Just got back from the Vet...

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Today has been a pretty tough day and I'm feeling pretty overwhelmed. Barry is one of 5 cats and he's been with us for less than a year. He showed up at our back door (we put out food for the neighbourhood feral and stray cats) and we eventually decided to take him in when we realized he had already adopted us by living on our deck pretty much full time. When we found out he was diabetic we didn't realize right away what we were signing on for. We thought he was doing well, so today was a shock. He seems to be feeling better already though so now we just need to get better at managing his diabetes. I can already tell that this website will be a wealth of helpful information! Thanks again!!
 
Welcome to all of you! This was a baptism by fire, for sure.

Your story sound similar to my experience with Cinco, and he even looks like him! You will find that dealing with his FD will bring you a special bond with Barry. Bless you for taking him in and stepping up to help him get better. Too many people just give up when they get this diagnosis. It's not easy, but it's very rewarding, and you'll make lots of new friends. We have all been through similar experiences and we all care about each and every cat that comes here. Ask lots of questions, and read as much of the info on the Lantus & Levemir page as you can. We're all here to help!

When you get a chance, can one of you get the spreadsheet set up, please? It is an amazing tool for helping us (and you) see what's going on with your kitty's numbers. Here are the instructions for creating it. If you have any problems or questions, just ask. We have a couple of people that are awesome with them and can get you on track quickly. Here is another post that might be helpful in learning to post here.

Your experience with your vet is troubling, and after things calm down, you might want to consider reporting this experience to the board that regulates vets where you live (may I ask where that is, by the way?). He endangered Barry's life by sending you away without proper treatment. At the very least, I'd find a new vet.

We're so glad you found us!
 
You are so welcome. We love all the kitties and do our best to help whenever we can.:D

Do keep a close eye on Barry. I sometimes find my girl gets more fidgety about testing when she is low than when she is high. His last reading was good so if he is acting fine, he is probably out of danger and just surfing along in some nice numbers now.

As the others have said, setting up a spreadsheet would be a great next step. And definitely look for a new vet! Sounds to me like yours is not well versed on using Lantus at all. If you want to log a complaint, you can do so HERE. I notice you are in Ontario. Where in Ontario are you? I'm in the west end of Toronto.

TLantMagnus said:
We also have access to this stuff called "Boreal" which has both wet and dry, and is high protein
Click to expand...

Just an FYI for future reference. The dry Boreal food although claiming to be low glycemic, is about 29% carbs, which is way too high for a diabetic cat....even one in remission if that turns out to be the case with Barry. The canned food while low carb is NOT a complete diet as it contains no taurine. It's fine for the occasional meal but not for a steady diet. Canned food is definitely preferable but if you HAVE to feed dry for some reason, let me know and I'll provide you with the best options in Canada because unfortunately we cannot get most of the very low carb dry foods available in the U.S.

If you continue having a hard time getting blood samples from Barry's ears, you could try using the large paw pad. Some folks find that easier although the majority use the ear.:)
 
Ok. Got another sample at 6:08 pm, only with the cat tester because we can't get a big enough blood sample for the human one. It read 2.4. So I gave him a teaspoon of corn syrup. We will try again in about half an hour. Should I give him any food as well?
 
I'm not sure which is higher in carbs so use the canned diabetic food for now. I'll have to check the Boreal carb level. The dry food is higher in carbs but will take longer to get into his system and fill him up faster which you don't want to do because he evidently needs a little more steering. The problem is that Lantus is a depot insulin which means each shot leaves a "shed" of insulin that keeps working. This means those low numbers can go on for hours.
 
So basically for now even though it's been about 21 hours since his last shot, keep giving him small amounts of food to keep his blood sugar at the same level?
 
K. Checked his blood with the cat tester. Came back at 4.7. So it's goin back up again.

Is it going to level out at all?
 
Looks like the Boreal canned is 1% and the dietetic is about the same if not lower so you may need to use some of the dry food to get him up and stay up. He's safe now but we really need to get him up and keep him up. We need to see 3 consecutive BG readings that are steady or rising before we know he is out of the woods. We don't know that at this point how long the insulin shed will keep him at these low numbers so we want to err on the side of caution and pump him up a bit higher.

As for the spreadsheet, it looks complicated but it's not.
Under the AMPS column you put in the reading you take before a shot. Under the "U" column, you mark in the number of units of insulin given. Each of the columns after that labeled +1, +2 etc. indicate readings that many hours after a shot of insulin.
I am not sure if you have been taking pre-shot readings up till now but those are very important as they tell you whether it is safe to give insulin to the cat. We also try to get at least one mid cycle test to figure out how low the dose of insulin is taking the cat. Lantus dosing is based on how low the dose takes him, not on pre-shot numbers.

How many cat strips do you have left at this point? 4.7 is a safe great number but that could be the corn syrup and it will wear off pretty quickly so more testing is going to be needed. Is your meter the AlphaTrak2 meter? If yes, then go to the drugstore and get some Freestyle Lite strips which will work in the meter. The readings won't be 100% accurate but good enough to enable you to keep Barry safe.
 
Ok! That makes sense. One last quick question. How often should we feed him? Wife and I are prepared to stay up tonight in shifts b
 
The goal here is to get and keep him in safe numbers but not fill him up with food too early in case you need to "steer" him again. Test in 20 minutes and see where he's at. I'll check back in and we won't leave you alone until Barry is staying in safe numbers.

You are dedicated pet parents and I salute you! :D
 
Cool on the kitten mode! He's feeling better than he has in days I'm sure! :cat::D

I know the vet told you Barry might be in remission but one hypoglycemic episode does not necessarily mean remission. I think it's safe to say Barry has been getting too much insulin and needs a dose reduction. And I would definitely skip his shot tonight as the vet said, but until he can stay in normal ranges for a period of 14 days without insulin, remission is still a big question mark.
 
Also how long of a time period so we need to have for a steady/rising test score? Or do we just need 3 in a row?
 
If you get 3 consecutive readings where his numbers are steady or rising, then I would test one more time an hour later to make sure he was staying up. Then I think you can relax. I have yet to see a cat going hypo that long after a shot although my cat stayed in low numbers for 22 hours on another depot insulin but she was never low enough to have a symptomatic hypo. I think Barry will start coming up soon but again it depends on how big a shed he has stored up. ECID (every cat is different).
 
Just a curiosity, what human meter were you trying to use? Wish I had thought of this earlier :oops: but if you are using the lancets that came with that human meter, that could be part of the problem. If you can catch your wife at the store, tell her to get some lancets that are 28 gauge as most human meters come with 31 gauge which make it harder to get a big enough bead of blood to test.
 
The human one is a One Touch Ultra Mini...and yeah, we use regular needle lancets to get the blood. We tried using the one that came with it, and it was futile lol.

Also do you know if the Freestyle Lite Strips require the same tiny amount as the Cat strips do, or do they need a lot more like the human strips?
 
We have been using 22 gauge needle heads to get samples and sometimes we get a lot and sometimes we get a little. The One Touch Ultra seems to require quite a large blood sample and the AlphaTrak has been a great switch because it needs such a tiny amount. I'm about to go in to get the Freestyle Lite strips but I'm hoping they won't need the same amount of blood as the One Touch or it'll be a sort of wasted purchase as we could use the One Touch to tide us over until we get more actual AlphaTrak strips.
 
I personally use the AT2 meter (pet meter) and the FS Lite meter( human meter). I have found from my own experience that both these meter us a very small blood drop. Many people here use the Relion meter and are very pleased with it, but in Canada where I am it is not available.
 
yes the Freestyle Lite strips are identical but have not been batch tested for use in the AT meter so it's the same tiny drop of blood needed to use them!

As to why he is meowing a lot I have no idea. Is he perhaps telling you he is hungry and wants some food? If so I'd give him a bit more food. Have you tested again yet or are you waiting for your wife and strips to arrive?
 
Great job getting the spreadsheet up. Now, when things calm down a little, you need to enter all the readings you have, back to your first test, if you can. If you haven't been recording them somewhere, your meter should have a memory so you can go back and see them.
 
Good job today. (Sorry, I had to leave earlier to do rescue transport.)

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You can try poking two holes close together to get a big enough bead. You can also put very thin skim of Vaseline or polysporin on the sweet spot before poking as that helps get the blood to bead up better and be more visible.
 
We tried massaging the ear and then I used a sock full of rice warmed in the microwave on the next try. All 3 of us were getting pretty frustrated and it was about time for him to eat. A big part of the problem is that I have a herniated disc in my back so I'm usually in pain when we're trying to get a sample. Add a very fidgety cat in to the mix and it's somewhat beyond what I'm capable of at times.

I also have to admit that I don't quite understand the "sweet spot". I looked at the picture posted above but I'm unclear - do we poke from the furry outside of the ear or the inside of the ear? And he seems to have rather thin veins even when they're warm, I can see that outside rim vein if there's light shining behind his ear but can't see it well enough to poke it when I fold his ear back, if that makes sense.
 
TLantMagnus said:
No, our vet is solid. Saved two of our cats lives. Like regular doctors, they have their strength and weaknesses.
Click to expand...


As one of the first people to respond to your post this morning I feel I need to express my opinion. Barry was having seizures when you took him to the vet. The vet did NOTHING except tell you to stop giving insulin. This advice was given from here just based on the fact that Barry was seizing. Your vet sent you home and Barry seized again on the way home. If the hypo had been any worse Barry could have passed away or been disabled permanently. My own personal opinion was the fact that your vet did nothing for a kitty in a critical , possibly deadly condition leaves much room for doubt as to their understanding of feline diabetes and its complications.

There have been a few kitties on this forum that have passed away from a serious hypo..and that was with proper treatment at animal hospital ER. when I first came across you posting this morning, my heart was in the pit of my stomach since I am aware of how serious this could have been. Sending Barry home without proper treatment and follow up ...IMHO...would be enough for me to seek out another vet no matter how good the vet had been in the past.

Sorry if I am being very blunt, but this episode and the lack of proper treatment today really upset me> The wonderful people here did far more to ensure that Barry was safe than the vet did.

OK Rant over. But the worth of a good vet is how well they treat an emergency.
 
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Ok perhaps now would be a good time to put a little of that kibble out for Barry (maybe 1/16th of a cup or so) just to ensure we get his BG up high enough till a reading can be taken. Going forward it would be a good idea to find a special testing place where you can be comfortable testing. I have two spots in my place. One is her table in the rec room and the other is a counter under the window in my dining room. Both are at a level where I can either stand up or sit down to test without having to bend myself into a pretzel to get a test. If you start getting Barry used to one spot and offer a treat after testing whether successful or not, he's likely to become accustomed to the routine and co-operate more and you won't be putting yourself in jeopardy looking after him. Doesn't matter where it is but it needs to be some place that is comfortable for you as well as Barry.
 
Many people say their kitties run to the testing spot as soon as they get the treats out. Alway give a treat, even if you don't get blood. You want the kitty to associate the treats with your messing with his ear.

Here is a link with a lot of good info and tips on testing.
 
We will start "training" him to enjoy testing starting tomorrow, thanks for all the helpful hints. It'll take some thought to pick the ideal spot, Barry doesn't really have a favourite spot of his own yet but I'm sure we can find somewhere that will work for all of us.

He has had a mix of wet, kibble and water for his last 2 feedings and our overnight plan is to take turns getting up to feed him every 1.5 hours. That should keep his BG high and steady enough that we don't have to both get up so we can test.
 
Sounds like a good workable plan although I think every 2 hours should be more than adequate. I hate to think of you having such a night but Barry is definitely taking his sweet time getting to more normal safe numbers and staying there so if you can't get another test to see what he's doing, this is your safest course of action.

I suggest you try to test him again tomorrow morning after food has been withheld for at least 2 hours so you can get a reading that has no food influence. Then test again about an hour to an hour and a half after his meal to see how much his BG spikes from food. This will give you a better idea of whether he is trying to head into remission or you are going to have to re-evaluate his dose and carefully restart his shots. You can post in the Lantus forum to get the assistance of those most familiar with that insulin. If you have any further need for assistance or questions tonight, posting here on Health is the best place at non-peak hours as we have members from around the globe so there is usually someone around.

I'll be watching to see how Barry's doing. :)
 
Relieved to see how things went.

Like others here, I am concerned about your vet's understanding of feline diabetes. I mean no offence to the vet but the hypo was not handled properly and safely; Barry needed emergency hospital treatment. You both did great getting him through what must have been a very stressful and frightening time for all of you.

After a symptomatic hypo cats may become MUCH more sensitive to insulin so much caution will be needed going forward should Barry still need insulin treatment. I strongly recommend that you ask for input from experienced members at FDMB before giving Barry any more insulin and that you give serious consideration to their suggestions when making any future dosing decisions.


Mogs
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To answer your question about which side of the ear to poke (from the inside or from the furry side) you can go either way, whatever is easier for you. I find it easier to go from the inside as I know (from experience) exactly how much of the lancing device I should be seeing sticking out from behind his ear to poke the right spot. My mum prefers to go from the furry side with her kitty.

Good job keeping Barry safe today
 
Good morning! Just checking in to see how things went last night.When you are up and have had your :coffee::coffee::coffee: please let us know! Really curious to see what Barry's numbers look like today! :)
 
I'm up but not very awake ;) Barry's "dad" stayed up late to do a couple feedings so the plan is to let him sleep in a while longer. Barry has just eaten so we will test him (fingers crossed for success) before his next small meal in 2 hours, per the advice here. He seems alert and happy this morning, hungry but not ravenous - although he is currently checking every other cat's bowl to make sure there wasn't anything left behind, not even a bit of kibble dust :rolleyes:
We will keep you all posted as we go today and I plan to do some reading and watching of videos re: testing. Thanks again!
 
Also, our plan, as previously suggested, is to test after food has been withheld for at least 2 hours, then again 1 to 1.5 hours after he eats. Other than that though I'm not sure what our plan for today should be - do we keep feeding him small meals every couple hours? Do we start giving him larger, less frequent meals? How many times and at what time frequency should we test his BG today? If his numbers are steady can we maybe sleep through the night without feeding him? So many questions for early in the morning on not a lot of sleep!
 
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