NEW MEMBER - Dx 9/23 - Sherri & kitty Isy - Need Advice

[Bron and Sheba (GA)]

Sherri, when you start your new thread, I would start it over on the Lantus forum where you will find everyone uses either Lantus or levemir (similar to Lantus) and you will be able to get lots of help.
Make sure you have your SS up and running before you post there.
We start a new thread every day on the L and L forum. In the subject line you give the date, cats name and AMPS (which is the am Preshot number.) You can add more in the subject line after that if you like. So it will look like ‘10/2 Isy AMPS xxx’. First post I would add ‘new member, first day on Lantus‘

Here is the Link to the Lantus forum.
See you over there!
https://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

 

[Sherri & Isy]

Thanks Bron! I was going to ask where I should post my new thread re starting insulin etc so you answered my question before I asked!

FYI - I haven’t tested Isy’s urine for ketones yet. I bought the ketone test strips and planned to check today but she didn’t pee on her pee pads again today (she went on the floor rug again sometime early this am while I was sleeping in another spot but still near her bed!) Ugh!
She hasn’t peed again today since! She usually was peeing at least 2x/day before when she was regularly using her pee pads. Today I have even carried her to her pee pads multiple times but she just sits there then lies down or walks away!
I’m guessing she’ll pee again tonight somewhere on the rug after I go to bed! It’s right in our living room so I need to find a way to get her Not to pee there and go back to using her pee pads in her little area off the kitchen.

As far as testing her urine, if I see her pee can I just stick the test strip into urine on the pee pad (assuming she goes on it again) OR do I need to try somehow to catch a sample in a container when she goes and then test the urine?

Also when I did the BG testing today, I got a pretty big drop of blood from Isy’s ear (larger than shown in the videos) - I used the 25G needles that my vet gave me. Could it be that the larger gauge caused a bigger prick so more blood? Or would I have hit that marginal vein by mistake?

BTW - looks like my ReliOn meter and test strips should get delivered sometime tomorrow (Friday), so I’m thinking I can maybe start insulin on Saturday.

I need to finish reading the posts tonight about how to set up my SS and then I will work on it tomorrow.
I’ll likely be ready to start my new thread on the Lantus forum later tomorrow (Friday pm).

(FYI - My days have been crazy right now, I have my 2 kids at home doing live online school distance learning since schools are closed here due to Covid, which requires a LOT of my time to help them, plus dealing with Isy’s health issues - so sometimes I have to wait until night time when my family is already in bed to get my own stuff done online like post here, catch up on emails etc! )

Thanks again for all your great advice and support!!

 

[Bron and Sheba (GA)]

As far as testing her urine, if I see her pee can I just stick the test strip into urine on the pee pad (assuming she goes on it again) OR do I need to try somehow to catch a sample in a container when she goes and then test the urine?

It is best if you can test a fresh urine sample, but if you can only get one that has been sitting on the floor or peepad, I would test that, to see if you can get a result.
Can you remove the rug altogether? I found that once they had peed on a rug, no matter how much I cleaned it, they still used it.

Also when I did the BG testing today, I got a pretty big drop of blood from Isy’s ear (larger than shown in the videos) - I used the 25G needles that my vet gave me. Could it be that the larger gauge caused a bigger prick so more blood? Or would I have hit that marginal vein by mistake?

It could have been the 25 gauge lancet or you could have hit the vein, although I think if you had hit the vein, you would have had a lot more blood. My main comment would be...lucky you getting a big drop because some people find it hard to get any blood in the first few days!

BTW - looks like my ReliOn meter and test strips should get delivered sometime tomorrow (Friday), so I’m thinking I can maybe start insulin on Saturday.

Great!

FYI - My days have been crazy right now, I have my 2 kids at home doing live online school distance learning since schools are closed here due to Covid, which requires a LOT of my time to help them, plus dealing with Isy’s health issues - so sometimes I have to wait until night time when my family is already in bed to get my own stuff done online like post here, catch up on emails etc! )

I get that totally! I was helping my 8 year old grandson with live online schooling earlier this year and it is very time consuming.

I need to finish reading the posts tonight about how to set up my SS and then I will work on it tomorrow.
I’ll likely be ready to start my new thread on the Lantus forum later tomorrow (Friday pm).

If you run into trouble with the SS just let us know.

Thanks again for all your great advice and support!!

We are very happy to help here...its a great community. We were all new once and understand the anxiety and stress of a newly diagnosed diabetic cat.

 

[Critter Mom]

Hi Sherri,

As far as testing her urine, if I see her pee can I just stick the test strip into urine on the pee pad (assuming she goes on it again) OR do I need to try somehow to catch a sample in a container when she goes and then test the urine?

You could maybe try putting a pee pad in a spot where Isy currently likes to relieve herself. If you cover the pee pad with cling film it would prevent the pee from soaking in and you could dip the test strip in it. Once you have the test done you could put another pee pad with the absorbent side facing down on top of the cling film to soak up the rest of the pee ready for disposal (or maybe soak up the pee with loo paper).

Brainstorming here, obvs.


Mogs
.

 

[Sherri & Isy]

Hi Sherri,


You could maybe try putting a pee pad in a spot where Isy currently likes to relieve herself. If you cover the pee pad with cling film it would prevent the pee from soaking in and you could dip the test strip in it. Once you have the test done you could put another pee pad with the absorbent side facing down on top of the cling film to soak up the rest of the pee ready for disposal (or maybe soak up the pee with loo paper).

Brainstorming here, obvs.


Mogs
.

Thanks Mogs! I’ll try that idea next time!
Thankfully Isy peed early this am on her usual place/pee pad and I was awake and saw her go. (Before I just saw your post/idea re the plastic cling film.)
The urine did mostly soak into the pad but a bit actually leaked onto the floor - so I used the ketone strips and tested both the pee on the pad and on the floor. Got the same result/color change for both,

It looks like it’s showing “small 15mg/dl” reading from the color change.
One question I’m wondering - Isy has visible blood in her urine (from her cystitis) which makes the urine a pinkish color, so would it affect the accuracy of the ketone strips?? (Or does the test strip only react with ketones to cause the color change so urine color or blood won’t affect it??)

Note: the photo shows the 2 test strip results compared to an untested strip and the Ketone color chart.

 

[Critter Mom]

Hi Sherri,

It looks like it’s showing “small 15mg/dl” reading from the color change.
One question I’m wondering - Isy has visible blood in her urine (from her cystitis) which makes the urine a pinkish color, so would it affect the accuracy of the ketone strips??

I can't give you a definitive answer on whether blood in the urine may or may not affect the ketone result. With multi-test strips there are reagent panels that include both blood and ketones so logic points to blood in the urine not affecting the ketone result but that is only speculation on my part.

One thing I can recommend with certainty is that you need to contact your vet immediately for advice on how to proceed because a 'small' ketone result needs to be addressed straight away. Ketones can build up very quickly and then tip over into DKA and that's something to be avoided at all costs.

I've had a quick scan back through your posts on this thread. Am I correct in understanding that you have not yet started giving Isy her insulin? If you haven't, then you need to speak to the vet about starting it as soon as possible in order to get rid of the current ketones and stop future build-up.

Your vet will need to know about how well/poorly Isy is eating at the moment, and also how much fluids she is getting (both sub-q and from drinking under her own steam). Please get input from the vet on what to give to Isy if she's not eating enough. Calories are what count here, even more than the carb level of the food. Also, ask the vet about fluids, and the cystitis. (Inflammation is another risk factor when ketones are present.)

This is an urgent situation. Be sure to update us once you've talked to the vet.


Mogs
.

 

[Sherri & Isy]

Hi Sherri,


I can't give you a definitive answer on whether blood in the urine may or may not affect the ketone result. With multi-test strips there are reagent panels that include both blood and ketones so logic points to blood in the urine not affecting the ketone result but that is only speculation on my part.

One thing I can recommend with certainty is that you need to contact your vet immediately for advice on how to proceed because a 'small' ketone result needs to be addressed straight away. Ketones can build up very quickly and then tip over into DKA and that's something to be avoided at all costs.

I've had a quick scan back through your posts on this thread. Am I correct in understanding that you have not yet started giving Isy her insulin? If you haven't, then you need to speak to the vet about starting it as soon as possible in order to get rid of the current ketones and stop future build-up.

Your vet will need to know about how well/poorly Isy is eating at the moment, and also how much fluids she is getting (both sub-q and from drinking under her own steam). Please get input from the vet on what to give to Isy if she's not eating enough. Calories are what count here, even more than the carb level of the food. Also, ask the vet about fluids, and the cystitis. (Inflammation is another risk factor when ketones are present.)

This is an urgent situation. Be sure to update us once you've talked to the vet.


Mogs
.

Hi Mogs
No I hadn’t started the insulin yet. I was planning to start today cause I was waiting to get the ReliOn meter and test strips (got delivered last night).
Also I got the insulin Wed but
My vet had given me the iPet pro meter on Wednesday and I got the insulin that day, but my schedule on Thursday and Friday in the am meant I couldn’t be home to start doing the insulin and monitor how Isy was doing, so that’s also why I planned to wait and start today (Sat).

FYI - I was planning to just use the iPet Pro meter to do the BG curve (7-10 days after being on insulin) for my vet.

My vet doesn’t know when I was planning to start the insulin.

I tested Isy’s BG this am with both meters - it was 155 on the ReliOn and 196 on the iPet pro meter.
I haven’t given insulin.

I will start a new thread on the Lantus group.
I need to get my SS set up. I had problems doing it - can Not get it to work using my iPhone so need to borrow my daughter’s laptop today.

 

[Critter Mom]

Did you manage to speak the vet yet about the ketones, Sherri? It's so important that you do. A cat throwing ketones is a very serious matter.


Mogs
.

 

[Sherri & Isy]

No I haven’t reached her. Texted her.
My vet didn’t tell me to test ketones so she’s likely going to ask me why I’m testing - what should I say?!

 

[Sherri & Isy]

My vet also told me not necessary to pretest BG or no need to monitor OVer the first week, just give the 1/2unit dose after food and watch for any physical changes and just test if seems Isy might be too low.
But I DID test her today before I was going to start the insulin (before food) and it was 155 on ReliOn and 196 on the pet meter.
It’s now noon here my time - should I just keep feeding Isy thru the day and test tonight and maybe start the insulin tonight to get onto a 12hr cycle for tomorrow?!

Ugh!! I’m starting to panic!!

 

[jt and trouble (GA)]

what should I say?!

you say..."Would you shoot insulin into your child before you know its safe to do so?"

 

[Critter Mom]

Don't forget to breathe!

No I haven’t reached her. Texted her.
My vet didn’t tell me to test ketones so she’s likely going to ask me why I’m testing - what should I say?!

Checking for ketones is a common monitoring activity for diabetics. For a newly diagnosed cat in hypoglycaemic numbers waiting to start insulin it's a basic safety precaution.

But I DID test her today before I was going to start the insulin (before food) and it was 155 on ReliOn and 196 on the pet meter. It’s now noon here my time - should I just keep feeding Isy thru the day and test tonight and maybe start the insulin tonight to get onto a 12hr cycle for tomorrow?!

Is your vet's office open? If yes, I'd suggest also putting a call in to their reception as well as texting, especially if there are other vets in the practice who might be able to help you if your favourite vet is not available.

I can't advise you any better than I have already, Sherri. For safety, I think it's vital that you get advice from a vet about how to proceed to address the ketone issue. When they're dealt with promptly, it avoids further complications developing. I'm not ducking here: Isy has a complicated history, I'm not a veterinary professional and I want the best for you and Isy. If you can't get hold of a vet at your own practice I suggest contacting a veterinary ER for advice. It's good that you've checked Isy's BG levels. You'll be able to give the vet information on the level she's running at now, as well as telling them about her food and fluid intake.

You could also post on the Lantus forum and ask for input from other members. (Be sure to add a link back to this thread so that they will be able to see what's already been posted.)

With regard to checking blood glucose levels, some vets recommend regular testing, others don't. At the end of the day Isy is your cat and you need to feel comfortable in how you manage her diabetes treatment. From your earlier posts, it sounds like you have a really good relationship with your vet. I'm sure that they'd give you a fair hearing if you explained that you'd have more peace of mind giving Isy her insulin if you did checks before each dose to make sure it was safe to give insulin and also doing spot checks to make sure that she wasn't going too low. It's not an unreasonable thing to want to do.


Mogs
.

 

[Sherri & Isy]

Don't forget to breathe!


Checking for ketones is a common monitoring activity for diabetics. For a newly diagnosed cat in hypoglycaemic numbers waiting to start insulin it's a basic safety precaution.



Is your vet's office open? If yes, I'd suggest also putting a call in to their reception as well as texting, especially if there are other vets in the practice who might be able to help you if your favourite vet is not available.

I can't advise you any better than I have already, Sherri. For safety, I think it's vital that you get advice from a vet about how to proceed to address the ketone issue. When they're dealt with promptly, it avoids further complications developing. I'm not ducking here: Isy has a complicated history, I'm not a veterinary professional and I want the best for you and Isy. If you can't get hold of a vet at your own practice I suggest contacting a veterinary ER for advice. It's good that you've checked Isy's BG levels. You'll be able to give the vet information on the level she's running at now, as well as telling them about her food and fluid intake.

You could also post on the Lantus forum and ask for input from other members. (Be sure to add a link back to this thread so that they will be able to see what's already been posted.)

With regard to checking blood glucose levels, some vets recommend regular testing, others don't. At the end of the day Isy is your cat and you need to feel comfortable in how you manage her diabetes treatment. From your earlier posts, it sounds like you have a really good relationship with your vet. I'm sure that they'd give you a fair hearing if you explained that you'd have more peace of mind giving Isy her insulin if you did checks before each dose to make sure it was safe to give insulin and also doing spot checks to make sure that she wasn't going too low. It's not an unreasonable thing to want to do.


Mogs
.

Hi Mogs,
I heard back from my vet (she is away traveling this weekend). She said based on the BG yes I shouldn’t give insulin.
She told me to continue my usual routine to feed Isy small amounts thru today. She will call me later today to advise re what to do about starting insulin.
Also as far as the ketones, she said with Isy spilling glucose into her urine that’s why I’m seeing ketones.
She told me to do subq fluids today and then will go from there as far as getting started on the insulin etc once she’s in touch with me tonight.

 

[Critter Mom]

Hi Sherri,

Thank you for the update! I'm very glad to hear that you were able to get in touch with your vet and that she's now advising you on how to proceed. Be sure to let us know how you get on later.




Mogs
.

 

[Bron and Sheba (GA)]

I am just catching up on this...... your vet is not correct about the ketones.... most Unregulated diabetic cats spill glucose into the urine and don’t show ketones in the urine unless there is an issue. .... her statement is definitely not correct.

The sub Q fluids will help with the ketones.

With the ketones strip... did you read it exact15 seconds after the test and take the photo then? Because it will keep going darker?
What do the three ketones strips in the photo represent?

it is important you get her to eat as much as you can

 

[Sherri & Isy]

I am just catching up on this...... your vet is not correct about the ketones.... most Unregulated diabetic cats spill glucose into the urine and don’t show ketones in the urine unless there is an issue. .... her statement is definitely not correct.

The sub Q fluids will help with the ketones.

With the ketones strip... did you read it exact15 seconds after the test and take the photo then? Because it will keep going darker?
What do the three ketones strips in the photo represent?

it is important you get her to eat as much as you can

Hi Bron
Re the ketones - I didn’t know the reading had to be 15 seconds after the test! Hmm - initially there was No color change and I just kept waiting! Then the strips turned darker over time to the color in the photo but didn’t get any darker so I thought that’s when I was supposed to read them! I misunderstood and thought you just wait till they stop changing color then read the color.

In the photo - The strip on the far left is an untested strip for comparison, the other 2 strips were from putting them in Isy’s urine (one by pushing the test strip down against the urine on the pee pad, and one directly into a bit of urine that ran off the pad onto the floor). Both tests were done at the same time and left until they stopped changing color which I’m pretty sure was more than 15seconds!

So now I’m not sure if those test strips are valid results. HOW LONG should I hold the test strip into the urine before I remove them and then start the 15second count?

Also Isy is only peeing once per day (at night) - it’s unusual for her (Usually she would go at least 2x/day) and just changed this past week! My vet isn’t sure why. So I’m sleeping in the living room near Isy hoping to hear her get up at night to pee so I can try to get a ketone test right away.
(I can’t stick a strip in until after she is done on the pee pad or she’ll stop and walk away - plus she finally went back to her original pee pad spot last night so I don’t want to do anything to discourage from going there. So for now I think the best I can do is wait til she’s done peeing and put the test strip in urine on the pee pad.)

I’ll be doing subq fluids tonight and also will continue to feed her.

My vet wants me to start 1/2unit insulin tonight (9pm PST- so that’s 30min from now). So I guess I should measure her BG again before I give insulin even tho my vet didn’t say to measure her.
Isy isn’t too happy with me doing the ear prick (and she can get really difficult about being handled at the best of times) so my vet is cautioning me not to test too frequently because I need to be able to test her when it’s most critical and to do the BG curves etc But I also don’t want to just blindly give insulin ! Ugh!

Thanks for your advice!

 

[Bron and Sheba (GA)]

Hi Sherri
With the ketone strips you just dip the strip in the urine and have your timer beside you and read it exactly 15 seconds later. Any later and the reading is not correct as the strip just gets darker.. I think that probably Isy had no ketones in her urine and you have read it later than15 seconds.

Make sure you test the BG before giving any insulin. It is really important to always do that. If she is under 150 don’t give the dose and don’t feed but post on the Lantus forum and say you are stalling.
Do you have honey if needed?

 

[Sherri & Isy]

Ok got it re the ketone test.

And re insulin - just about to go do the BG test now.
If below 150 I won’t give insulin or feed and will post over on Lantus boatd.
Yes I have honey on hand.
If I do give insulin (BG over 150) - How long after shot should I check her reading again? Maybe 2-3hrs? Longer?

 

[Bron and Sheba (GA)]

I’ll reply over on other thread