New Members/Lynn and Kitten

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Katlyn

Member Since 2012
Hello everyone. It was suggested that I join this group because my 11 year old cat is now on insulin 1.5 units twice a day. I am injecting her without knowing her numbers. Scary. I have the monitor and had trouble pricking her ear. I bought new 26 guage lancets today to try. I would not know how to adjust her insulin anyway at this point. She has an appt tomorrow at the 24 hour hospital with an IM vet.She is getting that Fructosamine test. She has an etube and will not eat much on her own. Kitten had almost died from DKA last week brought on by a high dose of Prednisone to control her asthma/lung issues. Sue is helping me do a spreadsheet today. She is being weaned off within a week using Prednislone. I want her OTJ or at least to feel better and get that tube out. I am hopeful I have found help. Time to go feed Kitten. confused_cat
 
Welcome to Lantus Land! The bigger lancet should help. Always reward Kitten for going through the process even if you aren't successful at first. You'll get it.
 
Hi Lynn and Kitten,
the information i gave you is in several of the following posts. So i'll just add my welcome.
take good care and give kitten a hug
mary and oliver
 
Hello Lynn and welcome to LL. Here is a link to a post by Marje that should prove to be very helpful to you.
http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=85113

I also recommend reading the sticky notes on the main page of TR for some more important information.

You're right shooting without testing is scary. Our cat had a BG of 42 today. Had I given him a shot when he was that low he most likely would went Hypo. You have found the best place for anyone with a diabetic cat. The people here love their cats and many are very knowledgeable about the various types of insulin.

Glad to hear you have help setting up your spreadsheet. Once you have that done work on a profile for kitten. The folks need to see those two documents in order to offer any treatment or dose advice. Also we open a new post, called a condo here, with each day's AMPS (morning pre shot #) and we include a link to the previous day's condo. You'll see these in the post. Some refer to them by their cats name while others simple call them "yesterday". I copied the instructions for that at the bottom.

I can tell you from experience that the amount of info you will receive can become overwhelming for a newbie. Digest what you can and ask questions. You'll pick it up as the days pass. If you have an emergency you can click on the 911 icon above the subject line but ONLY use that if you have an emergency. For non-emergency questions click on the "?" and the type a reference to your question such as "? DOSE". People will see this and know you have a question about the amount of insulin.

Again welcome to LL and don't be afraid to post any questions you have.

The way to make a fancy link is as follows:

1. Pull up the previous day’s condo

2. Copy the address of the link from the top of your browser

3. Then return to the Tight Regulations Page and click on the NEW TOPIC button on the top left above the first posts

4. At the top you will see several icons such as 911, a candle, rainbow, OTJ etc. Below them is the subject line. Put your subject beginning with the date (mm/dd) and your cats name then enter the numbers as you have been doing

5 Below the subject line are some tabs such as Quote, Code & URL etc. Click on URL

6. [url] will appear in white box belo... and place the condo link below your message.
 
Hi Lynn,
Welcome to Lantus Land!

Everyone, here is a link to Lynn's condo on the Health forum. Some of you had replied there.

http://felinediabetes.com/FDMB/viewtopic.php?f=28&t=85170

Lynn, I think Sue sent you a PM, probably about instructions for your spreadsheet. To see the PM, at the top of the page you should see a link towards the left that says (1 new message). Click on it, and it'll go to your PM folder.

Carl
 
Hi, Lynn.

I've been following your posts over on Health. I'm glad to see you here in Lantus Land.

From what you've been saying in your previous posts, I know you're feeling overwhelmed. That's pretty much where all of us were when we were new to feline diabetes (FD). So, take a few breaths. There are a lot of people here who will be there to support you and help you to learn what you need to do to keep Kitten safe and get her FD under control. There are many of us who have spent the same kind of dollars with a cat suffering from DKA. Keep testing for ketones at every opportunity. Ketostix are your friend. They are the cheapest form of keeping Kitten out of the ER that you can buy! So, I'm going to emphasize two points for now: home testing and food.

Right now, your priority needs to be getting comfortable with home testing.
Knowing Kittens blood glucose (BG) levels gives you incredible control. It also lets you know that Kitten is receiving the right amount of insulin to keep her safe. Fructosamine levels tell you where her numbers have been for the past 3 weeks. They don't tell you if her numbers are too low or too high right this minute. Urinary glucose testing doesn't give you up to the minute results, either. Your glucometer is the best means of giving you the data you need. Once you are more comfortable with testing, we can help you with dosing. Most of us do not rely on our vet when it comes to dose adjustments. In fact, I haven't asked my vet about dosing once I became comfortable with using the Tight Regulation Protocol. My vet leaves the day-to-day decisions to me. We will all help you to get to that same place if that's where you want to be.

Food is also critical. Fancy Feast Classics are low carb and a fine food for most cats. What you need to be attentive to is feeding a low carb (less than 10%) food. Most of us feed in the 5% carb range. The bottom line is that the best food is what your at will eat. The FAF group is wonderful with regard to assist feeding. They don't have our expertise with diabetes. What you do need to know is that the recipe for ketones is infection or inflammation + not enough insulin + not eating. So, food is very important to keep ketones at bay.

Please let us know how we can help. All of us have been in your shoes and there have been people here who helped us learn. Ask questions. We like questions! The people here are very generous with their time and knowledge.
 
Hi, Lynn and Kitten! Welcome!

I'm pretty new, about a month and a half, and I am so glad I found this forum. I was terrified/overwhelmed at first, but every question gets answered by reassuring, knowledgeable, and compassionate people here.

And testing DOES get easier, I promise!

~Josie (and Ripley)
 
Hi Lynn,
Glad to see you started posting over here.

I told you they would all come and gladly help. So keep asking questions. Keep learning.
Ater a while you stop feeling so overwhelmed but you've got a ways to go before that happens.

Did you make the liver shake and did Kitten like it?
 
Hi Lynn and Kitten welcome to Lantus Land! You are in the right place. So glad you found us. You have recieved a lot of great info so far. It is overwhelming at first but you and your kitty will adjust. The home testing will get easier and become second nature. Take care and good luck!!!
 
Welcome to LL! You are definitely in the right place. It really DOES get easier, and with LL in your back pocket, you've got tons of support and knowledge to help guide you!
 
As many others have said, Welcome to LantusLand. I know there is so much to take in, don't be afraid to repeat questions. One other thing that helps is to let us know where you live, just state and maybe city. People here are from all over the world and sometimes time zone can be a factor.

Also, there may be a member near you who could come and help you learn to test if you continue to have problems. Once you aren't stressed by it, Kitten will settle down too. They know when we are nervous. Always give a treat and some loves, even if you aren't successful. Freeze dried chicken breast is a great FD friendly treat. You won't believe it now but Tess usually purrs when I test (if she even wakes up!)
 
Welcome Lynn and Kitten! Try not to be overwhelmed -just take it one step at a time and get over the hump of setting up your spreadsheet and wandering your way around reading stickies and such. This is a great place, and there are never too many questions.
Good luck!
Lisa & Leo
 
easier for me to come copy and paste this on for Lynn. She saw the vet today.



Hello. Kitten saw the Internal Medicine doctor at the hospital today. She encouraged me to do at home testing and her tech will give me a free demo ear pricking with Kitten anytime I want to bring her in. I just might consider it. Kitten gained 1kg of weight. The doctor detected a gallop in her heart rhythm which was not there last week during hospitalization. She is going to check her chart to double check. I was told her heart test was great during hospital stay. Kitten may have 6 months to a year to live due to the growth. If she did not develop Diabetes due to the Prednisone, we could have put her on some drugs to slow it. The tumor is going to make the Diabetes harder to manage she said. She will call me tonight with results of her calcium ionzation and electrolytes test. The blood test results will be ready Thursday. Kitten is very agitated that they wrapped her leg at the injection site. I had to cut it off her. The vet refused script for MaxCal saying it could effect her pancreas. She is to stay on the DM. The tech relayed this info. It was another $800 today which included a $500 outstanding balance. I brought my insulin to have checked to make sure it wasnt bad. I had it cold the whole time. They told me to roll it gently. So, it has been a total of $6,000 since September which includes air purifiers, mortar and pestle and misc things I am using for Kitten. I blame myself and the original vet for the Diabetes. I am very upset that Kitten's last months could have been Diabetic free. Kitten is exhausted now and really ticked that they put a wrap on her. You can post this if you want on the board. Thanks to you both.

Lynn & Kitten
RI
 
Hello Lantus Land... Thankyou for the warm welcome. Kitten is my world and I am hers. So, we thankyou for offering help. I am running behind in my spreadsheet learning. Sue, I tried to send you two PM's today, but it said invalid. I messed it up. So, thankyou and I will do my homework and be in contact. Today had been busy with Kitten. The vet called awhile ago with some results from today's bloodwork. I think I should post it in the main health forum.
Lynn and Kitten
 
Hello Lantus Land... Thankyou for the warm welcome. Kitten is my world and I am hers. So, we thankyou for offering help. I am running behind in my spreadsheet learning. Sue, I tried to send you two PM's today, but it said invalid. I messed it up. So, thankyou and I will do my homework and be in contact. Today had been busy with Kitten. The vet called awhile ago with some results from today's bloodwork. I think I should post it in the main health forum.
Lynn and Kitten
 
This is another email which pertinent medical information for the "experienced eyes " to see and maybe help with the stomach nausea issues.




Hi.. I just read all my replies from the Lantus Forum. Thankyou for posting my email. I think my thankyou reply went thru on Lantus. I tried to send Sue two PM's today, but it said invalid. I do not want her to think I am ignoring her. I am doing a bit of scrambling today. The doctor called tonight and said Kitten's Potassium level and Calcium levels were regulated. She said she was "very pleased" considering she almost died just over a week ago. Her BSL was 270 at the hospital, but she was stressed. Her kidney level is high but lower than it was during DKA. I will know result of Fructo test Thursday ,and she will probably increase the insulin. She really wants me to move forward with the home testing. I have been trying, but that is a priorty now. She also decreased Kitten's Atopica 10 mg to every other day. This may help her belly too. She did cough tonight and wheeze, so she will probably have to have it increased again. Especially since her Prednisolone is ending this week. Time will tell.. And soon. I really believe Kitten has developed a strong food aversion to the DM. She snubs it but will try others. She knows the DM is in those syringes and associates the smell with her nausea and upset stomach. Also, the doctor said I need to start to "push" Kitten's etube feeding to 30cc's in a half an hour. I tried 20'ccs in 35 minutes tonight and Kitten coughed/gagged and burped after first 10cc's. I need to cure this nausea/ diarrhea. Tomorrow, I am making her new med sheets and prn sheets. I have food to make and scripts to get. And , i need to organize the kitchen/ med center. And start the ear pricking tomorrow. So, if I am not posting on board, I am just getting basics organized. I plan on posting soon though. I do much better navigating the board on the laptop vs. iphone. Thanks again.
Lynn & Kitten
RI
 
Lynn --

Did the vet give you any medications for nausea/vomiting? Usually a medication like Zofran (ondansatron) or Cerenia (maropitant) are prescribed. You may have heard people discuss these meds in the FAF group. These meds may help to settle Kitten's stomach so you have an easier time of getting food in.

It's great to hear that Kitten's electrolytes are stabilized. That's very important!
 
Lynn

Your vet is very incorrect...you do not roll lantus....ever. From the Sticky on Proper Handling and Storage of Lantus and Levemir

Lantus and Levemir should be inspected visually prior to administration and should be used only if it appears clear and colorless.

Never shake or roll your vial, cartridge, or pen.

In-use and unopened Lantus and Levemir should be stored in the refrigerator between 36 to 46 degrees F (2 to 8 degrees C).
Be careful your refrigerator is not so cold that the insulin freezes. Do NOT use Lantus or Levemir if it has been frozen.
Never reuse syringes. You'll run the risk of contaminating the whole vial/cartridge/pen.
Do not inject air into cartridges or pens. Cartridges and pens are designed to work on a negative pressure principle.
If you draw up too much insulin in the syringe... squirt excess either into the air dramatically like they do on TV or into a paper towel... anywhere but back into vial/cartridge/pen. There is a silicon coating inside the syringe. It may contaminate the insulin vial with silicon (this is probably what makes "floaties", it forms a white precipitate). Better to waste a drop than ruin whole vial, cartridge, or pen.

Pre-filling Syringes with Lantus (see page 3) is NOT recommended.

Lantus and Levemir should not be diluted or mixed with any other insulins or liquids.

I would not raise a dose based on a fructosamine test or one test in a vets office. The reason is because we base dosing on the nadir; if the vet catches Kitten at some other time in the cycle or in a bounce, she might raise the dose when it shouldn't be. As Sienne said, the home testing is going to give you the best, real time data and we can help you with the dose.

I also do not understand her being against the MaxCal. We recommend MaxCal be fed to cats with pancreatitis in order to keep enough calories in them. MaxCal is contraindicated in a cat with chronic kidney disease.

Lastly, did your vet check her hydration level? Dehydration can cause gallop rhythms.

Here is the best video I know of to learn home testing and it is what we learned from: home testing

I'm dubious about a vet tech teaching ear pokes. Every one that I've come across does it with a needle right into the vein on the ear instead of a lancet on the edge. Please be sure that they are not going to teach you how to poke her vein with a needle.
 
Sue and Oliver (GA) said:
Lynn, if the pms are hard for you, just send me back an email at the address I sent the spreadsheet.
it is the iphone screeen to small will have to start using laptop for this site Lynn and Kitten
 
Sienne and Gabby said:
Lynn --

Did the vet give you any medications for nausea/vomiting? Usually a medication like Zofran (ondansatron) or Cerenia (maropitant) are prescribed. You may have heard people discuss these meds in the FAF group. These meds may help to settle Kitten's stomach so you have an easier time of getting food in.

It's great to hear that Kitten's electrolytes are stabilized. That's very important!
Kitten is on prescribed dose of Ondansetron 4mg pill 1/2 pill twice a day. FAF suggested this drug, as the Cernia suggested by FAIM did not seem to help Kitten. Kitten is on Pepcid 10 mg 1/4 tab twice a day to help with the burping. These seem to help her handle more food. She was sent home on many drugs but with No nauseua/upset tummy meds??? Yet, she was on them in the hospital plus appetite stimulants. Also, a lower dose of 1mg 2 -3 times a day as suggested by FAF did not work for Kitten. To reply to the above post about lantus(I cannot seem to reply to that post separately)... I have been injecting excess back into Lantus bottle as shown to me by vet at discharge. I will stop. I knew this was wrong in my gut and from years of passing meds and liquids at work.Rule is you NEVER put a liquid back in bottle. But the pricetag overruled my thinking. I assumed Kitten was checked for hydration. The vet tech looked at her gums for a second and the doctor examined her and felt her belly. If I pull Kitten's fur up by her shoulder blades, it springs back down. I was told on FAF that if it is slow to lay flat, it is sign of dehydration. Kitten is drinking alot of water on her own now, esp Since she started eating the dry DM food. I will ask again for the MaxCal or atleast a further explanation. Kitten will not eat wet DM food on her own.She has a very strong aversion to it now. I put out some wet fancy feast classic chicken and she ate a tsp in the early hours.Kitten's hungry time is between 3am and 6am for years and continues. I left it in an adjoing room so she could "find" it and not stink up her main rooom all night. She then ate another 1/2 tsp.She will not eat anything dried up. She wants to eat but she is still suffering from the burps. I want an appetite stimulant with the least side effects.I have heard about Vitamin B. I might try the Slippery Elm Bark suggested by FAF. I will only bring Kitten in for a demo if I am desparate. My husband is a very calm helper and saved me along with FAF during the etube learning and has helped with the ear prick. He is very ill with complications of Lyme, so he is not up to his usual helping standards. I will call the doctor today about the stimulant, MaxCal and the galloping heart. I hope to post by tonight Kitten's BSL! Thanks :razz:
 
Food aversion is not unusual with assist feeding. It's often why it's suggested to use a food that isn't one of your cat's favorites.

Do you think there could be any issue with GI motility that's causing the burps?
 
Hi guys .. just wanted to welcome you to the board .. positive thoughts that kitten will be home and feeling good in no time!!
 
Sienne and Gabby said:
Food aversion is not unusual with assist feeding. It's often why it's suggested to use a food that isn't one of your cat's favorites.

Do you think there could be any issue with GI motility that's causing the burps?
Idk about the GI tract in her. I was thinking about the Slippery Bark Elm to try on her. I think the meds do not help. She does not do the burping when she eats other food that much. In her past and present. I do not think the etube feedings agree with her. After almost every etube feeding, she will go immediately to her dry food bowl? Why? Even if she had looked nauseated, she will nibble some dry food with a mission to override the etube feeding. Not sure why. I had banned her from dry food months ago, but I bought the DM dryfood last Saturday . It is calories . What should I ask for an appetite stimulant when the vet calls me with her Fructo results. Is "mirt" anygood? I dont know the spelling but she was on it at the hospital. Some people says it ramps the cat up. Kittens doctor stated Kitten was doing just fine with the large etube feedings at the hospital.. Well, Kitten was on nausea meds and appetite stimulant at the hospital. Why would they give her to me with a very harsh med/ supplement regimen without anything to help Kitten's tummy? And then act surprised that she is having acid?? I want this tube out of her .. I am getting really sick of it for my Kitten. We had to trim her ear hair today and did a prick, but no blood. She threw an absolute fit, but got over it quickly. We have a method in place. Kitten will require two people for first couple of weeks. I had to wrap her in a towel to train her with the inhaler masks. Now she is fine with it. We did manage to get blood from my other cat and it was 60. his ears were not hairy and he is mellow. Kitten is such a drama queen.
 
Hi all. My husband and I cannot get enough blood from Kitten's ears. It does not forn close to a droplet. She was very stressed during this and aggresssive. I rubbed the ears first. They were nice and warm. We tried to milk the little evidence of blood. We tried several times. We got a nice little droplet from our other cat earlier in the day. We have watched the videos. Very frustrating. confused_cat e
 
Lynn,
Are you using the lancet in the device, or just freehanding the lancet?
And what gauge is the lancet?

Carl
 
It can be frustrating. Some cats need to have their ears "trained" to bleed. In other words, the more you poke, the more the capillary bed in the area increases. The other consideration is that with some cats, one ear bleeds better than the other. So, try the other ear. In the meantime, you might need to double poke. You poke once and then poke again as close to the initial spot as possible. Sometimes this will help. I think you said you're now using a 28 or 29 gauge lancet. If I'm confusing you with someone else, then you should be using a lancet in that size range until you know you can get Kitten's ears to bleed.

There are 2 appetite stimulants that are typically used: mirtazepine or cyproheptadine. Usually, you don't want to give an appetite stimulant if a cat is nauseated. (Think how you'd feel if it were you.) If the nausea is under control, then the stimulant is fine.

I can appreciate your feelings about the e-tube. However, if Kitten isn't eating on her own, you do need to know you have it as an option so you can get sufficient calories into her.
 
Carl & Bob said:
Lynn,
Are you using the lancet in the device, or just freehanding the lancet?
And what gauge is the lancet?

Carl
I use a lancet pen. The guage is 26. I initially used the 31 which was even finer. We tried both ears and a couple of times in same spot but not quick enough like in one of demo video I saw.
 
Sienne and Gabby said:
It can be frustrating. Some cats need to have their ears "trained" to bleed. In other words, the more you poke, the more the capillary bed in the area increases. The other consideration is that with some cats, one ear bleeds better than the other. So, try the other ear. In the meantime, you might need to double poke. You poke once and then poke again as close to the initial spot as possible. Sometimes this will help. I think you said you're now using a 28 or 29 gauge lancet. If I'm confusing you with someone else, then you should be using a lancet in that size range until you know you can get Kitten's ears to bleed.

There are 2 appetite stimulants that are typically used: mirtazepine or cyproheptadine. Usually, you don't want to give an appetite stimulant if a cat is nauseated. (Think how you'd feel if it were you.) If the nausea is under control, then the stimulant is fine.

I can appreciate your feelings about the e-tube. However, if Kitten isn't eating on her own, you do need to know you have it as an option so you can get sufficient calories into her.
Kitten is nauseated from the etube feedings. She actually licked her lips when she saw the syringe tube and knew it was coming. She is eating dry on her own and she has been eating Wellness Core on her own. I believe if ahe had an appetite stim and was off the DM feeding.. She would eat the wet and be ok. I would rather assist feed to supplement calories. I finally pinpointed why Kitten runs to her dry bowl immediately after an etube feeding. It is a response to stress which is the etubw feeding. After the ear pricking growling/hissing episode, she ran right to the dry food even thligh she was extremely distressed. After Kitten's insulin shot and a pill ahe hates to swallow, she ran to the dry food in a frenzy. She was still annoyed from being pricked. So, I put some Wellness out, and she ate that in a frenzy. No licking lips or looking like she wanted to vomit. So , the lancets get finer as the number guage increases? I was told to
Use 26-28 for newbie ears. What do u think of the etube food making her nauseated. She really hates it.
 
Lynn and Kitten/ ear pricking

Thankyou for the member who put Kitten's spreadsheet on for me. I just noticed it! Thankyou. It may help me with my motivation to prick Kitten's ears. Kitten is going to be a tough ear prick battle. It is doable in the long run, but if she does not calm down ... I may have to not do it as much. I am not giving up on her, but I do not want her last months to be stressful. Kitten does not like to be touched and is has always been super agitated about her ears. I am hoping she can live a year but she may not, according to her tumor. I have ro be hopeful but also realistic at the same time.
 
I've not had to go through assist feeding so I'm not in the best position to answer your questions. Here's what I would suggest so you get the input you're looking for.

We typically start a new thread each day as we collect our test data for the day. The subject line is formatted:
date your cat's name AMPS-# +time-#​
You can also add something like, E-tube question, to the subject line. To edit your subject line, you change the subject line in the first post in the thread. It's only that subject line that's visible on the Board. You can also post a question about the E-tube on Health. There are a few vet techs over there who may be able to respond to your question.

Personally, since I would presume that the goal is to get your cat eating on her own. If she's spontaneously eating, that should be encouraged. I just don't want to offer you advice that's not based on fact.

Will Kitten eat treats? If so, give her a treat every time you test. It doesn't matter if it's not a good test, give her a treat. You want testing associate with a positive. It will really help to get her to settle down.
 
Sienne and Gabby said:
I've not had to go through assist feeding so I'm not in the best position to answer your questions. Here's what I would suggest so you get the input you're looking for.

We typically start a new thread each day as we collect our test data for the day. The subject line is formatted:
date your cat's name AMPS-# +time-#​
You can also add something like, E-tube question, to the subject line. To edit your subject line, you change the subject line in the first post in the thread. It's only that subject line that's visible on the Board. You can also post a question about the E-tube on Health. There are a few vet techs over there who may be able to respond to your question.

Personally, since I would presume that the goal is to get your cat eating on her own. If she's spontaneously eating, that should be encouraged. I just don't want to offer you advice that's not based on fact.

Will Kitten eat treats? If so, give her a treat every time you test. It doesn't matter if it's not a good test, give her a treat. You want testing associate with a positive. It will really help to get her to settle down.
okay...i will do that in my subject line...let me know if I am still not doing it right...Kitten at this point will not eat treats..but she wants to play with her wand toy...this is her reward for now.. I posted earlier that we were able to get a reading on Kitten today. It was 310mg AMPS +3 units of lantus 1.5U I am learning the lingo.lol i did not put this in the subject line but in the post..but now I know protocol...
 
Sienne and Gabby said:
I've not had to go through assist feeding so I'm not in the best position to answer your questions. Here's what I would suggest so you get the input you're looking for.

We typically start a new thread each day as we collect our test data for the day. The subject line is formatted:
date your cat's name AMPS-# +time-#​
You can also add something like, E-tube question, to the subject line. To edit your subject line, you change the subject line in the first post in the thread. It's only that subject line that's visible on the Board. You can also post a question about the E-tube on Health. There are a few vet techs over there who may be able to respond to your question.

Personally, since I would presume that the goal is to get your cat eating on her own. If she's spontaneously eating, that should be encouraged. I just don't want to offer you advice that's not based on fact.

Will Kitten eat treats? If so, give her a treat every time you test. It doesn't matter if it's not a good test, give her a treat. You want testing associate with a positive. It will really help to get her to settle down.
okay...i will do that in my subject line...let me know if I am still not doing it right...Kitten at this point will not eat treats(she was a treat hound pre-DKA)..but she wants to play with her wand toy...this is her reward for now.. I posted earlier that we were able to get a reading on Kitten today. It was 310mg AMPS +3 of lantus 1.5U I am learning the lingo.lol i did not put this in the subject line but in the post..but now I know protocol...
 
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