to sit in a cage for 12 hours. The vet says after the curve at her office, she will work with me to test at home.

My question is---is it really necessary to do that first curve at the veterinary office? If I say, no thanks, will I be endangering Stella and her treatment? I've been worrying about his for days. Thanks for your thoughts.

Sandi
 
I believe you mean 1 unit. An mL or milliliter of Lantus contains 100 units.

If you test at home, you can either do your own curve or test randomly at different times on different days around the probably nadir to see how low the glucose gets, rather than doing a curve at home

Vet stress may raise the glucose form 100 to 180 mg/dL. Dosing based on elevated numbers risks hypoglycemia.

I'm going to guess the insulin dose needs to be increased, however more test data is needed in the +5 to +7 hours post shot to give you the best feedback.

It'd be really helpful if you would set up a spreadsheet from our standard template. Instructions are here.

Understanding the spreadsheet/grid:

The colored headings at the top are the ranges of glucose values. They are color-coded to clue you in as to meaning.

Each day is 1 row. Each column stores different data for the day.

From left to right, you enter
the Date in the first column
the AMPS (morning pre-shot test) in the 2nd column
the Units given (turquoise column)

Then, there are 11 columns labeled +1 through +11
If you test at +5 (5 hours after the shot), you enter the test number in the +5 column
If you test at +7 (7 hours after the shot), you enter the test number in the +7 column
and so on.

Halfway across the page is the column for PMPS (evening pre-shot)
To the right is another turquoise column for Units given at the evening shot.

There is second set of columns labeled +1 through +11
If you snag a before bed test at +3, you enter the test number in the +3 column.

We separate day and night numbers like that because many cats go lower at night.

It is merely a grid for storing the info; no math required.
 
Just from personal experience, the Royal Canin Diabetic is still too high in carbs for Stella. When I got here, we had some of it to switch Cobb to. It calculated at 13% carbs. We like to keep our cats on food that has less than 10% carbs. I can't copy and paste very well on my new phone just yet, but there is a good food list floating around that you might want to look at. Prescription foods are unnecessary. Most people here feed Friskies or Fancy Feast pates.

As to your question, I've never had a glucose curve run at the vet.
 
Good morning! ~O)

Here's the link to the food chart Suzanne mentioned: http://catinfo.org/docs/FoodChartPublic9-22-12.pdf. Look at the third column in the chart - that tells you the carb content. As Suzanne mentioned, you're looking for food, ideally, that contains less than 10% carbs. Just keep in mind that switching to a lower-carb food might mean that the insulin dose needs to be reduced. It will be important to make sure you can test during the food switch.

I also never took my cat, Jersey, in for a curve at the vet's office. Since I was home testing, I already had the numbers in front of me (that were not affected by vet stress).

Encouraged by the thoughtful replies so far, I though I would risk another question.
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Ask all of the questions you have. We'll help you however we can! :-D

Shelly
 
I can't express the value of this feedback for me. I had not slept well for days thinking about that BG curve at the vet's office! To hear from you that it was not essential was such a relief! I called and cancelled the appointment the next day. I'm sure I will hear from my vet tomorrow, but I am prepared. After all, she referred me to this website in the first place! I've downloaded the template -- still working on printing it out though. (Do you have to open it in Google to print it out?) And I have replaced her food with healthier options that I hope she likes-"-I and Love and You" and have ordered some Instinctive Choice.

I noticed that you three also responded to my "unsupportive partner" post. I tried the test again today by myself, on the floor in the bathroom! I wrapped her in a blanket. But wasn't able to get a blood drop in spite of warming the ear and using Neosporin. I think I will try her pad now. Back or front? Do you use the side of the pad?

I feel like you are my best friends! Thanks again for your invaluable support!
 
You might try aiming directly for the vein in the ear. Just be prepared to snag a droplet on a clean fingernail and to blot quickly or blood will get spattered every where if successful. Plus, blotting will reduce bruising and scabbing.
 
Heating the ear could help. (uncooked rice in thinnish sock, knotted, heated in microwave until very warm). Also, a fatter lancet may work best at first - 25 to 27 gauge is better than the skinny 30/31 gauge ones.
 
I just read your other post entitled Unsupportive Spouse and am going to reply here, I hope that is okay. First of all, welcome to the forum, is your kitty eating and peeing and pooping normally now? Is she drinking water and using the litter box?

Kudos to you for wanting to learn how to Home Test- it is the best thing you can do to protect your kitty from danger of hypos, it gives you the ability to monitor and shoot safely or not to shoot if the numbers are too low. Like the others have said, I never thought I would be able to home test either, but now it's 2nd nature. First of all, breathe deeply- they can sense if you are nervous! 2ndly, don't apologize for what you are doing and 3rd, try singing a song. One suggestion I read on this forum was to sing the Hokey Pokey Song, it made me smile and it worked to calm me down! :-D

Are you offering kitty treats at test time? My kitty Tiger absolutely loves chicken Pure Bites, just like a kitty potato chip! At first I would just set her up on her pillow in the kitchen next to her bowl and practice rubbing her ears, then give the treat. I confess, at first I got my first few tests with her face in her bowl eating, and if I have to hurry, I still do that!!! :oops: I gave the shot that way too! Now she is waiting for me sitting on her pillow the instant I wake up in the morning and at PMPS time! I just make sure my hands aren't cold and clammy and rub her ears, then the task becomes easier.

My DH was frightened of learning to home test and give shots, he thinks it hurts Tiger and would not even watch! :roll: But he does now realize it isn't hurting her, in fact, he knows that she knows that it is helping her. She shows me with her little face that she appreciates what I do for her and even though I at first struggled to learn alone, I am glad I did it! You develop a very special, unbreakable bond with your sugarkitty, it is unlike any other relationship with a pet that I have ever experienced!

Good luck and keep posting, there are plenty of wonderful experienced people who care and can help! :smile:
 
I wanted to add that I'm another bean who does home curves. My Tasha is super stressed at the vet. She's the kitty who receives early release after dental procedures because she's so spazzy. You know how they usually say "Oh, kitty will be able to go home around 3 or so but we're open until 6 so just get her before then"? I get calls at 11am saying "Come get your cat. Now." There's no way I could leave her there for a curve and expect the numbers to be of any use.

A few years ago, I made little handwarmers as Christmas gifts for the women in my family. The first pair didn't turn out well and I kept them for myself - they're now what I use to warm her ear for testing. They're little cotton circles filled with rice and they work great. We use Halo chicken treats, and she goes to her spot several times a day begging to be tested just for the treats.

You'll get it! And kitty (and your wallet) will thank you for home curves.
 
Hi Sandi,

I live on my own so have to test by myself!!

What I do is to use the warm rice sock, hold the rice sock against the inside of the ear,with my thumb on the outside of the ear to keep it as taught as possible, then lance so the ear is 'sandwiched' between the sock and the lancing device. If Angel has some low carb treats he's usually still enough for me to manage. Although it's still not my favourite thing to do, I know it doesn't hurt him, and I make sure I'm chilled when i do it even if I don't get blood first time. Maybe your husband could be petting Stella and feeding her to distract her. Try to get him to look at it like something you can do together for your cat, maybe it will bring him and her closer. My man is not a cat person but he loves my cats, (though he would never admit it) not sure how much he would be involved in any testing etc if we lived together (which may happen one day) but he knows my cats are my babies.

My own vet does not believe in doing curves at the surgery as he thinks the added stress would give falsely high results. Plus he knows and appreciates I'm on a low income. I've done a couple of curves at home, due to do another this week for the trial Angel is on. Maybe point out to the vet how stressed Stella gets and see if she will work on the home testing with you .
good luck x
 
How is the testing going now? It looks like you've gotten some great tips for ear testing; I hope the tips have helped and you're now doing great with the ear testing.

I think I will try her pad now. Back or front? Do you use the side of the pad?
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With Jersey, we used the large paw pads on her back legs (the top, not the side of the pad). I did make sure that her paws were clean before testing, heated her paw with the rice sock, and used Neosporin before and after. I alternated paws for testing and also tried to move the testing site around on each paw (e.g., close to the edge one time, close to the middle the next time, etc.).

Let us know if we can do anything to help!
Shelly
 
Oh, you wonderful people!! It is so special to have all these concerned friends! Things are greatly improving. My husband and I were both stressed about the idea of taking Stella into the vet for an entire day. Once that stress was removed, we relaxed and figured out how to work together to do this thing. I read your responses to him and we both laughed to know there is a whole community out there sorting out the challenges of home testing. Based on feedback, we have chosen a special spot for testing--the kitchen counter. I wrap her in a blanket and carry her to the spot. My husband (an insulin-dependent diabetic) pokes the ear and I come in fast with the meter. It works! We have managed to test once per day for a few days and will try for twice tomorrow.

Stella is happy, eating well, and playing. Her numbers are in the 330 range, so she has a ways to go. But we are on a good path and very grateful to all of you for your stories and your tips. We truly would not have gotten there without you!

Kisses and hugs!!

Sandi
 
That's fantastic news, Sandi! I'm so happy that you've figured out a testing routine that's working for you. It will keep getting easier from here.

Since we have you on the road to testing, can we help you set up the spreadsheet now? I think BJ gave you the directions for it in an earlier response. If you can get that set up and start entering the numbers on it, we can help you figure out how well the dose is working.

BTW - I'm glad you've decided to keep the husband. It sounds like he's going to come in handy after all! :lol: ;-)

Shelly
 
KPassa said:
Tiger and Ruth said:
One suggestion I read on this forum was to sing the Hokey Pokey Song, it made me smile and it worked to calm me down! :-D
Click to expand...
If you're interested here's our modified version of it. :lol:
Click to expand...

OMG, I laughed so hard I have tears in my eyes!!! :lol: :lol: :lol:

Where was this when I first joined this forum!! :lol: :lol: :lol:

I bookmarked that page, thanks! :lol:
 
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