Jenny: 9/28

How are you doing through all of this. I can tell you that I look at Jenny’s spreadsheet and I get so impatient. I know we will get her into better numbers and I want it to happen now. You would think I would have learned to be so patient and so “zen” about it all by now! I know what to do, but I still want things to happen faster.

You are doing a great job of getting those ketone tests! What kind of blood ketone meter do you use? I have a Nova Max Plus blood ketone meter. Those strips are expensive, but I figured it was a lot less expensive than another DKA and week of emergency hospitalization.

While we are on the subject of meters… why are you using the Alpha Trak? There’s nothing wrong with it, but the test strips are sooo expensive? When managing lower numbers you will need to use a lot of strips. A ReliOn meter is quite reliable and you can get 100 test strips for $17.88. Some people use the ReliOn for daily use and will give the vet a curve using an Alpha Trak if the vet insists upon the AT. My vet uses human meters in the clinic so I never had a problem, but then again she also knew I was testing at home and when I showed her my spreadsheet one time, she knew she didn’t have to worry because he was never going to be in danger on my watch.
 
Hi Suzanne! I can probably move to 4 or the three cats to 5pm, which is +7 or +8, but doesn't that leave too long between the two main feedings, i.e 4PM to overnight 9AM, or 17 hours? I guess what you're saying is I need to get up earlier! Let me think about my schedule and what I can do....thanks!
 
There’s nothing wrong with 9 am/pm schedule if it works for you! What time do you usually go to bed? 1 am? You got that +4 test last night so I was wondering.

I used to set alarms at night to wake myself up to test Darcy and feed him the numbers warranted it — then I went back to sleep.
 
JennyAnyDots said:
Hi Suzanne! I can probably move to 4 or the three cats to 5pm, which is +7 or +8, but doesn't that leave too long between the two main feedings, i.e 4PM to overnight 9AM, or 17 hours? I guess what you're saying is I need to get up earlier! Let me think about my schedule and what I can do....thanks!
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If you start at 9 a.m. then you would give breakfast at 9 a.m. and then a snack/small meal at 11 a.m. and another one at 1 p.m. If Jenny can’t wait for 8 more hours to get her dinner at 9 p.m., you could give another small meal at 3 p.m., which would be +6. Then dinner would be at 9 p.m. with at least one small meal at +2 which would be 11 p.m. If you were still awake at 1 a.m. you could give another small meal at 1 a.m. for the +4 snack. Then she would hopefully be able to make it through the night until her breakfast at 9 a.m. again.
 
The reason that first +2 small meal/snack is so important is that it is the time when ProZinc onsets in many cats (approximately - with some being a little earlier). If you can get a +2 on Jenny it would help pinpoint if she’s started to go down by +2. She should.

The +2 snack is important to help prevent steep drops in BG, which can trigger a bounce later on.
 
I will leave you alone for a while! Too much information, right! You don’t necessarily have to change your shot times. Many people have different shot times with their work schedules, etc. It’s not imperative to even decide that now. The snack times are more important than the actual shot time if it works for you. 😊
 
I'm doing ok, not as overwhelmed and settling into a routine. My husband is taking a bit longer to come around to the need for so much testing. We're out in the country and use a country vet for all the routine care of the cats. When we suspected diabetes I made an appt with the cat specialist vet in Tulsa, about an hour+ away. They tested, and during the couple days awaiting results, I found this forum and read, read, read. Four days later we returned to the vet, they confirmed diabetes, and basically said Here's some insulin and a box of needles, come back in a week. I asked about home testing and the vet was like, sure, if you want, but you need to use the same meter that we use so our numbers are compatible.

They gave me the meter name, then when I looked it up it's a vet-only meter that costs like $300 (glucose and ketones) and was like nope. So I got a Contour NextGen from walmart and a KetoSens from amazon and used that for the first week or so. Then on visit 2 a week later I showed the vet the numbers and she 1) loved the numbers and me using the glucose monitor, and 2) said I have to get a pet monitor or she can't use the numbers. So I got the AlphaTrack3. I feel like the whole testing thing is a "directional" question and not absolute numbers, within boundaries--are we going the right way? But to appease the Vet I'm using the AlphaTrak. On the 3rd Vet visit for a curve, I printed my spreadsheet and told her I was now using a pet meter, and asked for her ok to adjust doses under certain parameters (based on this forum, YOU) and the vet was very happy and said yes, call with questions or concerns, and come back in a month or do your own curve and call it in.

So long story on why I'm using the AlphaTrak. I'll go back to the NextGen probably in 30 or 60 days, whenever I get a couple more curves in for the vet. I want to keep the cat specialist vet on my side for a while longer; it's also a cat hospital so I need to keep the relationship. Jenny's initial ketones of 5.4 scare me.

Once I feel Jenny is stable and I'm in control, I'm going to work with a larger vet practice near me and see if we can just manage insulin and routine things there. The cat specialist vet is fine, but these Vets do NOT teach a thing about how to manage this. Just how to do the mechanics.
 
I'm thinking about how best to change the schedule to something I know we all can adhere to. I did give Jenny her +2 snack. Our human schedule is generally get up at 9am, go to bed around 1am. But we're retired so in theory the schedule is ours to set :). We're just not disciplined.
 
JennyAnyDots said:
I feel like the whole testing thing is a "directional" question and not absolute numbers, within boundaries--are we going the right way?
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You are right about this! To some extent anyway…. We are looking for trends and patterns. Of course, with low numbers we have to …. at some point …. say that a certain number (our reduction point) is where we need to reduce, but a lot of the rest of the time it’s trends and patterns we are looking at. Of course, we want preshot numbers to come down and of course we want kitty to spend time in the lower numbers, but it takes most people a long time to realize that it’s more than each individual number we are looking at.
 
JennyAnyDots said:
So long story on why I'm using the AlphaTrak. I'll go back to the NextGen probably in 30 or 60 days, whenever I get a couple more curves in for the vet. I want to keep the cat specialist vet on my side for a while longer; it's also a cat hospital so I need to keep the relationship. Jenny's initial ketones of 5.4 scare me.
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This is perfectly fine, and I completely understand we can work with a pet meter of course! Those high ketones at diagnosis are definitely scary. High ketones in and of themselves won’t necessarily cause a DKA, but high ketones plus something else like an infection amd too little insulin can really be a tipping point.

This is why I am so happy that you are testing for ketones regularly. If for some reason they started to creep up, we would need to adjust the insulin doses more quickly. As it is, we can take a little more time. It’s best in the first few weeks to take a little more time and then we can talk about doing a different protocol if needed.

How is your sweet girl behaving and feeling these last few days and the last week? How do you think she’s feeling?
 
JennyAnyDots said:
Thanks Suzanne. +9 was 197. From her earlier nadir at 84, do I reduce to 1.5 tonight?
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Yes. I was just getting ready to answer this!
I would go ahead and reduce her dose to 1.5 starting tonight. If we find her numbers start to creep up, we can always go back up. She’s doing very well. You are a wonderful cat mom to her (and I bet to the other two as well!). For now, we will stick to the SLGS! 🙂
 
JennyAnyDots said:
but doesn't that leave too long between the two main feedings, i.e 4PM to overnight 9AM, or 17 hours?
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I didn’t understand this. He main meal would still be a 9 p.m. at the same time as you give the insulin. She needs to eat her “main meal” at 9 a.m. when she gets her shots and the other mini meals are to support her BG a little and smooth the cycle and prevent precipitous drops (and keep her happy!)
 
Thank you for the kind words ❤️. Jenny seems to be acting and feeling a lot better than 2 weeks ago. She is gaining weight, and doesn't feel as bony and is more her normal self. I wish she would eat better, but I may be thrown off by how ravenous her appetite was over the last few months and we're calming that now. They have always eaten FF pate so thankfully no change needed there.

I was living with my mom to take care of her during cancer, and one day three baby kittens climbed onto her porch and started playing. We figured out that the mom had the thee kitties under the house. When they got big enough I captured all four, got the mom fixed, and kept the 3 inside to learn to not be feral. Catmom could not be tamed and lived on the porch. The plan was to get the kitties fixed when they were 5 months old and rehome them. But they loved sleeping on my mom's bed with her, so the plan extended. Nine years later here we are :). I'm glad I kept them.
 

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The orange cat on the left is Jelly/Jello, then Jenny in the middle, then Mindy is the gray cat. Siblings, and all so different. Their mom was a tortoise, so I guess that's where all the colors come from. I'm giving Jenny a break tonight; I've tested her 4 times today and she's curled up sleeping. I appreciate you so much, Suzanne, for holding my hand and teaching me how to manage this.
 
I'm giving Jenny a day to settle into her new dose, so I'm not going to test her between am and pm today. Tomorrow I do a curve for the vet and send it to them.
 
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