Junior needs dose change? going to all wet food

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kay&junior

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Hi all,
By weeks end, he will be on all wet food, and he is doing well, he is still getting 2u Lantus BID, and I was told no more than 1u when on all wet food, how do I drop from 2u to 1u , 1 1/2 for a few days, then 1u? and still no blood from his ear, either one, got my Glucose Granulars in the mail, will do that as soon as I get home after work, the litter box test it is right now...still negative on Ketones. He does seem better eating wet food, more active, or trying to be!

any answers or links would be appreciated, his vet is out on call, hoping to hear back later.
 
Kay, don't give up with the blood testing. Is there anyone who can help you hold him while you're poking? Also, what size gauge lancets are you using? In the beginning, you want to use 26-28g lancets, because the really thin ones (30-31g) do not get blood at all. Are you warming the ear? Is he struggling? Let us know where you're having difficulty and hopefully we can get you testing successfully! If so you can lower the dose more gradually based on his numbers, which would be the safest way to make the diet change for junior.

The problem with urine testing is that it does not tell you if Junior is going too low, which is what we worry about when making a diet change. Some cats can go off insulin completely with a change, so even if you lower to 1u, 1u could still be too much insulin and you would have no way of knowing that with urine testing. Also, if your goal is remission, you'll need to home test eventually in order to fine tune the dose to get him off insulin.

You are doing great and making an awesome step with the food change. Hopefully we can help you with the testing. If you decide to make the change before you get the blood testing down, I would lower the dose to 1u immediately. Blood sugar can drop quite a bit with a diet change.
 
Hi Julia & Bandit!

I won't give up trying the blood testing, we did try together, me & hubby, to do it, but no go, I think I do better by myself, but then who knows, I haven't gotten any blood yet...lancets are 26 g., new ones, the ones that came with the Glucometer were 31 g., i warm the ear, and he struggles, seems like Houdini when I try to baby wrap him, he squirms, I get nervous because of his legs, and then he gets away, and we start all over again... I think next try will be with just the lancet as Carl says he does his kitty, and I also didn't know it was between the vein and the edge of the ear, and will try left ear again, went back to right because it was easier handling him.
I am hoping to get some kind of number from the glucose urine test, just anything to let me know how he is doing.
I did get to speak with the vet. asst., she also agreed I should drop him to 1u with all wet food, even without the BG.and she would check with the vet.
and he did get playful over the weekend, he tried to climb his tower, didn't make it, but made the effort, and just all around seemed brighter, he does like his wet food, and his water intake and urine output have both dropped. All these things make me happy, but I want blood! and yes, I also want remission!
thanks for your help Julia, purrs to Bandit! and Carl for the ear tip!
 
This is how I had to test Bandit in the beginning:

I got a basket a little bigger than him and lined it with soft fleece blankets. I put him in the basket for every test. Then I used another soft fleece blanket to tuck him into the basket so only his head is showing. From there I warmed his ear, and poked by aiming the center of lancet device where I want to get blood from, using a piece of tissue on the back side of his ear to back the device, and stop the bleeding after the poke. What type of lancet device do you have? The simpler the device, the better it works in my opinion. Also, you'll want to make sure it's on the deepest setting.

If you don't have a basket big/small enough, you can also use a plastic dishpan or storage container, or a box. Anything about his size should work. I'll see if I can't take some pictures of Bandit in his basket tonight to give you an idea.
 
do not give Lantus without testing blood, you will kill that cat. My cat would have been dead a million times over if I didnt test him. BD/Nova strips meters use the tiniest amount of blood. Keep trying.
 
I always wash my hands and clean my 2 fingers (that I will be using to put pressure on his puncture) with acohol. I use BD 33 gauge lancets. They are very thin- less pain- and yes it bleeds. no pen or device. Prick between the vein and the outer edge of the outside of the ear. Try not to go all the way through. BD/Nova meters use very little blood. Ive used 4 different meters- this uses the least.

Make a routine of this. Be calm, scratch his chin with 1 hand while your putting pressure on the bleed with the other hand. Then pet him & kiss him. He will get use to this.
 
Amy and Mickey said:
I always wash my hands and clean my 2 fingers (that I will be using to put pressure on his puncture) with acohol. I use BD 33 gauge lancets. They are very thin- less pain- and yes it bleeds. no pen or device. Prick between the vein and the outer edge of the outside of the ear. Try not to go all the way through. BD/Nova meters use very little blood. Ive used 4 different meters- this uses the least.

Make a routine of this. Be calm, scratch his chin with 1 hand while your putting pressure on the bleed with the other hand. Then pet him & kiss him. He will get use to this.
Click to expand...

It's really hard at first to use the thin lancets, and it can be counter productive. More cats are concerned about being restrained/wrangled than the pain from the poke--cats have an amazing tolerance for pain. So you want to use a thicker lancet like a 26g to get enough blood more quickly than a thinner gauge like a 33g. And some people (like myself) find the device to be easier, and some find freehanding easier. I think if you polled people here you'd find us split about 50/50 on what works best for us. You use the method you find easiest to get a drop. A little neosporin + pain relief helps a great deal in the beginning in case it gets a little sore from repeat poking. Scar tissue builds up after a couple of weeks and they don't feel the poke hardly at all.

Sometimes you also have to "milk' the ear to get a drop of blood--which means you have to very gently push the blood towards the poke spot to get a big enough drop. Also what can help is poking twice in the same area at first to help get enough blood for the test. If you're using the device, make sure it's pressed firmly against Junior's ear when you hit the trigger. I still sometimes miss getting blood if I don't have it tight enough against Bandit's ear.

Amy is right that meters that take a small amount of blood are the best to use. My Aviva uses .6 microliters, and the Relion Micro from walmart uses .3 microliters--you'll want a meter that is .6 or less, if yours doesn't take a small sample like this already.

It's unlikely that your cat will have a deadly hypoglycemic incident right away on 1u with the diet change, but it is a small possibility (there are quite a few cats that go into immediate remission when the dry food is removed, within a few days to a month) which is why being aggressive about getting testing down as soon as possible is very important.
 
Well,
that was a scare reading that...Do not give lantus without testing blood, you will kill that cat.
Hopefully I won't kill him before the testing, and I will learn to do the testing, I like Julia's idea about the basket, and I do have one at home, with fleece to line it, and 26 g lancet, trying tonite with no device. He isn't keen on getting his ear warm, not sure why, will try without warming? he started his methyl b-12 last night, and granular glucose testing went in the litter box today.
hope things get better real soon with this blood thing.
thanks for everyones help.
 
kay&junior said:
Well,
that was a scare reading that...Do not give lantus without testing blood, you will kill that cat.
Hopefully I won't kill him before the testing, and I will learn to do the testing, I like Julia's idea about the basket, and I do have one at home, with fleece to line it, and 26 g lancet, trying tonite with no device. He isn't keen on getting his ear warm, not sure why, will try without warming? he started his methyl b-12 last night, and granular glucose testing went in the litter box today.
hope things get better real soon with this blood thing.
thanks for everyones help.
Click to expand...

I want to repeat that it is EXTREMELY unlikely the diet change will harm your cat now that you're dropping down to 1u. I don't want to say it's impossible because there have been some cats that go into immediate remission, but that is not the usual situation. As long as you're testing within a week or two of the change you'll likely be fine. We always want to keep an eye out for hypoglycemia, but it takes some people longer than others to get a testing routine down and scaring them unnecessarily is not helpful.
 
Amy, I disagree with your advice, as well meant as I'm sure it was. Some of us take months to get the hang of testing, and to not inject (corrected error) during that time would be senseless. Testing does save lives, of course, but please try not to be so black and white about the situation.
 
Thank you both Julia & Jen,
I am trying, and will keep trying. He will be on 1u Lantus starting tomorrow when he is all switched to wet food.
I will keep an eye on him, and so will my DH, he is home tomorrow.
and my DH has said he will try tomorrow while I am at work, maybe that will help, someone else doing it.

thanks again :)
 
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