Moving forward after hypo

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heidi

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Thanks again for all of your help yesterday while my Frodo was hypo. What a relief to have such calm, knowledgeable help!

I'm trying to come up with a plan that is realistic for my home/health situation as Frodo and I go forward from here. Frodo is not regulated yet (diagnosed mid-Dec.). He switched to Lantus (1.5 u 2xday) 11 days ago from Humulin N (1 u 2xday) after a curve at the vet's office with very high numbers (not on SS--Frodo's spreadsheet starts with his first successful blood test 6 days ago).
Frodo is a former feral who is a happy lap cat now, but still gets nervous with any type of confinement or too much noise/activity. I am also a single mother of twin 3-year-olds and a Ph.D. student, newly diagnosed with adrenal fatigue and hyperthyroidism (think chronic fatigue). Testing is not going well for us, and I am often not home during the day to watch and test Frodo (yesterday was an exception). I am dedicated to testing and we will keep working on it, but it's unrealistic for me to believe I will always have a pre-shot number these next few days or weeks. I also may not get a real curve for awhile and although this week I've been really regular with his shots, that's also not always realistic. Frodo won't eat while the boys are around, so I have to let him eat after we leave the house in the morning. His usual pattern when I am home is to eat some, come back a little while later and eat some more, etc. until the food is gone about four hours later, but who knows what he does when I'm not there. It's hard to know how much he's eaten and how much my other four cats have eaten (canned food--low carb by my calculations but a store brand not on Binky's list). At this point, I don't check his urine. The thought exhausts me. I can't even imagine being able to separate his urine from the other cat's urine right now and how I'll have to rearrange my house to segregate him. Maybe when blood testing is in place I'll give it a go. But this is where I go into shut-down mode. One thing at a time . . .

My plan for the next few weeks: Drop from 1.5 units Lantus 2 x day, to 1.0 unit 2xday. Slowly and gently work on testing, especially at pre-shot and +5 or +6 hours (seems to be his low point) when possible. Hope to be in a position to do a full curve in 7-10 days from now with the new dose.

Does this seem reasonable? Any thoughts or suggestions?
Thanks again for your support.
Heidi and Frodo
 
Heidi,
Good work yesterday - you learned a lot.

I do have a concern with your plan above:

...but it's unrealistic for me to believe I will always have a pre-shot number these next few days or weeks.
Click to expand...

PLEASE don't give an injection without a pre-shot test. If you have time for an injection, you have time for a test first. You need to know what his bg is before you give it to him. Without that test, you have no idea if his pancreas has suddenly sputtered and you're shooting into an already low number. It's better hours too high than minutes hypo. Yesterday gave you a little glimpse into that world...it's not pretty.

BIG hugs to all of you!
 
Thanks for your concern, Lyresa and KT. I share it. Let me clarify. When I said it was unrealistic to have a pre-shot number I didn't mean I wouldn't try or that I didn't have time to try. I meant that testing is not going at all well for us and I can poke and poke and poke and still not get any blood or enough blood to test. And Frodo is getting almost unapproachable because he doesn't like the pokes. Right now I believe my ratio is about 150 pokes for every successful test. We are dismal failures at testing, except for the fact that I keep trying. This morning I did four separate "testing" sessions over an hour before I got the 510 reading. I hope this gets better. I hope no other newbies are reading this and getting discouraged about trying to test. I'm horribly discouraged. But I'm going to try again tonight when I get home from campus.

I guess I'm at a point where I either have to let go and just give him a lower dose of insulin even if I don't get the pre-test number. Or I've got to stop treating the diabetes while we learn how to test. Neither sound like very good options to me.
 
Heidi, testing is always hard the first week or so, but it's important not to give up.

Here are some common problems new testers have that might be making things difficult for you...

1. What size lancets are you using? Most meters come with 30-31g lancets, but these are too small, especially when you're first starting out. 26-28g are absolutely necessary. This is probably the most common problem I see with not being able to get enough blood.

2. Are you using a lancet device or free-handing? About half of us here use the device, and the other half free-hand. If you're using the device, what one are you using? Are you firmly backing the ear with a tissue or cotton ball when you poke?

3. Are you warming the ear (I use a damp washcloth warmed in the microwave in a ziploc bag, many people here use rice socks)?

4. Are you giving a low carb treat after each test?

5. Are you dabbing a little neosporin + pain relief ointment on before the poke?

6. Is you cat struggling, making you miss the poke? If so, a lot of members here can give you advice on how to restrain your cat until Frodo learns to tolerate testing. I had to restrain Bandit in a basket with a blanket the first few weeks, but now his "testing" basket is one of his favorite places to hang out.

And in case you haven't seen the picture of the "sweet spot," here it is: http://felinediabetes.com/images/laur_danny_famoussweetspot.jpg
 
Heidi,
Another BIG hug, I know how hard it is to get started, we were just there 6 months ago. It WILL get easier for all of you. Don't worry about the other newbies, we're just concentrating on you and Frodo here. You're NOT a dismal failure, you're just learning.

Another suggestion - try thinking of it as something other than a chore to do. It's so easy to fall into that making it a hassle for both of you. I still have to remind myself of that every few days when the world's spinning too fast...take a deep breath and relax, plaster a smile on your face (it really DOES help) then do it. We understand! Just trust us too, those aren't just words, we really DO understand. Vent when you need to also....we understand that too....

Another HUG!!!
 
Hi Heidi!

I had actually written a nice long response and for some reason it disappeared after I hit submit :( I wanted to say hi since I didn't get a chance to do so before....

Julia actually mentioned all of the things that I was going to, so that makes it easier so I dont have to retype half my response! lol. I just wanted to say that what you are feeling is EXACTLY what I was feeling for the first couple weeks of testing. It was awful. I would be so frustrated that I would cry...and this would happen often. It was so overwhelming and I never thought that it would become easier...I couldn't believe what others were saying that it will come. It didn't seem possible. But magically, it does...and its crazy how all of a sudden you go from how you're feeling now to calmness when it comes to testing (well for the most part...we still have our days).

Some things that made the difference for me. I use the lancet device, but I take the cap off. I tried free handing once...it wasn't meant for me. But without the cap, it was easier to know where I was hitting. Also, make sure to really really really warm the ear. I used to hold my warm rice sock to his ear for a minute before attempting. Treats are a definite need as well - low carb for him..chocolate for you. Another thing...try out a couple tests when you're not rushing somewhere or to do something. I find that when I'm feeling pressured, then things go badly, and take longer. When I have time, it goes quick. That's how life is usually lol.

So although Kit doesn't come looking for me when its time to test, he is a lot better and will sit there until its done...even when it takes 2 or 3 tries (which on occasion still does). I just wanted to let you know that even though you feel like you're alone, there are many of us that have felt the same way.

Here's crossing my fingers to better luck! :) Keep trying, you're doing great so far with not giving up. It will work out. Just dont forgot the chocolate :)
 
Just to add to the others' personal comments about testing--I remember being in TEARS the first week I tested Bandit because I was afraid he was going to die because I couldn't test him. My vet had told me I needed to learn to hometest or my cat could hypo, and she made it look soooo easy on their resident office kitty, who sat and purred through the whole thing. Well, when I got home and tested the first time Bandit sure didn't purr through the test. There was biting and clawing and growling and head shaking, and I felt like I would NEVER be able to do it, and I felt so bad for Bandit. And every thing changed once I resolved myself that we were getting this test no matter what because we needed it to keep him safe, whether he liked it or not. I plopped him in his basket, wrapped him in a blanket, firmly held his ear and poked. Sure enough--there was the blood drop and he wasn't freaking out.

Today, Bandit comes running when he hears the glucose meter beep on, runs to his basket, jumps in and waits patiently for me to test him. When I'm doing the poke, he's purring like crazy. If you'd have told me he'd be like this with testing that first week, I'd have said you were absolutely insane--but it DOES get better. You just can't give up. :-)
 
~O) I had a horrible time with Akbah too. I think if he could have cried he would have, I did. For the first 10 days of testing it was a shambles, and those first 8 days were not consecutive either. I didn't know that I needed pretests, I was following my vet. (Blame it on the vet, he's probably not reading this).
Anyway, today he came out for his test. I find that the ear warming made a big difference, not least because I had to sit there and count out 25 or 30 big long back strokes, and that calmed us both down. And the treat at the end? Priceless.
 
Hi Heidi,

I notice you are in Missouri. If you could include your city or nearest metro area, maybe we have someone from the board who is close enough they could visit for one on one BG testing help.

Urine testing for ketones is not necessary every day and testing urine for BG is really needed only in extreme cases, such as very feral cat. There are some simple tricks to collect urine easily such as putting plastic wrap over the litter as long as the cat isn't a crazy scratcher in the box. You can also get aquarium gravel and use that instead of litter in a box for a half day to collect urine. If your other cat isn't diabetic, if there are 2 pee spots test them both, if either one shows positive for ketones then you know which cat it is.

We have suggestions for just about any situation you can throw at us, we can help you turn down some of your stress level. It is like this for everyone in the beginning, you're among people who understand here!

Hang in there!
 
Thanks everyone for your encouragement. I was really emotional and frustrated about it this morning, but Frodo and I relaxed together this afternoon and testing went a little better. Frodo's BG is on the low side again. Definitely not hypo, but too low to give a shot I believe. Also, I had something bizarre happen during the pre-shot test. The first reading I got was 65. That seemed really low again and I really had expected to get an error message for too little blood or movement (he was flinging his head around). He was still bleeding, so I tested again on a drop that fell on the floor and got 110 (yes, I overcompensated my poke!). I entered the 110 in my spreadsheet because I feel it was probably more accurate, but is this common to get two numbers that different? Also, I assume 110 is too low for a shot . . . The test was at 12 hours and 5 min. past the last shot, so I'm right on time -- not early. How high should it be before you give a shot? 200? This is really bizarre. Should I test again in an hour? Just skip the shot for sure and try again tomorrow? I will be home tomorrow at least part of the day and can watch him.

Thanks,
Heidi
 
Hi Heidi and Frodo! cat_pet_icon

Congrats on the BG test! And, yes, it's not uncommon to get two very different readings, especially if one is just barely enough blood to test and the other had plenty of blood. :smile:

As far as whether or not to shoot, I'm not familiar with Lantus so I'll defer to the Lantus folks. :smile:

And the testing does get easier. :-D
 
Heidi,
I have to second everything that everyone said to you. It does get easier. Testing becomes a routine, eventually. (even though I never like to do it) Treats help a bunch. Warming the ear helps immensely, for me. I also use the freeze dried chicken for treats. My cats love it. Missy will let me do almost anything to get a treat. :lol: She even reminds me when it is time to test if I am running late.
As for testing for ketones, Missy would never let me catch urine. Besides, she much prefers the great outdoors to the litter box. If money isn't too much of an issue, you can test with a Precision Xtra meter. They have special strips (which I found cheapest at CVS) for testing ketones. Much easier than trying to follow a cat around and catch them peeing. You can even use the same poke to test BG and ketones if you get a big enough drop. I also have been told it is more accurate from a blood sample than urine.
I just get all my testing stuff together in a tupperware type dish (meters, strips, lancets, rice sock, cotton rounds, neosporin, treats, etc). I crunch up some treats to keep her occupied while I am warming her ear, do the test and give her another treat when we are finished. It doesn't take long for them to link the microwave (warming the sock) with treat time and they come running. (even when it isn't a test time :smile: )
You will get the hang of it. It gets easier.....honest!
Congrats on your blood test!!
 
Well Hello to you and Frodo...... I wanted to say....sooo proud of you for endurance!

Something that has not be brought up for testing and something I did have to do with Bean as she would let me poke, and then immediately bend that ear backwards and I would loose the drop :evil:.

Soooo, I would scoop that drop onto the back of the finger nail and bam, I got that test!!! Might be helpful at first if he wants down too soon and you do not have time to get the strip to the blood.

I understand about those low numbers....Beans first test (mamma was not doing it right either) she was only 27~eeeeks.... thank gosh I got that test and it was only 2 hours after her shot - oh my...it was a long long night, but that did make me promise her to never ever shoot her without testing first.
I remember being sooo nervous and upset that I would shake and break out into a sweat....Bean knew this and she would be upset too... AFTER a couple weeks, we both finally calmed down and it went soo much better.... I would have bet you my last breath that this would never happen, but it did.

Now, because of this forum and their encourgement, support and knowledge, my Bean girl is in remission!!!! HURRAY FOR BEAN

YOU ARE DOING GREAT and I guess so is Frodo with that low number....just look at yall go!!! and no hypo cuz of that test! WOW, brings a happy tear to my eye.. ;-)
 
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