My 16 year old cat was recently diagnosed with diabetes, need advice please.

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Ok, we just gave her .5 at exactly 8:30pm. We don't have an alarm clock because we always just use the phone and I'm going to have the phone at work. Dan has set an alarm on the computer for 2 hours so he can check her sugar. I have to leave for work right now, so we will each be posting here, me from work him from home to let you know how it goes.
 
Hi Dan,

- Injection time of 8:30pm is 'time zero'.

- When you post a test result please tell us the BG reading and how many hours after the dose it was taken. For example: if you were to test at 10:00pm your time and were to get a reading of 321, you'd post:

+1.5 - 321

We use +<hours> to keep track of BG levels in relation to how the insulin typically works over time so as to make sure the dose is OK. (It also helps members in different time zones to fully understand how things are going.)

As a precaution tonight, I suggest getting the first test at +1.5 hours after the injection. (Novolin N may have an early onset.)

- Post the +1.5 result here when you get it.

- Do the next test at at +2.

- Please keep helping Mittens to get food down.

* * * Did you give her any mirtazapine? * * *


.
 
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Critter Mom said:
Hi Dan,

- Injection time of 8:30pm is 'time zero'.

- When you post a test result please tell us the BG reading and how many hours after the dose it was taken. For example: if you were to test at 10:00pm your time and were to get a reading of 321, you'd post:

+1.5 - 321

We use +<hours> to keep track of BG levels in relation to how the insulin typically works over time so as to make sure the dose is OK. (It also helps members in different time zones to fully understand how things are going.)

As a precaution tonight, I suggest getting the first test at +1.5 hours after the injection. (Novolin N may have an early onset.)

- Post the +1.5 result here when you get it.

- Do the next test at at +2.

- Please keep helping Mittens to get food down.

* * * Did you give her any mirtazapine? * * *


.
Click to expand...

Ok I can check her BG at 10:00 and post back here, and again at +2. We did not give her any mirtazapine yet. Should i try and feed her now before the BG test or wait until after? Thanks again.
 
Ok got her to eat a small amount of the chicken n broth baby food, and tested her BG a few minutes after. Her BG was 237, is that ok?
 
Hi Dan. Remind me what she was at PMPS (that means PM pre shot) test, again.
I like seeing the response to the insulin. Give her some food. If it were me, I would test again in an hour. Would feeding her for 15 minutes and then sleeping for 45 minutes be okay with you for now, or are you afraid if you nap you won't wake up?
 
Dan&Heather said:
Tested it at +1.5 -237. I think i got that right, that seems like a sharp drop though im not sure.
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It's a substantial drop, Dan, but she's in safe numbers. (On a human meter, 50 is the lower end of the normal reference range.)

How did the last feed go, Dan? Was it a little bit easier than earlier on?
.
 
Dyana said:
Hi Dan. Remind me what she was at PMPS (that means PM pre shot) test, again.
I like seeing the response to the insulin. Give her some food. If it were me, I would test again in an hour. Would feeding her for 15 minutes and then sleeping for 45 minutes be okay with you for now, or are you afraid if you nap you won't wake up?
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Her PMPS was 389 about 2 hours before the shot of insulin. Yeah i can feed her some more, will do that right now. Ill be fine, i wont fall asleep. Gonna feed her now.
 
Critter Mom said:
It's a substantial drop, Dan, but she's in safe numbers. (On a human meter, 50 is the lower end of the normal reference range.)

How did the last feed go, Dan? Was it a little bit easier than earlier on?
.
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Thanks, thats good to know. Shes fighting the feeding kind of bad now, but it just takes a little longer.
 
Did you watch the video and see how the less restraint the better? I just remember I petted J.D. while he laid next to me, and when I went to give him a ml or so of food, I just held his head a little with my left hand, while my right hand worked the syringe. I would let him swallow and pet him some more, and then do the next ml or so. I also warmed the food if needed by placing any refrigerated (cold) syringes in a tall cup of not hot but very warm water for a few minutes. How are you doing the assist feeding? I know some kitties need more restraint at first.
 
Hi everyone, this is Heather I am at work now. I just got my first break and I'm glad to see her number is down. Thank you Dan, I'm sorry I had to leave you at home to take care of this alone! Specially cause we're just beginning the insulin and I know your tired.

I should be getting breaks every hour and a half or so and I go straight to the message board when I get to the break room. I'm so sad that I'm not there, I have tomorrow off though so I can help with this. I watched some of the syringe feeding video I'm going to finish it in a bit, I hope it gets easier. Or better yet I hope she starts to feel better and starts eating on her own.

Thank you to everyone on here I really truly don't know how this would have ended up if we hadn't found you. Well, I do know how it would have ended and I can't even think about that right now. I wish we lived closer to you guys, we owe out alot of juicy steak dinners!

I'm going to keep being hopeful that she responds well to the insulin. I will check back on my next break.
 
Dan&Heather said:
I wish we lived closer to you guys, we owe out alot of juicy steak dinners!
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As much as I love steak, don't even worry about it!! We're all here for the same reason.....we reached out for answers when we didn't like the ones we got at the vet or we wanted to learn more about what we were up against

The people here are great and are just "paying forward" the kindness that was shown to them when they were new, scared and confused.

Soon, you'll be reaching out to a newbie too....if only to say "we were where you are not long ago and we understand. If we can do it, you can too"....those are some of the most beautiful words anyone can share
 
Dan&Heather said:
Thanks, thats good to know. Shes fighting the feeding kind of bad now, but it just takes a little longer.
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As Dyana says above, lots of gentle and reassuring praise can really help.

(I also find that if I try to explain to my kitty exactly why I'm doing something helps me calm down a bit. And when we're calmer our little ones feel more reassured.)

.
 
Ok, Dan here again. When im here alone i just go lay on the floor by her and try to feed her with the syringe, i usually let it sit under some warm running water, i just fed her some beef and broth baby food, she didnt want much but ill try again after i post this message. I have not watched the video yet, but i will before the night is over.

I just checked her BG again at +2.5(2 and a half hours past the insulin)and it was 266. So i think the write way to phrase it is +2.5 -266? Sorry if i got it wrong but 2.5 hours after the insulin her BG is 266. Gonna try to give her the rest of the syringe of baby food now.

I cant stop saying Thank You enough, the amount of help here has been huge!
 
You did perfect Dan. Her +2.5 is 266. That's good.
Have you tried to cut up a pill of mirtazapine yet? Do you have a pill cutter or a clean razor blade?
How were you planning to give it to her? You only want to give her like 1/8 of the little tiny tablet.
 
Dyana said:
You did perfect Dan. Her +2.5 is 266. That's good.
Have you tried to cut up a pill of mirtazapine yet? Do you have a pill cutter or a clean razor blade?
How were you planning to give it to her? You only want to give her like 1/8 of the little tiny tablet.
Click to expand...

I havent tried the pill yet, i can do that now. I dont have a razor blade handy, we got some pretty sharp knifes which is the closest thing we got. Im just hoping she opens up for me, shes been pretty reluctant with the feeding syringe. I was gonna try to set it in the back of her mouth and massage her throat softly? I think we watched a video on it, i honestly cant recall right now tho. It would be easier if i could give it to her in some food but i understand if that wouldnt work. She drank some water on her own after the last BG.

MrWorfMen's Mom said:
U said that just perfectly Dan and we know what you are up against being so tired and worried. That number is fine and good that you got more food into her.
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Thank you, im really glad its come down some from yesterday.
 
Dan, pilling isn't really that hard if you can get one hand on top of her head and your fingers just behind her canines. Then use your other hand to pull down her lower jaw and put the pill on the back of the tongue. Usually they will open wide if you get the top hand in just the right spot. You may need to kneel on the floor and put Mittens between your legs but I find it easier to sit my cat on my lap because then I can see what I am doing and where I am placing the pill.
 
Pill admin - part 2 .....as soon as you get the pill on the back of her tongue, close her mouth so she doesn't spit it out and stroke her throat to get her to swallow. Then grab a syringe with water and give her a bit of water to get her to swallow again. Just keep an eye out for the pill because they can be little devils and spit them out even if you think they've swallowed it.
 
Repeating the pilling technique from earlier:

To give the 1/8 tablet try this method:
  • Kneel on the floor with Mittens between your thighs, back towards you and facing away from you.
  • Tilt her head back and ease open her jaws with thumb and forefinger. You need to see the back of her tongue.
  • Gently drop the 1/8 tablet into her mouth so it lands on the back of the tongue.
  • Keep Mittens' mouth closed and very gently rub her throat - it will encourage her to swallow the tablet.
  • Syringe about 3-5ml of water after giving the tablet to wash it down properly.
  • Keep an eye on her for a minute or two to make sure she doesn't spit it out! ;)
.
 
Critter Mom said:
Repeating the pilling technique from earlier:

To give the 1/8 tablet try this method:
  • Kneel on the floor with Mittens between your thighs, back towards you and facing away from you.
  • Tilt her head back and ease open her jaws with thumb and forefinger. You need to see the back of her tongue.
  • Gently drop the 1/8 tablet into her mouth so it lands on the back of the tongue.
  • Keep Mittens' mouth closed and very gently rub her throat - it will encourage her to swallow the tablet.
  • Syringe about 3-5ml of water after giving the tablet to wash it down properly.
  • Keep an eye on her for a minute or two to make sure she doesn't spit it out! ;)
.
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Thank you, i was just gonna make sure it was 1/8 and not 1/4. I will give it to her in a little bit, just trying to let her rest for a few minutes. She probably thinks im so annoying right now, if only she knew it was for her own good.

I was gonna do another BG test in about 25 minutes, that would be +4 past the insulin shot, does that sound good? Sorry for keeping everyone up so late :/ I think we were gonna test at 1.5, 2.5, 4 and 8, at least thats what i think Heather told me, does that sound ok to everyone?
 
Dan&Heather said:
Sorry for keeping everyone up so late :/ I think we were gonna test at 1.5, 2.5, 4 and 8, at least thats what i think Heather told me, does that sound ok to everyone?
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You're not keeping anyone up...you'll soon learn who's online at what hours and you'll find that we're pretty much a 24/7 board here.....when the west coasters are heading to bed, the UK'ers and Europeans are getting up! We're actually slow right now due to the holidays

Those would be great test times!

Another tip on pilling....once the pill is in the back of the throat, if you blow gently on their nose it makes them swallow (it's reflex)

Next time you're out at a PetSmart or Petco ( or you can order from Amazon) you should look into getting a pill gun....they're worth their weight in gold!!
 
Chris & China said:
You're not keeping anyone up...you'll soon learn who's online at what hours and you'll find that we're pretty much a 24/7 board here.....when the west coasters are heading to bed, the UK'ers and Europeans are getting up! We're actually slow right now due to the holidays

Those would be great test times!

Another tip on pilling....once the pill is in the back of the throat, if you blow gently on their nose it makes them swallow (it's reflex)

Next time you're out at a PetSmart or Petco ( or you can order from Amazon) you should look into getting a pill gun....they're worth their weight in gold!!
Click to expand...

This is a great community you have here, im a member of quite a few different forums and none of them have been like this. Thanks for the tip, and we'll pick one of those pill guns up asap.
 
Dan&Heather said:
I think we were gonna test at 1.5, 2.5, 4 and 8, at least thats what i think Heather told me, does that sound ok to everyone?
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Ask for feedback after the +4 test. Novolin N can keep numbers down a little past +4.

Members helping you at that time will be able to let you know if you need to test earlier than +8.

If it were me, even if numbers were OK at +4 I would get a +6 and a +8 test. It's standard practice to do this series of readings at regular intervals (a glucose curve) when starting insulin treatment to check the safety and the duration of the dose.

Dan, Heather: hats off to you both.

:bighug:

.
 
Ok, got her BG tested again at +4 -258. So 4 hours after insulin her BG is 258. Gonna work on the 1/8 pill now and follow it with some water and food, the chunk of pill is small enough so im thinking it shouldnt be too bad.

Critter Mom said:
Ask for feedback after the +4 test. Novolin N can keep numbers down a little past +4.

Members helping you at that time will be able to let you know if you need to test earlier than +8.

If it were me, even if numbers were OK at +4 I would get a +6 and a +8 test. It's standard practice to do this series of readings at regular intervals (a glucose curve) when starting insulin treatment to check the safety and the duration of the dose.

Dan, Heather: hats off to you both.

:bighug:

.
Click to expand...

Ok, i will test at +6 too :) thanks again.
 
I can't leave it any longer to take my sleep meds so that I'll be able to check back in for the UK leg. (NB: I could be knocked out until about 12:00 noon GMT. Need cover till that time.)

For members assisting:

Potassium supplement - Dosing:

- Rx is for a whole tablet twice a day for two weeks.
- first dose was administered somewhere between 21:46 and 22:30 GMT. (ETA - These are the UK Zone time stamps on the relevant posts - needs to be adjusted to D & H's time zone.)

Jill's tips for administration:

Try crushing the potassium tabs into a fine powder. If Mittens will eat, you can mix it in a little food. It'll go down easier mixed in food. If not, mix the potassium powder and a little water in an oral syringe and give it to him that way. Follow it with a water chaser... about 4 - 5 ml of water.

.
 
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Good night Mogs. Thanks for helping. :bighug:
What she's saying Dan, is Mittens needs to have her potassium dose 12 hours after you gave the 1st dose. You're on EST, so what time would 12 hours after you gave the first dose of potassium be?
 
Dan, if you don't remember the exact time you gave the potassium, then figure on 10:00 am as your next dose. We know roughly when you gave it and a half hour one way or the other is not a problem.

Summary of BG so far for reference
PMPS - 389 (2 hours pre-shot with no food for 90 minutes prior) - given 0.5u Novolin N (NPH)
+1.5 -237
+2.5 - 266
+4 - 258
 
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Dyana said:
Good night Mogs. Thanks for helping. :bighug:
What she's saying Dan, is Mittens needs to have her potassium dose 12 hours after you gave the 1st dose. You're on EST, so what time would 12 hours after you gave the first dose of potassium be?
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MrWorfMen's Mom said:
Dan, if you don't remember the exact time you gave the potassium, then figure on 10:00 am as your next dose. We know roughly when you gave it and a half hour one way or the other is not a problem.

Summary of BG so far for reference
PMPS - 389 (2 hours pre-shot with no food for 90 minutes prior) - given 0.5u Novolin N (NPH)
+1.5 - 266
+4 - 258
Click to expand...


We gave her the first dose of potassium almost 8 hours ago, so I will wait another 4 hours for that correct? I tried with the mirtazapine pill, i had it in her mouth and it popped out, ill try again after posting.
 
MrWorfMen's Mom said:
Dan, if you don't remember the exact time you gave the potassium, then figure on 10:00 am as your next dose. We know roughly when you gave it and a half hour one way or the other is not a problem.

Summary of BG so far for reference
PMPS - 389 (2 hours pre-shot with no food for 90 minutes prior) - given 0.5u Novolin N (NPH)
+1.5 - 266
+4 - 258
Click to expand...
Wasn't there a 237 at +1 too? I may not remember right.

Critter Mom said:
Potassium supplement - Dosing:

- Rx is for a whole tablet twice a day for two weeks.
- first dose was administered somewhere between 21:46 and 22:30 GMT.
Click to expand...
I think GMT is 5 hours different than EST.
Maybe pick a time that would be convenient for you to dose his potassium at regular 12 hour intervals. Be sure to wait the 12 hours after his initial dose though, you don't want him to have too much potassium either.
 
Ok so you gave it around 5pm? I thought it was later but no matter...Looks like it was a time zone issue.

Yes you give it twice daily so every 12 hours. so next dose would be at 5am but that is not very convenient under normal circumstances so pick a time early morning and then in the evening that will work for your schedules going forward. I would however try to give it pretty early in the morning right now (may be 6am) to keep the dosing somewhat consistent and then shift the time ahead gradually perhaps a half hour daily until you get to the time you prefer. Getting her potassium up right now is going to help her feel better and should help with any nausea.
 
I believe right now were at
PMPS - 389

+1.5 -237
+2.5 -266
+4 -258

I'll test again at +6 too.

Dyana said:
Wasn't there a 237 at +1 too? I may not remember right.


I think GMT is 5 hours different than EST.
Maybe pick a time that would be convenient for you to dose his potassium at regular 12 hour intervals. Be sure to wait the 12 hours after his initial dose though, you don't want him to have too much potassium either.
Click to expand...

Ok, maybe ill wait till tomorrow around noon for the potassium, noon and midnight i think would be easy times to give her potassium on regular 12 hr intervals.

Edit: Gonna give the potassium at 6am and start 12hr intervals after that :)
 
MrWorfMen's Mom said:
Ok so you gave it around 5pm? I thought it was later but no matter...Looks like it was a time zone issue.

Yes you give it twice daily so every 12 hours. so next dose would be at 5am but that is not very convenient under normal circumstances so pick a time early morning and then in the evening that will work for your schedules going forward. I would however try to give it pretty early in the morning right now (may be 6am) to keep the dosing somewhat consistent and then shift the time ahead gradually perhaps a half hour daily until you get to the time you prefer. Getting her potassium up right now is going to help her feel better and should help with any nausea.
Click to expand...

Ok I can give her the potassium at 6am that works for us, we keep pretty odd hours here so theres always one of us up at those times.
 
Whoa! Right now you need to get potassium into Mittens. I know the early morning is a pain but I think it's important to give it as close to 12 hours as possible right now and gradually move it to the preferred noon/midnight timing.
 
MrWorfMen's Mom said:
Whoa! Right now you need to get potassium into Mittens. I know the early morning is a pain but I think it's important to give it as close to 12 hours as possible right now and gradually move it to the preferred noon/midnight timing.
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Ok, the last time i gave her the potassium was only around 8 hours ago. Not sure if i misunderstood, do i need to give her more? Sorry for the confusion.
 
If you gave it about 8 hours ago (maybe 8.5 now?) then that would have been about 5pm. So the next dose would be due at 5am. I'm suggesting you give the next dose at 6am/6pm today. Then next day move it ahead to 6:30am/6:30pm and so on just so you keep doses fairly close to every 12 hours until you get to your preferred time (noon/Midnight)

Thank you for the corrected summary. It gets tough going back through the thread when they get this long! Tomorrow I think you should start a new thread and link this one to it.
 
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