New to this forum and have a few questions

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Fiona1, Apr 17, 2018.

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  1. Fiona1

    Fiona1 Member

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    Hi everyone,

    I have managed to make a spreadsheet.

    So after the possible failed attempt of 2u of insulin at 7.30, I tried to do a BG test at 9.30. Unfortunately, not enough blood went on the bit which sucks it up so I got an 'E-4' on my machine. I decided I'll test her again at what is the general nadir (although of course, it's different for all cats). I tested her at 12.10 and after trying the first time, not enough blood came out, so I had to try again. I tried straight away and got 22.3. I'm unsure if she had the insulin though. She's been sleeping or sitting down quite a lot today. She is liking Bozita, but hasn't eaten that much of it. Put Little Big Paws out again today and she gave it a couple of licks. My other cat is not eating either and has been hissing, stressed and dry heaving in the middle of the night and I'm worried they are both stressed out. They are usually fine together but Patch (my other cat), keeps hissing every time she passes her. I'm also worried that I'm going to make Tinkerbell's ears sore with these failed tests because it's not a very large area between the vein and rim.

    Tinkerbell seems really off and I'm not sure if she just feels ill or she resents me testing her (which I will still continue to do).
     
  2. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Yay! Well done, Fiona! :bighug::bighug::bighug:

    It might take a while for both kitties to adjust to Tinkerbell being home from the vet. Tinkerbell may smell different. Also, your other kitty will be used to having you all to herself...
    Do your kitties like to be brushed? Maybe some grooming sessions (and perhaps both kitties with the same brush) will help them to get re-aquainted..?
    Or maybe a Feliway plug-in might help..?

    Quite a few folks worry about this at first. (((Hugs))) But the ears soon seem to get used to testing. Also, in quite a short while they begin to bleed more easily. The ear produces more blood vessels in response to those tiny 'injuries' we're inflicting.
    It's often the case that one ear will bleed more easily than the other.

    Here's some things that have helped me with testing. Some of them may be helpful for you also:

    1. Warm ears. Ears bleed so much more easily if they've warm. If they don't feel warm to the touch then briefly massaging can stimulate blood flow. Or you can hold something warm (ie a pill bottle filled with warm water) against the inside of the ear.
    2. Resistance. The lancet needs something to 'resist' otherwise it can push the ear away rather than prick through it. Some folks hold a little bit of cotton wool or folded tissue against the underside of the ear, opposite to where they're pricking. I usually use a finger tip, but sometimes get blood from myself that way too..)
    3. Two ear pricks can be better than one. Two ear pricks close together can often produce enough blood for a test where one ear prick might not.
    4. Massaging below the ear prick with fingers and thumb can 'milk' more blood out. I almost always do this unless the ear is especially warm.
    5. Vaseline: A teensy weensy smear of vaseline on the outer edge of the ear can help the blood to 'bead up' rather than disappear into the fur. I found it so much easier to see the blood droplet because of it 'sitting on top' of the vaseline. I did this for the first few weeks when I was learning to test.
    6. Get comfortable. I find it much easier to test if I pop Bertie up onto my desk or a counter top. I find it easier to see what I'm doing, and I'm physically more comfortable. And my desk lamp is a good source of local light. ..Some people prefer to put their kitty on their lap, or are happy to test if the kitty is sitting alongside them. Find out what works best for you.
    7. Remember to breathe... The more relaxed you are about the process the more relaxed your kitty is likely to be. Take deep breaths. Approach the situation in a 'matter of fact' kind of way if you can.
    8. Rewards. Always reward the kitty for every attempted test, whether successful or not.
    9. Reward yourself too!

    Do be patient with yourself, Fiona. This is something of a steep learning curve. But you are doing incredibly well. Honestly!
    .
     
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  3. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Another thought...
    Are you testing Tinkerbell's pee for ketones?
    The test just involves dipping the end of a ketone test strip (Ketostix or Ketodiastix) into a drop of pee. Crumpling clingfilm over the litter tray is often a good way to catch a sample. The pee collects in the creases.

    The test strips don't register all kinds of ketones, so also be aware of how Tinkerbell's breath smells. It should smell like 'normal kitty breath' (!). If it smells sweet like acetone that can also indicate ketones.
    .
     
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  4. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I see the red 22.3 on your spreadsheet. Is that the most recent test? It's not at all surprising if you had a fur shot. Hang in there!
     
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  5. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Thank you for all the tips. Yeah that was the last test 22.3. Going to do pmps in just over an hour. Hopefully i can make a better go of the curve tomorrow.

    I bought a massive play pen to test ketones due to both cats using both litter trays. Put her in the pen with blankets, food, water, litter tray with cling film and very tiny amount of litter. Within 10 minutes of going in, she urinated! I got the result as traces. I bought the play pen purely for that reason as im renting and didnt want the cats to damage carpets if separated, which they did when we lived at my mums. Let her straight back out. This was just before i posted this message.
     
    Last edited: May 5, 2018
  6. Diana&Tom

    Diana&Tom Well-Known Member

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    Great comments from Elizabeth above, Fiona, ref testing. You're doing incredibly well so don't lose heart, keep going, this is a learning curve! If I were you I'd put today down to experience and start afresh tomorrow with the aim of giving insulin after testing... Tinkerbell may well feel better if her bg isn't too high.

    As for "traces" ketones readings - that's a bit concerning... do you know if she was tested for ketones at the vet's (sorry, can't remember)?
     
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  7. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    H
    he said there were no ketones in the vets. Shall i still test her tonight before this shot? Shall i stick at 2 given that there are traces?
     
  8. Diana&Tom

    Diana&Tom Well-Known Member

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    Yes definitely test before ANY shot, Fiona, ALWAYS. She will probably be in the 20s still but we need to have that info anyway. I would probably stick to 2u, yes, because that's still a reasonable dose for many kitties and - sorry to sound like a broken record - we need more data to see how she is utilising the insulin before we can definitely suggest an increase. For all we know, 3u upwards may be too much, drop her too low and send her skyrocketing again... it really is trial and error but remember to always err on the side of safety.
    Trace ketones need monitoring so check again tomorrow and meanwhile do try to get her to eat. She needs to stay hydrated so add a little water to her food if she'll accept that. Give her whatever she likes to eat - you seem to be trying various things which is great but maybe she's getting confused! Maybe you could add just a little of the Hills to the Sheba if it means she'll eat something.
     
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  9. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Will definitely test for ketones.
    Just tested her at 18.3
    Just given her bozita and shes eating. She only seems to eat when i take it to her
     
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  10. Diana&Tom

    Diana&Tom Well-Known Member

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    I expect she got used to waitress service at the vet's!
    18.3 isn't too bad. If she's eating a decent amount now, good, then take it away and test again at about 9pm with a view to shooting.
     
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  11. Diana&Tom

    Diana&Tom Well-Known Member

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    Oh, PS to the above - you said that 18.3 was the pre shot number so you're going to shoot now-ish? That should be ok as long as she hadn't had a massive amount to eat recently - from what you say, she hasn't.
     
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  12. Fiona1

    Fiona1 Member

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    Lol at the waitress service.
    Yeah she hasnt eaten too much. Going to shoot 2u at 7.30pm. Been practicing another syringe on a satsuma today.
     
  13. Diana&Tom

    Diana&Tom Well-Known Member

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    Great stuff! Paws crossed you'll get the needle in this time! Then try to test again a couple of times this evening if poss.
     
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  14. Diana&Tom

    Diana&Tom Well-Known Member

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    And sorry, one more thing... do I remember correctly that Tinkerbell has already been treated for ketones? If so, keep a specially close eye on her and call the vet if you get readings that show higher levels... this is really important. But good news that she is eating, and if you can get insulin into her that's good too.
     
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  15. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Yep ill test her for ketones tomorrow, she has had Dka.
    I did it! It definitely went in! Felt different from earlier :)
    So shaky now, but confident i can do it.
    Ill set an alarm for 4.5 hours from now unless im awake. Shall i also test her in 2 hours?
     
  16. Diana&Tom

    Diana&Tom Well-Known Member

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    Excellent! This will certainly give you confidence.
    Ref the testing - it's up to you and what you and Tinkerbell can manage... as we've said, it's good to get as much data as possible, but don't bust a gut attempting too-frequent tests if it's distressing either of you.
     
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  17. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Gosh, well done on getting a quick ketone test!
    Anything above 'traces' is a reason to contact a vet ASAP (because ketones can quickly escalate and then develop into DKA, so it's important to get vet advice in that situation.)
    The classic 'recipe' for DKA is high blood glucose, plus insufficient insulin, not enough food intake, and maybe also an infection or illness of some sort. Although some cats will develop DKA without everything in that list.

    Given that Tinkerbell has had DKA it's really important to keep on top of this. She may be prone to ketones. Some kitties are.
    Ketones can be produced when fat breaks down. And most often that means body fat. So it's really important to get sufficient food into the kitty. That means tempting her with yummy food whenever an opportunity presents itself. She needs to eat enough food to meet her calorific requirements so that she doesn't start to break down more body fat.
    How is Tinkerbell's weight? Is she normal weight, overweight, underweight..?

    And well done for getting that insulin shot in.
    It really WILL get easier. :cat:
    .
     
  18. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Im not working til tuesday so this weekend is all about tinkerbell :) i just really hope that tomorrow is a better day of testing so she is ok to leave come tuesday. Just gonna try and get a bit of sleep in the day tomorrow, between shots
     
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  19. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    She was slightly overweight before she got dka. Shes now 4k and looks a normal weight.
    Shes got some leonardo down now, as well as bozita. I gave her this because the bozita had a lot of meat left with no jelly. She has gone back, without me taking it to her, to 3 more small helpings of leonardo and is walking around quite a lot now, rather than sleeping. Going to test her now, then update my SS.
     
  20. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    PM shot +2 14.9 reading. Eating again also. Seems to eat very little, but often.
     
    Last edited: May 5, 2018
  21. Diana&Tom

    Diana&Tom Well-Known Member

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    This is looking good, Fiona. The pmps wasn't too bad and the successful 2u shot has produced a gentle drop... keep an eye (I know you are of course) and get another test or two tonight if you can.
    Very well done - am very impressed with how quickly you're taking everything on board.
     
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  22. Diana&Tom

    Diana&Tom Well-Known Member

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    One more little thing, Fiona... most of us posting on your thread are fellow UKers so we are in the same time zone as you and can get back to you in "real time" but this is an international board and there are people from the US and elsewhere online during our night. So if you need help late at night and we don't see your post (I for one will be off to bed soon) you can either start a new thread with a specific query in the title, or tag people in this thread who have been following you, such as @Kris & Teasel who is in Canada.

    In between testing, shooting and feeding this weekend lol you might want to spend a few minutes reading other threads here and acquainting yourself with how to use the board to max advantage. You're already doing so well though!
     
  23. Fiona1

    Fiona1 Member

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    Yeah i completely agree with this, will start reading up some other threads.
     
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  24. Fiona1

    Fiona1 Member

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    PM shot +4 is 8.8
     
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  25. Kris & Teasel

    Kris & Teasel Well-Known Member

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    This is a great number! It looks like I wasn't too far off with my suggestion of a 2 u dose. Congrats on getting the shot in and the tests done. :D
     
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  26. Monica & Josie

    Monica & Josie Member

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    First of all I didn’t get any ‘new posts’ notifications today for some reason so I completely missed this whole second page of your posts and just caught up with it all, sorry!
    +4 8.8 is a great number, once again well done for managing so well trying to stay on top of things!
    Brilliant job with injecting as well.
    As for kitty’s poor battered ear you can get a tube of Aloe Vera gel in Boots, Holland and Barrett or in a supermarket keep it in the fridge so it’s nice and cool when you apply on her ears after testing. It’s soothing, healing and anti-bacterial as well. Or just get Savlon, also very good
     
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  27. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Will get the aloe vera gel. Is there any specific type? Do any have bad ingredients like tea tree, for example.

    AMPS 7.5 - not giving a shot. Shall I still test every 2 hours today?

    Put her in the play pen to get urine again. Mixed some water with her food which she is eating. She tends to eat more in the play pen.
     
  28. Diana&Tom

    Diana&Tom Well-Known Member

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    Lovely amps number, Fiona - that 2u seems to be very effective. So no, no shot. The problem is of course that she may well start rising again and need insulin at least by pmps time... this is where it gets tricky. If you still get trace ketones today (or higher, but let's hope not) she should really get some insulin, but if you start giving small doses before normal shot times you're starting to muddy the waters and it all gets more difficult. I'd rather we got comments on this from someone with dka experience... @Kris & Teasel @Elizabeth and Bertie do you know yourselves or can you suggest anyone to tag? Or perhaps Fiona needs to start a new thread asking for dosing advice post-dka?

    In any case, I don't think you can do much at the moment, Fiona. It's good that Tinkerbell is eating, good that you're adding water, and best of all good that her bg is a nice 7.5 this morning. So yes, you do need to keep testing when you can to identify when and how fast the bg starts rising... assuming that it does. In some cases, once numbers start to get lower -and you're getting much better numbers than when she was at the vet's - numbers settle in a certain range and you may not (paws crossed) see those super-high numbers again. Time will tell.

    So for now I'd say let's see if anyone else can comment on your dosing strategy today... I'll be out for a few hours in the middle part of the day and will look in when I can, but I don't think I'll have a lot to add to what you already know and are doing very well. The general picture is looking good, it's just the ketones we need to keep in check so bear that in mind and when in doubt, ring the vet.

    Hope it's a great day for you and Tinkerbell!
     
  29. Monica & Josie

    Monica & Josie Member

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    Morning Fiona,
    7.5 amps is a beautiful number.
    Definitely not shootable so good call holding it off.
    I have no experience with ketones so cannot comment on that part.
    I would test a few times throughout the day and check for ketones as well but not sure if there’s anything else you can do at this point.
    I’m still thinking maybe going down to 1u instead of 2u and start from scratch might be a good idea... to see how she responds and whether you get more balanced overall readings..
     
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  30. Diana&Tom

    Diana&Tom Well-Known Member

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    Monica makes a valid point about possibly reducing the dose... we don't know if the first/only 2u you've injected dropped her a little lower than we'd like overnight... hopefully not, and she has just "surfed" in nice single numbers for the second half of the cycle. But we had to start somewhere and 2u was a decent guess and has ensured that she had necessary insulin to hopefully keep ketones in check.
    As time goes on and you get the needle in at each dose, and test during the cycle, we will more easily be able to see what the dose is doing so we can think about adjustments - up or down - when you next get a shootable number at shot time. There may be a big difference in results between 1u and 2u but you could always try 1.5u, or even 1.25u or 1.75u... there may be a "magic" dose for Tinkerbell, we will have to see!
     
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  31. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Yeah 1u could be a good idea later. Got a reading of 14.2 just now which was disappointing. However she was a bit stressed in the pen, so let her out after half hour.
    The syringes from the vet only have whole numbers.
     
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  32. Diana&Tom

    Diana&Tom Well-Known Member

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    Yes thought she would be going up now... maybe it will be good to reduce the dose a bit so it doesn't last quite as long and you can shoot at usual times.
    Have to go now but good luck for the rest of the day.
     
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  33. Fiona1

    Fiona1 Member

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    Yeah that sounds like a good idea. Thank you. Have a good day!
     
  34. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good to hold off on that shot this morning. I’m just now getting out of bed and will answer in greater detail in a little while.
     
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  35. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Next test done. No insulin this am. Would have been +4 and was 15.4
     
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  36. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Ooh, lovely number! Very nice to see......
    Given that Caninsulin has a fairly short duration it would seem that Tinkerbell was able to hold her blood glucose down on her own; so her pancreas was putting in a little bit of work there.

    And if no shot given, it's just a morning BG rather than a morning PS, so it's AMBG instead of AMPS. (Sorry about all the jargon... :oops:)

    No need to be disappointed. That's not bad at all. Especially given that her +4 wasn't significantly higher, only 15.4.
    These are very early days in Tinkerbell's diabetes story and these numbers are pretty good so far.

    As to suggestions of reducing the dose, those numbers are looking fine so far. But Tinkerbell's blood glucose does seem to be coming down over all, and it may be that a reduction becomes necessary.
    The situation is complicated somewhat by Tinkerbell having had DKA, especially since she was showing 'trace' ketones yesterday. More than ever there's a balance to strike between the need for the body to have insulin, and the need for the blood glucose not to drop too low.

    How is Tinkerbell's appetite today?
    And if you could get another ketone test at some point that would be great. I do understand that it's stressful for her to be in the crate.... ....Are you able to keep an eye on which kitty uses the litter tray at all...?

    Eliz
     
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  37. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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  38. Monica & Josie

    Monica & Josie Member

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    Fiona I know it’s not easy but try not to be disappointed over the readings as at this point anything can happen.
    Best not to have expectations as these kitties tend to surprise us by responding totally different to what we expect!
    Just have an open mind and be prepared for anything taking each day as they come. Like I said before this attitude helped me to keep my sanity!:)
    Again considering she had no insulin this morning her BG readings actually been pretty good and lowish steady so far.
    How is Tinkerbell otherwise?
    Eating drinking playing, purring..?
    At the beginning I was so busy with all the stress of testing monitoring and trying to get everything right that I forgot that Josie was still a loving affectionate little companion who needed attention and TLC and not just a project with numbers...
    You two are doing so incredibly well, make sure you both get some rewards for your hard work!:cat:
     
  39. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I apologize for taking so long to get back here - sidelined by other things. I suggest dropping the dose tonight to 1 unit. Get a before bed test to see what's happening. The low number this morning could have been a result of the 2 u being too much insulin. That can increase the dose's duration so that it's still doing its thing at the 12 hour mark - not typical of Caninsulin. If you haven't had a chance to read through the excellent Caninsulin user's guide, I'd recommend that. (http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/)Meanwhile, here's the section on handling lower pre shots:

    Q. Is my cat’s BG high enough for insulin?
    For those NEW to treating feline diabetes, and/or those who don’t have much data about how their cat responds to insulin, we generally recommend that a shot isn’t given if the pre-shot BG, is below 200 mg/dL [11 mmol/L] on a human meter.
    If you use a pet meter, such as AlphaTrak2, you may want to raise the initial ‘no shoot’ threshold. This gives an added margin of safety when using a pet meter. (If in doubt seek advice from your vet.)


    Q. It’s time for my cat’s shot, but the BG is a little too low. What now?

    • If your cat’s BG is a bit below 200 mg/dL [11 mmol/L] on a human meter, consider ‘stalling’.
    • Stalling is waiting - without feeding your cat - for 20+minutes, then retesting to see if the BG has risen to a suitable level.
    • If using a pet meter, such as Alphatrak2, you may want to raise number above 200 mg/dL. (If in doubt seek advice from your vet.)
    • You are looking for a number that is rising, not falling, and is high enough to give insulin.
    • Note: As you gain experience with home testing, and have gathered data to show how your cat responds to insulin, you might consider it safe to reduce the ‘no shoot’ threshold, and to give insulin at lower pre-shot numbers.
    • If you have time, you can repeat the stalling process to see if the cat’s BG reaches a number you can shoot. If in doubt, skip the shot.However if your cat has history of ketones or DKA, or other health issues, or you are concerned, DO post on the Main Health forum for further advice.
    • Ask for help on the forum before giving insulin if you are unsure, as you can never ‘un-shoot’ insulin.
     
  40. Diana&Tom

    Diana&Tom Well-Known Member

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    Excellent comments from the others here, Fiona! You two are doing so well, we're proud of you! I know you have to go back to work in a couple of days but it would be very optimistic to get any kind of solution to this in just a weekend... but you are nevertheless making amazing progress, I hope you're giving yourself credit!
     
  41. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Thanks @Elizabeth and Bertie I had a look at that diagram. I kept the litter tray in whichever room I went into, to keep an eye on the cats but unfortunately she hasn't urinated yet. Just done AMBG + 6 and got 17.1. She ate equivalent to half a pouch this morning and since then, has had small amounts, mixed with water.

    Thanks @Monica Lewis She hasn't been purring since this morning when I woke up. She's been sleeping quite a lot. She did go and sit in the sun at the window for a while though. She's not an extemely playful cat with toys. I put my hand under a cover and she tried to get it a couple of times. She's washing. She's not playing with my other cat, Patch, but I don't know whether that's because she doesn't feel like it or Patch is still nervous. Patch was hissing again this morning.

    Thanks @Kris & Teasel I was thinking of 1u myself because I really want to be able to do a proper curve tomorrow and I can only do this if I give her insulin in the morning. I'm working on Tuesday so would not be able to do another one until next Saturday.
    I'm going to try to buy some syringes which aren't just whole numbers but I'm a bit unsure of where to buy them and if they are sterile, for example, and that can be trusted. I understand they have to be U40, with caninsulin, but I'm not really sure what that means.

    Thanks @Diana&Tom I am dreading leaving her but I only have 4 more days of work until I move on 23/05 so hopefully I can make some progress before that point.

    I did smell both cats breaths and they smelt the same. I pulled their skin up and my other cat's skin went back quicker than Tinkerbell's. Looking for potential DKA signs or symptoms. I haven't seen her drink water today, she has only had it mixed with food. That's not to say she wasn't drinking in the night. I even took her a glass of water seeing as I've seen her try to get mine on the table before when she has her own out! lol But she still wasn't interested.
    Is an overnight curve as beneficial? Or is it best to just wait to do a curve, with insulin, tomorrow?
    Can I buy a blood testing ketone machine? I've seen there are some, via this forum, but I didn't know if they are in the UK.
     
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  42. Kris & Teasel

    Kris & Teasel Well-Known Member

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    An overnight curve would be great if you can tolerate the interrupted sleep.
     
  43. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Fiona, you can get half-unit syringes for U40 insulin at VetUK here:
    https://www.vetuk.co.uk/veterinary-...nsulin-syringe-with-needle-box-of-100-p-11335

    'U40' just means there's 40 units of insulin per ml of liquid. Caninsulin and Prozinc are both U40.
    Most other insulins are U100, or 100 units insulin per ml.

    Incidentally, if it happens that Tinkerbell starts to need small doses you may find it helpful to switch to U1oo syringes as these make measuring small doses of U40 insulin much easier. However the U100's have to be used with a conversion chart when using U40 insulin so that you get the right dose.
    .
     
  44. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    You're a hard taskmaster, Kris, haha! :p :D
    .
    [​IMG]
     
  45. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Do you think her ears will be ok with an overnight curve seeing as I've done it every 2 hours today so far?
     
  46. Kris & Teasel

    Kris & Teasel Well-Known Member

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    I think you can stop until PMPS. If not a full curve tonight, try for +3 and +6.
     
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  47. Diana&Tom

    Diana&Tom Well-Known Member

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    Good plan.
     
  48. Fiona1

    Fiona1 Member

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    She has been quite sleepy today, not drunk water except what was in her food, not urinated as far as ive seen and has made a snotty sound with her nose a few times.
     
  49. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    My kitties have been flaked out all day, and aren't that interested in food. The heat is getting to them a bit, I think. They'll probably perk up once the sun goes down.
    Could it just be the heat that's affecting Tinkerbell also...? (That doesn't account for the snotty-sounding nose though, admittedly...)
    .
     
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  50. Fiona1

    Fiona1 Member

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    Yeah it could be as shes gone to lay down in a cooler room.
     
  51. Diana&Tom

    Diana&Tom Well-Known Member

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    I think we're all feeling the heat and we humans don't have to wear fur coats and can take cold drinks... must be more uncomfortable for kitties. Hopefully they'll perk up when it cools down in the evening as Eliz says.
     
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  52. Fiona1

    Fiona1 Member

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  53. Diana&Tom

    Diana&Tom Well-Known Member

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    That's really not too bad considering 24 hours without insulin. Are you sticking to the 1u plan? It may or may not have the effect we're looking for but we won't know until you try it. Let's hope so!
     
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  54. Fiona1

    Fiona1 Member

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  55. Fiona1

    Fiona1 Member

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  56. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Yeeeesssssssss!!!!!!!!!!!!!!! Great news.... :woot:
    With that negative ketone result, and the numbers staying as steady as they have all day, the one unit looks like a good call...
    .
     
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  57. Monica & Josie

    Monica & Josie Member

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    16.0 still sounds pretty reasonable.
    Hopefully we’ll get a good response to this eve’s 1u,. Yay for negative ketones!

    As for warm weather and kitties lack of appetite I can only join you ladies, Josie was so picky today turning up her nose at every item of the kitty buffet I laid out for her on the kitchen floor.. she was driving me bonkers!:banghead:
    Hopefully Tinkerbell will settle back into her old routine soon, also that she’ll get along with her kitty buddy Patch as well..
    Oh and we use exactly the same needles by VetUK as recommender above , they are pretty reliable and a decent quality.
     
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  58. Fiona1

    Fiona1 Member

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    Shes become so lethargic and hardly eating :(
    Pm shot +3 is 8.8
     
  59. Fiona1

    Fiona1 Member

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    I didnt get +6 as i must have turned my alarm off in my sleep which was annoying.
    Shes a bit better this morning. I woke with her on my pillow with me, purring.
     
  60. Monica & Josie

    Monica & Josie Member

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    Oh well at least you got some sleep!
    Glad she’s feeling happier
     
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  61. Fiona1

    Fiona1 Member

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    She was 13 this morning so i gave her 1u.
    Whats an ideal amps for a diabetic cat (if there is 1)?
     
  62. Diana&Tom

    Diana&Tom Well-Known Member

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    I think you've answered your own question - there isn't exactly an ideal amps. If anything, you could say it's a number that's familiar to you and which your data shows responds satisfactorily to a certain dose. So you might get a 13 at amps, shoot 1u because that seems as good a dose as any going on recent data, cycle pans out nicely on that dose... so that would therefore be an ideal amps *at that time*. On another occasion, you might get an amps of 20 and shoot 2u because your data tells you that 2u is a good dose at that number *at that time*.

    I don't think I'm explaining this very well but maybe I've misread your question... maybe you mean what's an ideal ambg for a diabetic cat not consistently on insulin, ie regulated? That would be a number within normal range which is approx 4.5 - 6.5...

    I'm really not sure if I'm making sense. More coffee needed! Can anyone give a clearer answer please @Monica Lewis @Elizabeth and Bertie ?????
     
    Last edited: May 7, 2018
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  63. Fiona1

    Fiona1 Member

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    No i think that answers it so thank you :) i guess its every cat is different.
     
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  64. Diana&Tom

    Diana&Tom Well-Known Member

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    YES! Every Cat Is Different (ECID) is a phrase you'll hear a lot on this board. And really, not so unusual because every human and probably every other living thing is different too... we all respond differently to various treatments because we are not robots!
     
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  65. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    I got 8.5 at +2 of the shot. Im a bit concerned its going to drop a lot as we are not at nadir yet.
     
  66. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    That number is fine, but her BG is dropping a little fast at this point.
    It may be OK, but if you are concerned you could try a very small snack of low carb food just to slow that drop down.
    Are you able to test again in half an hour so we can see what the trajectory is?

    Edited to add: What a wonderful response to this insulin dose! It's really nice to see those blood glucose levels coming down....
    .
     
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  67. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Fiona @Fiona1 , which blood glucose monitor are you using? Is it a pet monitor or a human one?
     
  68. Fiona1

    Fiona1 Member

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    Its human. Accu chek performa nano.

    Tried some wet food but she already had some this morning and wouldnt eat it. Instead i gave her 6 porta 21 dry food biscuits. Will test her in 10 mins as thats gonna be +3.
     
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  69. Fiona1

    Fiona1 Member

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    I know! :)
    To think, a week ago, while she was still in the vets, we were thinking she might not respond to insulin.
     
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  70. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Okey dokey.
    The aim, with the food is just to try to slow the drop a little, but without robbing her of some nice BG numbers. But, given that we don't know upfront how food will affect our kitties we can only experiment...

    With Caninsulin, at first, the 'aim' is to not let the BG drop much below 5 mmol. That is just to allow some buffer of safety in case the BG does actually drop lower than that.
    .
     
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  71. Fiona1

    Fiona1 Member

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    Theres a big change in her today. Shes sunning herself, purring, walking around. :)
     
  72. Fiona1

    Fiona1 Member

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    +3 is 6.9
     
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  73. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    That's looking nice. And she's only dropped about 1.6mmol in the past hour.

    :bighug::bighug::bighug:
    .
     
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  74. Monica & Josie

    Monica & Josie Member

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    At work since 7am so just caught up but I like what I’m seeing so far, sounds like a jolly good morning all round..:cat:
    @Diana&Tom your reply made me smile..:)
     
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  75. Monica & Josie

    Monica & Josie Member

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    Also may I just add that I’m so pleased Tinkerbell is responding so beautifully to the 1u dose, it’s mortifying to think back that she was getting 6u at the vets with odd readings all over the place..:nailbiting:
    This shows that increasing the dose is not always the answer..
     
  76. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Do you think it could be worth me buying syringes with numbers less than whole numbers today, as shes going to be on her own tomorrow? Or wait and see the full curve? Or stick with 1?
    I did phone 1 emergency vets but they only have half units. I have a few in the area though, who might do quarters too.
     
  77. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    There are syringes available with half units, but not with quarter units as far as I know. (If they are available that would be great!)
    It is possible to 'eyeball' a dose between two lines on a syringe, especially if holding the syringe against a light source, so you might well be able to measure less than a whole unit on your current syringes.

    Given the current rate at which Tinkerbell's blood glucose is coming down, it could well be that she does need a smaller dose than one unit... If that is the case - and if you're comfortable with doing so - then you could consider a switch to U100 syringes, which make small doses of U40 much easier to measure.
    .
     
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  78. Diana&Tom

    Diana&Tom Well-Known Member

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    Did it @Monica Lewis ? I'm not normally a funny person.... ;-) !!
     
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  79. Diana&Tom

    Diana&Tom Well-Known Member

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    Very very true. Whatever was the vet thinking of. When you report back, @Fiona1 it will be interesting to see what he has to say for himself!
     
  80. Diana&Tom

    Diana&Tom Well-Known Member

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    Soooo pleased that things are moving in the right direction, Fiona. You've worked so hard and deserve this. I hope you're doing something nice today - celebrating our achievements here is always thoroughly recommended!
     
  81. Monica & Josie

    Monica & Josie Member

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    Given the current rate at which Tinkerbell's blood glucose is coming down, it could well be that she does need a smaller dose than one unit... If that is the case - and if you're comfortable with doing so - then you could consider a switch to U100 syringes, which make small doses of U40 much easier to measure.
    .[/QUOTE]
    I’ve been actually thinking the same Eliz, an even smaller dose might be even better...
    Fiona we are giving Josie 0.75u using the needles recommended above...
     
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  82. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Thanks will have a look into those syringes.
    She hasnt really eaten since this morning and even this morning, it was equivalent to about a quarter of a pouch.
    Ive taken some more readings. Do you think she is rising too fast?
     
  83. Diana&Tom

    Diana&Tom Well-Known Member

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    My cat isn't eating much today either... this warm weather affects their appetite I'm sure. As for Tinkerbell rising now... no, it doesn't look particularly fast, given that it's now past nadir so she may not have a lot of insulin left. She may be up in the teens at pmps but we can only take it one step at a time really. Hopefully by then it will be cooler and she'll be more interested in food.
     
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  84. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Shes not eating and we are now 20 mins before the shot. Reading of 15.3. Should i still give the shot?

    Update: shes had about 5 mouthfuls. Not drinking water either really, unless i mix it with food.
     
    Last edited: May 7, 2018
  85. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    Fiona, do you know why she's not eating..?

    ...Given her recent history of DKA it would be good to get some insulin into her, even if that is a reduced dose.

    But, if her blood glucose does drop too low you'd need to be OK with raising that. That would mean either getting her to eat something, or, if the situation really warranted it, getting a little glucose or honey into her.
    With a reduced dose I think it would be unlikely that the blood glucose would drop too low given her PMPS....

    Edited to add: The timing of Caninsulin shots can be a little bit flexible. It doesn't have to be exactly 12 hours apart. So, you can have some breathing space to think...
    .
     
  86. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Im not sure why shes not eating. I think she doesnt like any of the foods yet. She will have a few bites and thats it. My other cat isnt eating them either. I gave them both a bit of tuna in spring water earlier which they ate but tried to give more and they wouldnt eat it.

    I gave 1u as she ended up having some food but will keep an eye on her.
     
  87. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Sep 6, 2010
    OK, Fiona. She'll probably be just fine.
    If you can snag a test at +2 that might clue you in as to how the rest of the cycle might go. (It's not a perfect indicator, but can often give some important clues..)
    Because this is an international forum there is always someone here. If you are concerned at any point DO post. And if you want to attract attention a new thread may attract fresh 'eyes'.
    .
     
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  88. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Ambg is 11.4 so fed her and going to do another test in 20 mins.
     
  89. Diana&Tom

    Diana&Tom Well-Known Member

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    Dec 29, 2009
    Spot on, Fiona... and that's a lovely ambg number even though it leaves you in a quandrary about shooting. I think you're going to work today, right (?) - the thing here will probably be to dose very conservatively (unless she has shot up). She is giving you some very nice numbers now on a small dose and we want to make sure she's safe while you're out of the house.

    One of the other sayings here is "better too high for a day than too low for a minute" or something to that effect... your situation is complicated by the recent dka episode so we do want to make sure that Tinkerbell has insulin if she needs it, but equally, we don't want to risk hypo. So we may be treading a fine line. By a "conservative" dose we'd mean giving slightly less than you might think; you could also give a "token" dose which would be a very small, maybe 0.5u. But see what your next test result is.

    It's also a working day for me today but hopefully @Elizabeth and Bertie may be around to give more concrete advice.
     
    Last edited: May 8, 2018
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  90. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Oh, that 11.4 is lovely to see....

    Her BG may rise now, but that increase may be food-induced and therefore not a 'true' number. There's no way to tell whether it would have risen anyway on its own.
    So, if that situation happens again (number a bit too low to shoot) another option is to 'stall'; that is, to wait without feeding and see if the number rises on its own. (Difficult to do with a hungry kitty, I know!)
    It may be safer now to assume that the AMPS is still 11.4.

    I know you're out today, and this is a lower AMPS than you've shot before. It's new territory.
    In this situation I would not advise giving a whole unit of insulin because you can't be around to monitor and take any necessary action. And it may be that this preshot number needs less insulin anyway.
    It may also be the case that Tinkerbell won't eat so much if you are out, and that too could affect the numbers.

    You could consider a reduced dose, or even a tiny weeny token dose - if you can measure it - so that she has 'some' insulin in her system.
    Or you could skip the shot. This is the safest in terms of her BG levels.

    I know it's a bit more awkward because of her recent DKA history, so it's a matter of doing what seems safest overall in the circumstances. (And, fortunately, her last pee test didn't show any ketones.)
    .
     
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  91. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Just done another and its 13.4. Going by yesterdays curve, think i might eyeball 0.5.
     
  92. Diana&Tom

    Diana&Tom Well-Known Member

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    And try to ensure she has some food?
     
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  93. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Gave her just under 0.5.
    Will try to give her some more food.
     
  94. Diana&Tom

    Diana&Tom Well-Known Member

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    Think that's what I'd have done too... a "just under" dose is what we call a "skinny" dose (and a "just over" dose would be a "fat" one!). What time are you leaving? Can you do another test before then?
     
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  95. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    No im unable to test her as ive already left :(
    She did eat some more food though.
     
  96. Diana&Tom

    Diana&Tom Well-Known Member

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    OK no worries... she should be fine. You've dosed conservatively based on yesterday's curve data, knowing she needed at least some insulin... you've done the very best you can. Tinkerbell will probably have a nice quiet day in a cool room somewhere, like most of our kitties atm.
    Try to have a good day yourself! Keep us informed later.
     
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  97. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Good call! I think she’ll be OK. :)
     
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  98. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Thanks everyone.
    Just got a cab home in my lunch break quickly. She was asleep. Tested and she was8.8. Nadir will have already passed most likely as we are now at +6.5
     
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  99. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Oh my goodness, you are SO dedicated! :woot:

    And it looks like the insulin dose you gave this morning was a really good call. :)

    It looks like 8.8 is her favourite number at the moment; it's appeared quite a few times on her SS....
    .
     
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  100. Fiona1

    Fiona1 Member

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    Apr 17, 2018
    Yeah i was thinking that about 8.8 lol
    Shes quite lively this evening.
     
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