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[Katherine&Ruby]

I'm done with the testing. I had my Mom hold her tonight and I jabbed her several times with no blood. She cried every single time. I will not alienate my cat for these test and will leave it to the weekly testing at the vets.

Don't give up yet! I CRIED every time I tried to get blood out of Ruby for 6 weeks before I bought a lancing device and it made the whole experience so much easier. Now Ruby doesn't even flinch. She hates her shot more! I love this video starring Peanut: https://www.felinediabetes.com/FDMB...to-get-a-blood-sample-starring-peanut.175369/

Not testing leaves you not knowing at all where your cat's glucose levels are. She can have a hypoglycemic episode in between vet tests. Please reconsider this. I poke Ruby about 8 times a day and trust me, she still loves me.

 

[Chris & China (GA)]

Diane, I got Susie's Spreadsheet loaded on to my signature page but how do I get back to the spreadsheet to update it from this site?

You can't do it from the link in your signature. You have to go to Google Drive and open it from there.

 

[Diane Tyler's Mom GA]

You can't do it from the link in your signature. You have to go to Google Drive and open it from there.

Thanks Chris , she got very over whelmed See #50 ♥

 

[Summer and Susie (GA)]

Don't give up yet! I CRIED every time I tried to get blood out of Ruby for 6 weeks before I bought a lancing device and it made the whole experience so much easier. Now Ruby doesn't even flinch. She hates her shot more! I love this video starring Peanut: https://www.felinediabetes.com/FDMB...to-get-a-blood-sample-starring-peanut.175369/

Not testing leaves you not knowing at all where your cat's glucose levels are. She can have a hypoglycemic episode in between vet tests. Please reconsider this. I poke Ruby about 8 times a day and trust me, she still loves me.

Good video, Katherine. I watched a few videos yesterday about how to do the testing. Each cat would sit perfectly still. Mine does not. Yesterday was a nightmare for me. I'm sure I will try again and will use a warm sock. If I could just test once a day I would be happy. She is scheduled to go in tomorrow morning for a test. I will certainly rethink my decision not to test. I know it is important. Just breaks my heart every time I have to stick her.

 

[Pookie (GA)]

I wonder if your vet clinic would be willing to allow a vet tech to give you a hands-on tutorial? (My vet all but insisted on it.) COVID rules are changing everything so I don't know if that's still in the cards, but there couldn't be any harm in asking?

When I first started testing Lola I did so in the bathroom sink. The depression of the sink helped to keep her contained, there was great lighting overhead, it was a convenient height, and there was a shelf right there to hold the things I was going to need. But best of all, in my tiny little bathroom the sink is surrounded by walls on three sides, and I could block her attempts to escape with my body on the fourth side. I think not being able to see an escape route helped to reduce her escape attempts. Is there a place in your home like that?

For what it's worth, we've only been testing about 2 months and Lola's so blase about it now that if she's asleep on the bed and I come over and start warming up her ear for a test she doesn't even lift her head. (Although she might open one eye to give me a sidelong stinkeye.) As Lola and I both became accustomed to the process it has just become a non-issue. Here's hoping the same for you!

 

[Summer and Susie (GA)]

I wonder if your vet clinic would be willing to allow a vet tech to give you a hands-on tutorial? (My vet all but insisted on it.) COVID rules are changing everything so I don't know if that's still in the cards, but there couldn't be any harm in asking?

When I first started testing Lola I did so in the bathroom sink. The depression of the sink helped to keep her contained, there was great lighting overhead, it was a convenient height, and there was a shelf right there to hold the things I was going to need. But best of all, in my tiny little bathroom the sink is surrounded by walls on three sides, and I could block her attempts to escape with my body on the fourth side. I think not being able to see an escape route helped to reduce her escape attempts. Is there a place in your home like that?

For what it's worth, we've only been testing about 2 months and Lola's so blase about it now that if she's asleep on the bed and I come over and start warming up her ear for a test she doesn't even lift her head. (Although she might open one eye to give me a sidelong stinkeye.) As Lola and I both became accustomed to the process it has just become a non-issue. Here's hoping the same for you!

I did get a hands-on tutorial from a vet technician. Of course, I was holding Susie so she couldn't run away. It figures that she would do just fine at the vets but not at my house. I like the idea of the bathroom sink. I have been trying to do this on a low table and I need to raise her up. The lighting would be better in there too. She seemed to accept the "rice in the sock" warm up for a brief time then tried to take off. I tried this this morning. I saw blood, today, but it smeared on her fur and she would not sit still for me to try to get a drop. I have seen videos where people smear a little vassoline on the ear to get the blood to "drop" instead of smear. I'll try all of this again later today. I like your "stinkeye" statement. Funny thing is Susie doesn't hold any grudges after going through all this trauma. She comes back and wants to be loved. Do you do anything special to get the blood to form a drop so it is easy to get the strip up next to it? Thanks for your support. There are a lot of supportive people on this site.

 

[Summer and Susie (GA)]

I wonder if your vet clinic would be willing to allow a vet tech to give you a hands-on tutorial? (My vet all but insisted on it.) COVID rules are changing everything so I don't know if that's still in the cards, but there couldn't be any harm in asking?

When I first started testing Lola I did so in the bathroom sink. The depression of the sink helped to keep her contained, there was great lighting overhead, it was a convenient height, and there was a shelf right there to hold the things I was going to need. But best of all, in my tiny little bathroom the sink is surrounded by walls on three sides, and I could block her attempts to escape with my body on the fourth side. I think not being able to see an escape route helped to reduce her escape attempts. Is there a place in your home like that?

For what it's worth, we've only been testing about 2 months and Lola's so blase about it now that if she's asleep on the bed and I come over and start warming up her ear for a test she doesn't even lift her head. (Although she might open one eye to give me a sidelong stinkeye.) As Lola and I both became accustomed to the process it has just become a non-issue. Here's hoping the same for you!

It is wonderful that you have Lola OTJ! I assume that means "off the juice"?

 

[Pookie (GA)]

Vaseline made ALL the difference for me! (That, and not trying to get blood from her paws.) Just a thin smear will allow the blood to pool into a drop instead of diffusing into her fur. Just be careful not to get any on the test strip so it can't suck up the blood!

I also don't actually plug the strip into the meter until I know I have enough blood. Then I reach over and push it all the way in (with the finger that doesn't have any vaseline on it). (I kept timing out or getting "not enough blood" error messages.) Some people "scoop" the blood drop onto a fingernail and then test from there. I've done that a few times when Lola was particularly squirmy.

Yes, Lola is Off the Juice We were very fortunate that simply a change to the low-carb diet, along with a few weeks of support with insulin injections, was all she needed at this point. Of course she's still a diabetic and therefore subject to fall out of remission, so she'll have to be monitored from here on. I'm only doing tests every other day now. My vet suggested twice a week, but I'm still too nervous for that.

I'm super lucky in that my vet is very experienced with diabetic cats and fully supported (and even suggested) home testing. I wish I had been doing it when she suggested it 20 years ago when we had our first diabetic cat. (But he managed to live a long life - albeit with one life-threatening DKA event - in spite of my clueless-ness.)

I know the whole diagnosis and testing is overwhelming, but it does get better. Really!

 

[Summer and Susie (GA)]

Thanks, Enid & Lola and Pookie. I'll try the vaseline this afternoon. What is a DKA event?

 

[Pookie (GA)]

.. What is a DKA event?

Diabetic ketoacidosis. A very, very, very scary (and expensive) thing: Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

I'm going to tag a couple of experienced members and ask if they would give you a proper answer because it's too important for me to risk giving misinformation @Critter Mom @tiffmaxee

 

[Summer and Susie (GA)]

Diabetic ketoacidosis. A very, very, very scary (and expensive) thing: Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

I'm going to tag a couple of experienced members and ask if they would give you a proper answer because it's too important for me to risk giving misinformation @Critter Mom @tiffmaxee

Wow, that sounds really scary, Pookie. I'm glad she pulled through. This diabetes thing is truly overwhelming. I thank you for your support.

 

[Katherine&Ruby]

Good video, Katherine. I watched a few videos yesterday about how to do the testing. Each cat would sit perfectly still. Mine does not. Yesterday was a nightmare for me. I'm sure I will try again and will use a warm sock. If I could just test once a day I would be happy. She is scheduled to go in tomorrow morning for a test. I will certainly rethink my decision not to test. I know it is important. Just breaks my heart every time I have to stick her.

I understand feeling heartbroken! I did too until I got the technique right. Ruby also began associating the experience with nice things--being rubbed with a warm sock, a nice meal or snack immediately after--so when I pick her up to bring her to the chair to do her testing, she now sits right down and waits for it to happen. She also knows that until we hear the beeps from the meter that no one is going anywhere. Never thought one could train a cat but this is about as close as I've come. It took me SIX WEEKS of crying, scabby ears, tons of Neosporin ointment, dozens of test strips and about 50 gray hairs that sprouted from my head but we did it! Yesterday I tested her 11 times, and trust me, she still loves me.

 

[Summer and Susie (GA)]

I understand feeling heartbroken! I did too until I got the technique right. Ruby also began associating the experience with nice things--being rubbed with a warm sock, a nice meal or snack immediately after--so when I pick her up to bring her to the chair to do her testing, she now sits right down and waits for it to happen. She also knows that until we hear the beeps from the meter that no one is going anywhere. Never thought one could train a cat but this is about as close as I've come. It took me SIX WEEKS of crying, scabby ears, tons of Neosporin ointment, dozens of test strips and about 50 gray hairs that sprouted from my head but we did it! Yesterday I tested her 11 times, and trust me, she still loves me.

Thank you for the encouraging words. I need them! Can't believe you are testing 11 times a day. Susie went to the vet last Thursday. Her glucose was down to 220 and she dropped .3 lbs. The vet was happy. She went from a glucose reading of 299 to 220 in a week. Do you use vaseline on the ear tips? Seems her blood just smears into her fur. I take her in for her first "curve" next Wednesday.

 

[Critter Mom]

Hi Summer,

Here is the testing method I used. Perhaps it might give you some ideas to add to your own testing technique.

1. For most meters you can insert a test strip part way without switching it on. Once you've done the poke you can then push the strip the rest of the way into the meter to activate it. (Reduces the likelihood that the meter will time out before you can get the blood sample onto the strip.)
   
   
2. Fold a sheet of kitchen paper in four lengthwise and cut it up into 1" strips. You will use these to cushion and support the ear during the test.
   
   
3. Apply a thin film of Vaseline or Neosporin ointment (not the cream!) onto the edge of the ear to help the blood sample bead up instead of wicking into the fur. (Wipe off any excess.)
   
   
4. To get a blood sample you need to increase the blood flow to the ear, so make sure the ear is really, really, really warm (but not hot) - especially in the early days of testing. (Note: With repeated 'poking', more capillaries form in the test area, so it becomes easier to get samples reliably.)
   
   
5. Once you have the testing area of the ear well warmed, wrap a strip of folded kitchen paper round your index finger then place finger under the sweet spot area of the ear you're testing to support it during the poke.
   
   
6. Use your thumb and middle finger to lightly but firmly grip the ear and paper strip in place so that the edge of the ear is taut but not overstretched; the little bit of tension will make it easier for the lancet to break the skin surface (and it helps to keep kitty's head from moving around too much).
   
   
7. When using a lancet 'freehand', make sure the bevelled side of the lancet is facing upwards. Hold the lancet at a slight angle to the ear similar to the way you hold a pen when writing, not perpendicular (easier to see where you're aiming and also makes skin prick easier).
   
   
8. When it comes to the actual poke, prick the sweet spot on the edge of the ear in a similar way to how you might quickly prick a balloon with the tip of a needle to make it pop. If you aim as close to the edge of the ear as possible you are less likely to hit the marginal ear vein.
   
   
9. Keep hold of the ear while you're pushing the test strip into the meter to activate it. (Kitties are prone to shake their heads after a poke, sending your precious blood sample flying across the room. Holding the ear reduces likelihood of this happening.)
   
   Note: As you become more practised in testing, you'll be able to activate the meter just before doing the poke and still have plenty of time to collect the sample on the strip before it times out.
   
   
10. When using the glucometer, bring the test strip to where it j-u-s-t comes into contact with the blood droplet and hold it there. The strip should then 'sip up' the amount it needs to run a valid test. Most meters beep or give a visual cue to let you know that enough blood has been collected on the strip.
    
    If your cat is a wriggler, try collecting the blood sample on the back of your (clean) fingernail and test it from there.
    
    If a test fails and you still have a lot of blood on the strip from the failed test, don't throw it away. Instead, you could pop another strip into the meter and test using the blood on the strip from the first test. (Saves an additional poke so also helpful for wriggly kitties!)
    
    
11. After the test, fold the paper strip over the edge of the ear and apply gentle pressure to the test area for about 20-30 seconds to minimise bruising.
    
    
12. Keep giving lots of praise throughout the process and reward with a favourite diabetic-friendly treat or favourite activity (e.g. brushing).

With a bit of time and practice you'll be able to work out a technique and a routine that works best for you and Susie.

Mogs
.

 

[Katherine&Ruby]

Thank you for the encouraging words. I need them! Can't believe you are testing 11 times a day. Susie went to the vet last Thursday. Her glucose was down to 220 and she dropped .3 lbs. The vet was happy. She went from a glucose reading of 299 to 220 in a week. Do you use vaseline on the ear tips? Seems her blood just smears into her fur. I take her in for her first "curve" next Wednesday.

I used Neosporin ointment on her ears at first because I heard it would help pool the blood and it also helped with healing but now I only use the ointment on her ears at the end of the night for healing. Ruby’s ears have “learned to bleed” and so if I have the lancing device properly positioned with my finger supporting the ear with a piece of gauze, I get a nice drop of blood without any Vaseline or ointment. She does of course decide to move, flick her ear, or do a whole host of things that makes it difficult to get it into he first try, especially at 6:45 AM when I haven’t had my coffee yet!

I did not test her 11 times a day when Ruby was in higher numbers. I would get away with a minimum of 4 tests a day with SLGS. I test her more now because we’re doing TR or tight regulation and she has earned a lot of reductions very quickly and hovers around some low numbers that require more monitoring. The more I test, the more I can be confident that I am catching the times she dips below 50 and can guide her back up with food or honey and also know to reduce her dose during the next shot time. The testing has become a part of our daily rhythm. I plan the rest of my life around it as much as I can, hoping that we can get closer to remission more quickly. Another reason to test: you can adjust doses more quickly if you do it at home rather than curves every few weeks at the vet and therefore can achieve remission more quickly if that’s in the stars for your cat. The longer the cat remains a diabetic the harder that goal becomes to achieve. Please see my Ruby’s spreadsheet as an example. My vet wanted me to adjust doses every 2-3 weeks based on in office curves. She would still be unregulated if I listened to him.

 

[Critter Mom]

Another few tips:

1. Stick to the one spot for testing. In the early days, try bringing Susie to the testing spot and just give fusses and diabetic-friendly treats several times a day. Only test when you actually need the readings. It may help Susie to associate the testing station more with good things happening and less with the occasional ear poke.

2. Try reframing your view of testing as a really good and loving thing to do, not as a thing that hurts (cats don't have that many nerve endings in their ears) but as a thing that protects (keeping Susie safe from hypoglycaemia).

3. Cats are notorious for picking up on our emotional states. If you're tense and upset about testing then Susie is likely to feel the same way. Whenever you bring her to her testing station, try talking in a very positive tone of voice, praising her all the way. And sing! It changes your own mental state and helps you to feel more relaxed, even if it just makes you laugh at yourself for doing it! That could help Susie feel more reassured and accepting of the activity.


Mogs
.

 

[Teresa & KitKat]

My 8 year, 8 month old kitty, Susie, has just been diagnosed with diabetes. I don't have a problem with the insulin injections but she doesn't like her current prescription diet (expensive). My Vet wants her on a prescription diet but if she isn't going to eat it I am not going to give her the shots. She was given the Hills W/D (wet) and I have also ordered the Hills W/D dry which I have not received. I also ordered the wet Purina DM and wet Royal Canine Glycobalance. If she won't eat these foods I am going to be devastated. I have read, in other sites, that the prescription diets are not necessary and that the Fancy Feast Classic are a good alterative. She like Fancy Feast and has been eating it for years. What do I do if my Vet will not allow it?

I just wanted to say, pretty kitty.

 

[Summer and Susie (GA)]

Hi Summer,

Here is the testing method I used. Perhaps it might give you some ideas to add to your own testing technique.

1. For most meters you can insert a test strip part way without switching it on. Once you've done the poke you can then push the strip the rest of the way into the meter to activate it. (Reduces the likelihood that the meter will time out before you can get the blood sample onto the strip.)
   
   
2. Fold a sheet of kitchen paper in four lengthwise and cut it up into 1" strips. You will use these to cushion and support the ear during the test.
   
   
3. Apply a thin film of Vaseline or Neosporin ointment (not the cream!) onto the edge of the ear to help the blood sample bead up instead of wicking into the fur. (Wipe off any excess.)
   
   
4. To get a blood sample you need to increase the blood flow to the ear, so make sure the ear is really, really, really warm (but not hot) - especially in the early days of testing. (Note: With repeated 'poking', more capillaries form in the test area, so it becomes easier to get samples reliably.)
   
   
5. Once you have the testing area of the ear well warmed, wrap a strip of folded kitchen paper round your index finger then place finger under the sweet spot area of the ear you're testing to support it during the poke.
   
   
6. Use your thumb and middle finger to lightly but firmly grip the ear and paper strip in place so that the edge of the ear is taut but not overstretched; the little bit of tension will make it easier for the lancet to break the skin surface (and it helps to keep kitty's head from moving around too much).
   
   
7. When using a lancet 'freehand', make sure the bevelled side of the lancet is facing upwards. Hold the lancet at a slight angle to the ear similar to the way you hold a pen when writing, not perpendicular (easier to see where you're aiming and also makes skin prick easier).
   
   
8. When it comes to the actual poke, prick the sweet spot on the edge of the ear in a similar way to how you might quickly prick a balloon with the tip of a needle to make it pop. If you aim as close to the edge of the ear as possible you are less likely to hit the marginal ear vein.
   
   
9. Keep hold of the ear while you're pushing the test strip into the meter to activate it. (Kitties are prone to shake their heads after a poke, sending your precious blood sample flying across the room. Holding the ear reduces likelihood of this happening.)
   
   Note: As you become more practised in testing, you'll be able to activate the meter just before doing the poke and still have plenty of time to collect the sample on the strip before it times out.
   
   
10. When using the glucometer, bring the test strip to where it j-u-s-t comes into contact with the blood droplet and hold it there. The strip should then 'sip up' the amount it needs to run a valid test. Most meters beep or give a visual cue to let you know that enough blood has been collected on the strip.
    
    If your cat is a wriggler, try collecting the blood sample on the back of your (clean) fingernail and test it from there.
    
    If a test fails and you still have a lot of blood on the strip from the failed test, don't throw it away. Instead, you could pop another strip into the meter and test using the blood on the strip from the first test. (Saves an additional poke so also helpful for wriggly kitties!)
    
    
11. After the test, fold the paper strip over the edge of the ear and apply gentle pressure to the test area for about 20-30 seconds to minimise bruising.
    
    
12. Keep giving lots of praise throughout the process and reward with a favourite diabetic-friendly treat or favourite activity (e.g. brushing).

With a bit of time and practice you'll be able to work out a technique and a routine that works best for you and Susie.

Thank you for all this wonderful information. My cat is a wriggler but, like so many have said, I think she is picking up on my nervousness. I printed out what you said. I had to get my Mom to hold her this afternoon - in a towel in the sink. I can see so much better in there (better light) and she is better controlled. We tried on my bed and after poking her several times, with no success, I decided to go with a tip Enid gave me. Try the bathroom sink. Her glucose went up to 242 7 hours after her morning shot. I asked the vet if I could increase her food at her two feedings because she was getting very hungry. I have only been giving her one 3 oz can in the morning and at night. He said I could try one and a half cans. I'm wondering if that is why is glucose went back up or if it had just been a while since her insulin shot. Shouldn't the glucose go down when it has been a while since the shot and the food?

Mogs
.

 

[Summer and Susie (GA)]

I used Neosporin ointment on her ears at first because I heard it would help pool the blood and it also helped with healing but now I only use the ointment on her ears at the end of the night for healing. Ruby’s ears have “learned to bleed” and so if I have the lancing device properly positioned with my finger supporting the ear with a piece of gauze, I get a nice drop of blood without any Vaseline or ointment. She does of course decide to move, flick her ear, or do a whole host of things that makes it difficult to get it into he first try, especially at 6:45 AM when I haven’t had my coffee yet!

I did not test her 11 times a day when Ruby was in higher numbers. I would get away with a minimum of 4 tests a day with SLGS. I test her more now because we’re doing TR or tight regulation and she has earned a lot of reductions very quickly and hovers around some low numbers that require more monitoring. The more I test, the more I can be confident that I am catching the times she dips below 50 and can guide her back up with food or honey and also know to reduce her dose during the next shot time. The testing has become a part of our daily rhythm. I plan the rest of my life around it as much as I can, hoping that we can get closer to remission more quickly. Another reason to test: you can adjust doses more quickly if you do it at home rather than curves every few weeks at the vet and therefore can achieve remission more quickly if that’s in the stars for your cat. The longer the cat remains a diabetic the harder that goal becomes to achieve. Please see my Ruby’s spreadsheet as an example. My vet wanted me to adjust doses every 2-3 weeks based on in office curves. She would still be unregulated if I listened to him.

Looks like you are getting some good numbers but I am confused. If the numbers are low shouldn't the insulin shot be reduced. I am still trying to wrap my mind around all of this. I was able to get a test this afternoon but only after my Mom helped hold her, I poked her several times and then finally moved her to the bathroom sink where we had better control and light. I went up from 220 last Thursday morning to 242 this afternoon. I did increase her food this morning from one (1) 3oz can to 1 1/2 3oz cans. I wonder if that is why her glucose went up. Also, it was seven hours after her morning shot.

 

[Summer and Susie (GA)]

I just wanted to say, pretty kitty.

Thank you and Buddy is a handsome ginger! Is Buddy still with you? I don't see anything on the spreadsheet after August.

 

[Summer and Susie (GA)]

I just wanted to say, pretty kitty.

Another few tips:

1. Stick to the one spot for testing. In the early days, try bringing Susie to the testing spot and just give fusses and diabetic-friendly treats several times a day. Only test when you actually need the readings. It may help Susie to associate the testing station more with good things happening and less with the occasional ear poke.

2. Try reframing your view of testing as a really good and loving thing to do, not a thing that hurts (cats don't have that many nerve endings in their ears) but a thing that protects (keeping Susie safe from hypoglycaemia).

3. Cats are notorious for picking up on our emotional states. If you're tense and upset about testing then Susie is likely to feel the same way. Whenever you bring her to her testing station, try talking in a very positive tone of voice, praising her all the way. And sing! It changes your own mental state and helps you to feel more relaxed, even if it just makes you laugh at yourself for doing it! That could help Susie feel more reassured and accepting of the activity.


Mogs
.

Thanks for the tips. I think I'll be doing it in the bathroom sink from now on. I have better light and more control if she is wrapped in a towel. I'm sure she is picking up on my stress and I have to have my Mom hold her so that is also totally new. She is so sweet and never seems to hold a grudge - no matter how many times I stick her.

 

[Teresa & KitKat]

Buddy is still with me, I cannot seem to keep his SS up to date any more. I am going to try again in 2021 to start over with his SS. Buddy, is a true Blonde Beauty, not ginger. A lot of people see his picture and think he is a ginger kitty, but he is not.

 

[Summer and Susie (GA)]

Buddy is still with me, I cannot seem to keep his SS up to date any more. I am going to try again in 2021 to start over with his SS. Buddy, is a true Blonde Beauty, not ginger. A lot of people see his picture and think he is a ginger kitty, but he is not.

Hard to tell in the picture. Whether he is ginger or blonde - he is beautiful. I am so happy your "blonde beauty" is still with you.

 

[Critter Mom]

Summer wrote (in post #68):

Her glucose went up to 242 7 hours after her morning shot. I asked the vet if I could increase her food at her two feedings because she was getting very hungry. I have only been giving her one 3 oz can in the morning and at night. He said I could try one and a half cans. I'm wondering if that is why is glucose went back up or if it had just been a while since her insulin shot. Shouldn't the glucose go down when it has been a while since the shot and the food?​

With Vetsulin, typically at +7 hours after administration the effect of the dose pretty much peter's out. Here's an illustration of an 'ideal' response to Vetsulin for a feline diabetic:

As you can see, Vetsulin's typical duration in cats isn't great (lasts longer in dogs because their metabolisms are different).

Because Susie's not yet regulated her body isn't currently able to utilise the nutrients she eats hence the unusual hunger, and it's common to feed extra to unregulated cats - especially if they are underweight. A substantial feed is needed 30 minutes before insulin administration because Vetsulin typically hits hard and fast. Thereafter, it's OK to give smaller feeds, ideally before +7. The only time grub should be withheld completely (assuming the cat is not in low numbers) is in the two hour period prior to the preshot reading, since this should not be influenced by food.

Glucose gets into the bloodstream when food is digested at mealtimes and also from the liver between meals. The liver stores sugar in the form of glycogen and breaks it down into glucose again between meals to provide fuel for the body's metabolic processes (glycogenolysis). The liver can also synthesize 'new' glucose from the body's stores of fat and protein - a process called gluconeogenesis - and then release that to provide the body with fuel. Therefore, even if it's a long time after a meal has been eaten it is very much possible for BG levels to rise due to sugars released from the liver, especially when the insulin dose is wearing off.


Mogs
.

 

[Teresa & KitKat]

Hard to tell in the picture. Whether he is ginger or blonde - he is beautiful. I am so happy your "blonde beauty" is still with you.

I also like black and black & white kitty's. Good luck, you are getting a lot of good info from people with a lot of knowledge.

 

[Katherine&Ruby]

Looks like you are getting some good numbers but I am confused. If the numbers are low shouldn't the insulin shot be reduced. I am still trying to wrap my mind around all of this.

Don't worry, it's a TON of information to absorb and there's a huge learning curve. If you look at the U column in Ruby's spreadsheet, you will see the units of insulin I'm shooting everyday. I adjust her dosage according to her nadirs or lowest numbers in the cycle. I've chosen to increase her dose at times when her nadirs weren't getting low enough, as is happening recently where we are going back and forth between two different doses. You will see that in nearly every single case there is a lime green number on the spreadsheet, I reduce her dose by .25 units. Ideally we want Ruby to remain in the range of 50-80 in order for a strong remission to take hold and we haven't gotten there yet, hence the increases in dosage.

 

[Summer and Susie (GA)]

Summer wrote (in post #68):

Her glucose went up to 242 7 hours after her morning shot. I asked the vet if I could increase her food at her two feedings because she was getting very hungry. I have only been giving her one 3 oz can in the morning and at night. He said I could try one and a half cans. I'm wondering if that is why is glucose went back up or if it had just been a while since her insulin shot. Shouldn't the glucose go down when it has been a while since the shot and the food?​

With Vetsulin, typically at +7 hours after administration the effect of the dose pretty much peter's out. Here's an illustration of an 'ideal' response to Vetsulin for a feline diabetic:

As you can see, Vetsulin's typical duration in cats isn't great (lasts longer in dogs because their metabolisms are different).

Because Susie's not yet regulated her body isn't currently able to utilise the nutrients she eats hence the unusual hunger, and it's common to feed extra to unregulated cats - especially if they are underweight. A substantial feed is needed 30 minutes before insulin administration because Vetsulin typically hits hard and fast. Thereafter, it's OK to give smaller feeds, ideally before +7. The only time grub should be withheld completely (assuming the cat is not in low numbers) is in the two hour period prior to the preshot reading, since this should not be influenced by food.

Glucose gets into the bloodstream when food is digested at mealtimes and also from the liver between meals. The liver stores sugar in the form of glycogen and breaks it down into glucose again between meals to provide fuel for the body's metabolic processes (glycogenolysis). The liver can also synthesize 'new' glucose from the body's stores of fat and protein - a process called gluconeogenesis - and then release that to provide the body with fuel. Therefore, even if it's a long time after a meal has been eaten it is very much possible for BG levels to rise due to sugars released from the liver, especially when the insulin dose is wearing off.


Mogs
.

Strange how you give them insulin to lower the blood glucose but the body kicks in to provide more. I only gave her one can (3 oz) this morning at 5:30 . I would like to feed her a half a can around noon just to space out the food. I feed her again around 4:00 pm. She is always really hungry around then. Do you think that would be okay instead of giving her 1 1/2 cans all at once in the morning? Also, what diabetic treats can you recommend? I've been giving her Purebites Chicken Breast and Catnip and have on order the Purebred Beef and Liver. These are freeze dried. Thanks, Mogs.

 

[Summer and Susie (GA)]

Don't worry, it's a TON of information to absorb and there's a huge learning curve. If you look at the U column in Ruby's spreadsheet, you will see the units of insulin I'm shooting everyday. I adjust her dosage according to her nadirs or lowest numbers in the cycle. I've chosen to increase her dose at times when her nadirs weren't getting low enough, as is happening recently where we are going back and forth between two different doses. You will see that in nearly every single case there is a lime green number on the spreadsheet, I reduce her dose by .25 units. Ideally we want Ruby to remain in the range of 50-80 in order for a strong remission to take hold and we haven't gotten there yet, hence the increases in dosage.

Katherine, isn't 50 a really low number for the glucose. Seems dangerous. My vet said he would be happy if Susie's glucose was in the low 100's. I feel like I need to be a "rocket scientist" to understand all this. Was it a struggle for you too?

 

[Summer and Susie (GA)]

Is there a book like "Understanding Diabetes in Cats - for Dummies"? I would love a good reference book on feline diabetes that is easy to understand.

 

[Katherine&Ruby]

Katherine, isn't 50 a really low number for the glucose. Seems dangerous. My vet said he would be happy if Susie's glucose was in the low 100's. I feel like I need to be a "rocket scientist" to understand all this. Was it a struggle for you too?

You've only been a part of this forum for 10 days. Keep asking questions, you don't need to be a rocket scientist! It was a HUGE struggle for me. I was so emotional and felt like I couldn't retain any information, I was so overwhelmed. But I read every sticky, started following the journeys of the other cats and caregivers on the Lantus forum and study their spreadsheets. I also look at the spreadsheets of cats who have gone into remission so I can understand how they got there. This board has become an important part of my daily life and the people here are my lifeline.

The vet's job is to keep your cat as safe as possible, which means assuming you don't know how to deal with lower numbers or hypoglycemic events. The people on the board can help you through it. And there's nothing wrong with numbers in the 100s, but for a strong remission to take hold we need the bg levels to be lower. There's also a wide range of opinion as to what levels of BG are "healthy" for a cat if you do a search on the web. That's why Tight Regulation is an aggressive method because it pushes for a lower bg range in order to have the greatest success. Here is a sticky on the two dosing methods that I read on a nearly daily basis so I can understand and even so I still mess it up as I did this morning! Here's the paragraph from that sticky re: getting your cat to remission (OTJ means "off the juice"):

• We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL) overall.

 

[Katherine&Ruby]

Strange how you give them insulin to lower the blood glucose but the body kicks in to provide more.

This is called "bouncing" and your cat needs to be on insulin for it to go through "liver training school" so that it stops dumping glucose into the blood when sugar levels become lower than the cat is used to. Here is a whole conversation on bouncing that I found super helpful!

 

[Summer and Susie (GA)]

This is called "bouncing" and your cat needs to be on insulin for it to go through "liver training school" so that it stops dumping glucose into the blood when sugar levels become lower than the cat is used to. Here is a whole conversation on bouncing that I found super helpful!

Good explanation and I think I actually understood it! I also printed it. Thanks!

 

[Summer and Susie (GA)]

Okay, folks, I need some advice. After Susie's first curve last Wednesday (12/30) her insulin was increased from 1 unit to 1.5 units. She seemed fine (although I had not been testing her) until yesterday morning when she only at 2/3 of her breakfast. This is VERY unusual for her. Last night she barely touched her dinner so I did not give her a shot. This morning she acted hungry but just ate a small portion - mostly licking the juices. I went ahead and gave her 1 unit of insulin. Her lack of appetite made me nervous so I made myself test her glucose about 3 hours after her shot. It was down to 154. A good number but I am alarmed that she has lost her appetite. I spoke to the vet. He is also concerned and said it could be something other than the diabetes. I checked her blood again 7 hours after her shot and it is up to 165. I will see if she eats tonight and check her blood before I feed her. Vet said if the numbers fall into the low 100's then I should skip the injection. Anybody else experience something similar with a lack of appetite with an increase in insulin? Thanks so much. I thought we were doing pretty good but I am more concerned that she eats than the high numbers with diabetes.

 

[Katherine&Ruby]

Hi Summer, I don't think it's the insulin that is causing a loss of appetite but rather high glucose levels. When Ruby was in high numbers she lost her appetite a lot. I gave her cerenia for nausea and mirtazapine if she went for hours without eating and that always did the trick. You can get these from your vet. Since her glucose levels became regulated her appetite has been pretty good though she has short lived moments of inappetence or just plain finickiness. You should always do a test before her shot and before feeding her. I make sure Ruby has her head in the bowl eating when I give her her shot or has eaten shortly before as you shouldn't give insulin if the cat won't eat.

Very often when a dose is increased, cats go through what we call here New Dose Wonkiness, where BG levels are elevated for a short period of time before they start to go down, but we don't know where Susie's BGs are because you're not testing enough.

 

[Summer and Susie (GA)]

Hi Summer, I don't think it's the insulin that is causing a loss of appetite but rather high glucose levels. When Ruby was in high numbers she lost her appetite a lot. I gave her cerenia for nausea and mirtazapine if she went for hours without eating and that always did the trick. You can get these from your vet. Since her glucose levels became regulated her appetite has been pretty good though she has short lived moments of inappetence or just plain finickiness. You should always do a test before her shot and before feeding her. I make sure Ruby has her head in the bowl eating when I give her her shot or has eaten shortly before as you shouldn't give insulin if the cat won't eat.

Very often when a dose is increased, cats go through what we call here New Dose Wonkiness, where BG levels are elevated for a short period of time before they start to go down, but we don't know where Susie's BGs are because you're not testing enough.

I agree. I am not testing enough. My fear of her being ill forced me to test twice today. It gave me a little confidence to do more testing especially when she is not "normal". Hopefully, she will eat a good meal tonight and I will be able to sleep. It is strange to me that with her glucose levels being pretty good today she still has no appetite. Thanks for getting back with me, Katherine.

 

[Katherine&Ruby]

I agree. I am not testing enough. My fear of her being ill forced me to test twice today. It gave me a little confidence to do more testing especially when she is not "normal". Hopefully, she will eat a good meal tonight and I will be able to sleep. It is strange to me that with her glucose levels being pretty good today she still has no appetite. Thanks for getting back with me, Katherine.

You're very welcome! It's hard to say that her glucose levels are pretty good today because you only have data for 2 out of the last 24 hours. You should try to test before every shot and at least once or twice in between shots to get a fuller picture of what's going on. She could be bouncing into very high numbers and we're just not seeing that because there aren't tests.

Did your vet rule out pancreatitis?

 

[Critter Mom]

Hi Summer,

his morning she acted hungry but just ate a small portion - mostly licking the juices

Here's a helpful page on nausea symptoms and treatments (licking the juice but leaving the rest when normally a kitty would eat everything could potentially be due to nausea). If you recognise any of the symptoms in the list then that might be helpful info for your vet.

In the interim, I'd suggest raising Susie's food and water bowls a few inches (e.g. by sticking a couple of paperbacks under them) to see whether that might make it more comfortable for her to eat (no need to bend down to the food). I'd also suggest monitoring Susie's pee for ketones as a safety precaution.

If she doesn't start eating normally overnight I'd suggest asking your vet whether it might be advisable to run a test for pancreatitis (often a fellow traveller with diabetes).


Mogs
.

 

[Summer and Susie (GA)]

Hi Summer,


Here's a helpful page on nausea sympto

You're very welcome! It's hard to say that her glucose levels are pretty good today because you only have data for 2 out of the last 24 hours. You should try to test before every shot and at least once or twice in between shots to get a fuller picture of what's going on. She could be bouncing into very high numbers and we're just not seeing that because there aren't tests.

Did your vet rule out pancreatitis?

You're very welcome! It's hard to say that her glucose levels are pretty good today because you only have data for 2 out of the last 24 hours. You should try to test before every shot and at least once or twice in between shots to get a fuller picture of what's going on. She could be bouncing into very high numbers and we're just not seeing that because there aren't tests.

Did your vet rule out pancreatitis?

ms and treatments (licking the juice but leaving the rest when normally a kitty would eat everything could potentially be due to nausea). If you recognise any of the symptoms in the list then that might be helpful info for your vet.

In the interim, I'd suggest raising Susie's food and water bowls a few inches (e.g. by sticking a couple of paperbacks under them) to see whether that might make it more comfortable for her to eat (no need to bend down to the food). I'd also suggest monitoring Susie's pee for ketones as a safety precaution.

If she doesn't start eating normally overnight I'd suggest asking your vet whether it might be advisable to run a test for pancreatitis (often a fellow traveller with diabetes).


Mogs
.

 

[Critter Mom]

I am floored though - her glucose level went from 165 this afternoon at 1:15 to 302 at 3:45.

One can only speculate about what's happening without a preshot BG reading. The 302 reading at +9.5 would have been taken after the time when a Vetsulin dose has typically petered out. It's possible that the 302 might be somewhat elevated by bouncing. It's also possible that Susie's preshot BG may have been round about the same level as the +9.5 reading. Vetsulin typically produces bucket-shaped curves.

(When you have a minute, Summer, for safety and security I'd suggest taking down the pdf with the lab results, removing your personally sensitive info (addr) and then uploading an anonymised version.)


Mogs
.

 

[Katherine&Ruby]

Summer, please look at Ruby's spreadsheet, using October 29, 2020 as an example when we were still looking for the right dose. https://docs.google.com/spreadsheet...y8i6gV3whR0ZDyqUFzRGdSl_tI/edit#gid=361360320

You will see there are numbers in all colors of the rainbow on some days. The pinks and reds are Ruby bouncing from the green numbers. Once her liver got accustomed to lower numbers, she stopped bouncing and her numbers leveled out. This could be happening with Susie.

Nothing goes in a straight line with feline diabetes it seems, so try not to worry about numbers that bounce around a lot at the beginning. With consistent dosing, Susie should be able to level out.

 

[Summer and Susie (GA)]

Thanks, Mogs and Katherine. I was going to get a preshot reading this morning but Susie had gone in, during the early morning hours, and eaten her left-over dinner from the previous night so I didn't feel the reading would be helpful after she had eaten. Yes, I need to remember the "bouncing" aspect. Mogs, thanks for the advice about the blood test. I guess I can be too trusting. Katherine, I see the "bouncing" on Ruby's spreadsheet for 10/29. Happily, Susie's appetite seems to have returned. I gave her a shot at 6:30 and will test around 8:30. I have two additional questions. Can you reuse the lancets if you sterilize with hot water? Seems a waste to use them once then throw them away. Also, please recommend some good diabetic treats. I have tried the Purebites freeze dried but she does not like them. I would like to reward her with a treat after I test. As always - thank you, ladies!

 

[Critter Mom]

Happily, Susie's appetite seems to have returned.

Glad to hear this.

Can you reuse the lancets if you sterilize with hot water? Seems a waste to use them once then throw them away.

The tips of the lancets degrade markedly after even a single use, so they wouldn't be as sharp.

Also, please recommend some good diabetic treats. I have tried the Purebites freeze dried but she does not like them. I would like to reward her with a treat after I test.

You could perhaps try poaching or baking chicken breast and cutting it up into treat-sized pieces. You could then freeze the diced chicken in small portions and thaw out one portion each day to use for post-test treats.


Mogs
.

 

[Summer and Susie (GA)]

Glad to hear this.


The tips of the lancets degrade markedly after even a single use, so they wouldn't be as sharp.


You could perhaps try poaching or baking chicken breast and cutting it up into treat-sized pieces. You could then freeze the diced chicken in small portions and thaw out one portion each day to use for post-test treats.


Mogs
.

Thanks, Mogs. Was hoping to find a treat I could buy but will buy chicken breast the next time I shop. I just got a 125 bg reading at +5 hrs 45 minutes. She is really hungry. Will check her blood again before I feed her dinner at 4:00 pm. I don't wait the 12 hours between the meals. Normally she cannot tolerate a 12 hour wait during the day.

 

[Summer and Susie (GA)]

I spoke with my vet today. He told me not to do too many glucose test. He doesn't want to stress Susie or me. He also said he does not want to change the insulin dose on a whim. He said it was more important that she is not stressed and that we keep the dose the same for now and allow her to graze on her food since she is not eating like she used to. Susie had her highest and lowest blood glucose today. I guess this is the "bouncing" but I will go along with what he says. No adjustment on insulin at this time. I will remain with the dosage and not feel the pressure to stress her with a test prior to her morning food and shot. I will give her the insulin injections 20 to 30 minutes after her morning meal and will test only a couple of times the remaining day. I have to go with my vet's recommendations and will not feel pressured to test constantly.

 

[Marje and Gracie]

Hi Summer, I don't think it's the insulin that is causing a loss of appetite but rather high glucose levels. When Ruby was in high numbers she lost her appetite a lot. I gave her cerenia for nausea and mirtazapine if she went for hours without eating and that always did the trick. You can get these from your vet. Since her glucose levels became regulated her appetite has been pretty good though she has short lived moments of inappetence or just plain finickiness. You should always do a test before her shot and before feeding her. I make sure Ruby has her head in the bowl eating when I give her her shot or has eaten shortly before as you shouldn't give insulin if the cat won't eat.

Very often when a dose is increased, cats go through what we call here New Dose Wonkiness, where BG levels are elevated for a short period of time before they start to go down, but we don't know where Susie's BGs are because you're not testing enough.

New Dose Wonkiness does not occur with Vetsulin Its specific to Lantus and Levemir.

 

[Summer and Susie (GA)]

New Dose Wonkiness does not occur with Vetsulin Its specific to Lantus and Levemir.

Thank you, Marje. She only had two, maybe three days where she lost her appetite. Strange that on 1/4 and 1/5 she had a couple of good BG readings but these were the days she did not eat well. I cannot figure out this diabetes disease. Nothing makes sense to me but I continue to follow my vet's recommendations and we will see where it leads.

 

[Summer and Susie (GA)]

New Dose Wonkiness does not occur with Vetsulin Its specific to Lantus and Levemir.

According to AAHA: "Note: When selecting products, veterinarians have a choice among those formulated for humans and those developed and approved by veterinary use. Manufacturers of veterinary-specific products spend resources to have their products reviewed and approved by the FDA for canine or feline use. These products are specifically designed and formulated for dogs and cats and have benefits for their use; they are not human generic products. AAHA suggests that veterinary professionals make every effort to use veterinary FDA-approved products and base their inventory-purchasing decisions on what product is most beneficial to the patient". I don't think that Lantus or Levemir were developed and approved for veterinary use - were they? Maybe this is why my Vet has prescribed the Vetsulin. Marge, what kind of food did you/do you feed Gracie to get her BG under control? How much? How often? Thank you.

 

[Summer and Susie (GA)]

Glad to hear this.


The tips of the lancets degrade markedly after even a single use, so they wouldn't be as sharp.


You could perhaps try poaching or baking chicken breast and cutting it up into treat-sized pieces. You could then freeze the diced chicken in small portions and thaw out one portion each day to use for post-test treats.


Mogs
.

What do you feed your kitty? I'm thinking Fancy Feast Classic is not the best but she would not eat the Hill's WD (too high in carbs anyway) and will eat the Royal Canine Glycobalance but not all the time? She never seems full. She only gets one 3 oz can in the morning and one 3 oz can in late afternoon.

 

[Critter Mom]

I'm in the UK so we have a different range of cat foods available. Saoirse had chronic pancreatitis so that greatly limited what she could eat. She settled on Sheba Fine Flakes in Jelly pouches (chicken and turkey only). I used to weigh her weekly, keep a log of how much she was eating (adjusting amount fed as needed), and regularly assessed her physical form against a body condition chart.

She never seems full.

Cats will be hungrier when they're in higher numbers (body can't use the nutrients properly).

Cats may get hungrier when they're in low numbers (but there's no guarantee they will be able to seek food, hence importance of testing mid-cycle).

I think that FF classics only have about 90-ish kilocalories per can. As a very rough guide, a cat should need about 20kcals per lb of ideal weight per day (more if trying to regain weight, less if weight needs to be lost). There's helpful info on calorie requirements and weight management at this link.


Mogs
.

 

[Summer and Susie (GA)]

Mogs, the link you sent has a lot of good information. I had read some of the "Feline Diabetes" section recently. I just wish I could understand what is going on. Susie is up and down, up and down even though I try to be consistent with the food and the times she is fed and when her shots are given. We just increased her insulin to 1.25 because she had a score of 446 on 1/8. I had never had a score that big and it scared me. Anyway, I appreciate your help. Maybe like someone tried to explain - she is "bouncing". I'm doing so much better with the testing. I never thought I would get to the point where I was comfortable but she is more comfortable with it now so that helps me. Wish I had a really low (in carbs) dry food that I could throw around the room to get her to chase for exercise. Or a really safe treat but it seems all dry food is bad. Thank you, again!