Newly diagnosed, scared, but coping

Status
Not open for further replies.
Vidya & Boo

Vidya & Boo

Member
Hi,

I hope I'm posting in the right place!

My sweet baby, Boo, was just diagnosed this week. This has been a very scary and stressful week, but I just wanted to thank all of the members of the FDMB, as I don't think I could have gotten this far without all the help. The postings here helped me make the dramatic diet change (high-carb dry food to primarily low-carb, affordable wet food) several days before starting the insulin, choose a decent glucometer (Accu-check Aviva), master the blood testing (28-gauge lancets used freehand are infinitely easier/better than the 30-gauge lancet-pen I was using at first), pick the best needles (5/16" are perfect for Boo), understand how to do a glucose curve, become aware of how to watch for hypoglycaemia, and find the necessary photos and videos to learn how to fill syringes, inject the insulin, and test the glucose appropriately. Thank you all so, so much! I'll keep reading FDMB in the coming weeks as we try to get Boo as well regulated as possible.

Vidya (Boo's mum)
 
Welcome Vidya and extra sweet Boo!

WOW!!! Just look how ready you are for getting your baby regulated! Already testing - WONDERFUL JOB!!!! You're a wonderful MamaBean!!!

HUGS!
 
You're doing a great job, Vidya, Welcome to fdmb!

What insulin are you using? We have groups for the different types of insulin and you would get the best advice and learn the most that's particular to your circumstances by posting on that particular board about anything insulin related. You also want to set up a spread sheet so you can track Boo's progress and at the same time it will allow those who know your insulin to help you better.

Melanie & Racci

I'm not sure where you are but this is the link to the spreadsheet. It's the world spreadsheet so if you are in Europe it will automatically change your BG to US on the US page:
World Spreadsheet http://felinediabetes.com/FDMB/viewtopic.php?p=179835#p179835

If you have any questions, please ask.
 
Hello, I'm Boo's dad (I suppose) and Vidya's room-mate. Thanks to everyone for their assistance.

Does anyone have any tips on how to make a fidgety cat hold still for testing and injections?
 
We're using Lantus (my vet's recommendation). Now that Boo's dad (TheNewTeddy, posted just above) and I are starting to have more success with the lancets/bloodtesting, we should hopefully have enough info to work out some solid spreadsheets and 'curve' graphs soon.

This is all really challenging, but my vet -- we use a 'mobile vet' who makes housecalls, to avoid the stress of travel -- says she knows others who, with her guidance and their own research, have managed to regulate their diabetic cats well. All fingers, toes, and paws are crossed -- and prayers and good thoughts are very welcome.

Vidya
 
TheNewTeddy said:
Hello, I'm Boo's dad (I suppose) and Vidya's room-mate. Thanks to everyone for their assistance.

Does anyone have any tips on how to make a fidgety cat hold still for testing and injections?
Click to expand...

Ya, treats after testing.

Always give a low-carb treat after a testing session. Even if you don't get a
successful test.
 
Welcome to the FDMB Family!!

not only is it possible with some cats to get them regulated, but some even go completely off insulin after awhile. :-D I have one guy here that has been off insulin and diet controlled for over a year now. (Just thought I would give you something else to shoot for. :-D ).

But even if Boo never goes off insulin you will quickly find that once you find your groove with testing and shots it becomes second nature and is just one of those daily things like feeding them and cleaning the litter box.

Sounds like you both are off to a flying start on caring for your extra sweet Boo-kitty, what a great set of fur-parents he has.

Mel, Maxwell, Musette & The Fur Gang
 
Lantus is a great insulin! I use that too. We're celebrating a cat going off the juice, off insulin, right now on the Lantus tight regulation board. You ought to come on over and join us. You'll get a lot of support and help there and maybe yours will be one of the lucky ones. Your vet is very right in that. Not only regulating but remission is possible. If you go to the board index, there's a link on the upper right hand corner of the page, when you get there you'll see Lantus land. Go to tight regulation and check it out. All you need is a spreadsheet, you have everything else.

The most important tests to take are the pre-shots and the nadir or lowest point, which is for most cats, around +6 hours after the am shot and pm shot. You should also regulate when you feed and feed low carb wet food. We have links to that as well if you haven't found them give a yell.

Some cats have to be burritoed at first if they won't sit still. Just wrap in a towel or blanket like a newborn babe or burrito to keep them there while giving treats but most will sit with you if you keep the treats coming and they know it as a good time. Have all your supplies ready beffore you get him so you can be efficient and warm the ear so it bleeds easier. Vaseline or neosporin with pain relief is good to keep the fur from soaking the blood up before you can. And treat, treat, treat.
 
Wow! You really did your homework have everything down right! This is what I love to see. :-D

Bandit fought me tooth and claw the first couple weeks of testing. On my vet's advice, I got a basket that was a little bigger than him, and lined it with several soft, fleece blankets. I then used a third fleece blanket and used that to tuck him in so that only his head stuck out (like the burrito technique mentioned above). I made sure I gave him a treat after every test, and dabbed a tiny bit of neosporin + pain relief on the poke spot (after applying pressure for 20 seconds to prevent bruising). After a few weeks of that, I didn't have to tuck him in with the third blanket, he would just sit still when I put him in the basket. Today, when he hears the glucose meter beep on he comes running, jumps in his basket, lies down and starts purring. You cannot underestimate the power of freeze-dried chicken and salmon treats! :-D
 
Thanks, all, for the further points of advice.

We're trying for a pre-shot and an estimated-nadir reading at least once a day at this early period. Boo's only on a 2-unit dose of Lantus, so he's not getting low enough yet for hypoglycemia to be a concern (though we've prepared a kit of high-carb food, corn syrup, and emergency vet phone numbers just in case). In about a week's time, we'll do our first real glucose curve.

Since switching to the 28-gauge freehand lancets today (aided by the heated rice sock), I've had a lot more success with the blood tests. Little pain or struggle for either of us, and a nice, larger-than-necessary blood drop on the first try almost every time (with the 30-gauge lancet pen, we were lucky to get one usable drop out of 20 punctures). Our vet gave us a roll of partly-used inch-wide bandage tape (about a quarter-inch depth of tape still left on the roll), and I just slip the roll onto my finger behind Boo's ear to hold it firmly and prevent any poking of my own finger. Depending on how we do with this approach, I'm also considering buying one of these, if I can find a source that ships to Canada for less than $50 S/H(!): http://illumavein.com/ (Does anyone here use this? It might also be a nice tool to have on hand just in case we ever need to quickly train a cat-sitter to do the blood tests.)
 
You're not trying to hit the vein, you're aiming for the area between the vein and the edge of the ear. You're wanting capillary blood, not venous blood. It's not a problem hitting the vein every once in a while but don't aim for it. I think we ALL started by thinking we needed to do that...

Welcome Boo's PapaBean too!

HUGS!
 
vidya said:
We're trying for a pre-shot and an estimated-nadir reading at least once a day at this early period. Boo's only on a 2-unit dose of Lantus, so he's not getting low enough yet for hypoglycemia to be a concern (though we've prepared a kit of high-carb food, corn syrup, and emergency vet phone numbers just in case). In about a week's time, we'll do our first real glucose curve.
Click to expand...

Actually, 2u is on the high end of a starting dose. How much is Boo supposed to weigh? Most cats on a low carb canned diet don't need much more than 1u of insulin, so hypoglycemia is indeed a concern for you at this point. The starting dose should be .25u per kg of ideal weight. Only very large cats (large framed, not fat because you're dealing with ideal weight) are started at 2u, and even then the weight-based formula is questionable because they usually do not need that much insulin. My friend's cat is a large framed 18 lb (8kg) Maine Coon and he's currently well regulated on 1.25u of Lantus. He started at 1u, and never needed more than 1.75u. My 13 lb (6 kg) cat is in remission now, and his highest dose was 1.25u (only for about 24 hrs before it dropped his blood sugar too low), but he was well regulated on .75u-1u. If I had started him at 1.5u like the weight formula recommends, I would have been overdosing him from the start.That's why 1u is a good dose to start with. Too much insulin will keep blood glucose levels just as high as too little insulin, and you won't catch that it's too much insulin unless you're testing more frequently.

With Lantus, you should be testing at least 3 times a day--once before each shot to make sure it's safe to give insulin, and then a nadir test about 6 hrs after each shot, and a curve should be done once a week. The reason why you need both pre shot tests is because a cat that is going hypoglycemic in one cycle, is going to rise to very high numbers in the next cycle because their livers dump glucose into their bloodstream to counteract the low numbers. So if you're only getting tests in one cycle, you're not getting the complete picture. For example, what if 2u is too high and you test, get a high number in the morning and at his nadir, but then your PM preshot drops to 50? You need to be safe for both shots. Cats are very good at hiding things, and they usually do not show physical symptoms of a hypo until they've already had a hypo incident multiple times and they've depleted their bodies emergency stores of glycogen. Testing both cycles is very important.

The risk of hypoglycemia is significantly lower with micro doses (.5u-.1u), but with anything above .5u, the risk of hypoglycemia is very real. I'm not trying to scare you, but many cats have had hypoglycemic incidents on less than 2u, so you do need to be vigilant, especially on that higher dose.
 
Boo is a very large cat. Scout (his sister) is also on the large side but not as much. My roomate and I can also be considered "Large" by some, so we are perhaps "fat friendly". We have however taken a strict control over their diets, and are only feeding them a certain amount of a certain food that we are more sure is healthy and low in sugars than their previous foods. His first tests were in the range of 23 (420 US) but recent tests have been down to about 12 (220 US) so we are hopeful that the regimen he is on will work, and I in particular an hopeful that with good care he will go OTJ at some point and stay that way.
 
Thanks for the further info re: hypoglycaemia. My remark about little concern with hypoglycaemia is based mostly on the fact that even his nadir readings are not (yet) falling very low; certainly we'll keep testing and be extra-cautious if there's an increase in his response to the 2-unit dose this week. We've been doing a combination of scheduled and 'random' testing at this point, and recording everything.

As Boo's dad mentioned above, Boo is a huge cat -- big frame, heavy bones, strong muscles, and a bunch of pudgy pudginess as well. He's even been mistaken by neighbours, at a quick glance, for a dog on more than one occasion!
 
vidya said:
Thanks for the further info re: hypoglycaemia. My remark about little concern with hypoglycaemia is based mostly on the fact that even his nadir readings are not (yet) falling very low; certainly we'll keep testing and be extra-cautious if there's an increase in his response to the 2-unit dose this week. We've been doing a combination of scheduled and 'random' testing at this point, and recording everything.

As Boo's dad mentioned above, Boo is a huge cat -- big frame, heavy bones, strong muscles, and a bunch of pudgy pudginess as well. He's even been mistaken by neighbours, at a quick glance, for a dog on more than one occasion!
Click to expand...


I see. Then 2u wasn't an inappropriate starting dose. Please make sure that you are testing in both cycles though, because like I mentioned, even larger cats may have a reduced need for insulin, especially after a diet change, and one cycle may not be giving you the whole picture. Many cats will have lower numbers in one cycle than another. And you also never want to shoot insulin without testing first.

Also, many vets try to increase the dose too quickly, so watch out for that. Dose adjustments should be made in .25u increments (.5u increments if the nadirs are above 300). But it sounds to me like your vet knows what they're doing. :-)
 
Hi Vidya and Boo! (and dad)!

Welcome to another fellow Canadian!

You are receiving such great advice here...so I won't add to that...simply wanted to stop by and say hello! :-D
 
Julia & Bandit said:
Please make sure that you are testing in both cycles though, because like I mentioned, even larger cats may have a reduced need for insulin, especially after a diet change, and one cycle may not be giving you the whole picture. Many cats will have lower numbers in one cycle than another. And you also never want to shoot insulin without testing first.

Also, many vets try to increase the dose too quickly, so watch out for that. Dose adjustments should be made in .25u increments (.5u increments if the nadirs are above 300). But it sounds to me like your vet knows what they're doing. :-)
Click to expand...

Thanks -- now that we're getting better at the blood tests, we are testing prior to each dose, and keeping an eye on the nadirs. As Boo's only been getting insulin for two days now, our monitoring strategy is evolving as we go along and see/measure his response. Given that he's only recently (four days ago) been switched to the low-carb diet, I'm especially watching to see how that factor interacts with the insulin response.

Yes, our vet also recommended the smaller dose adjustment, unless high nadirs are an issue. So far, we've been blessed with sound advice from many quarters, for which I'm extremely grateful.
 
I'm relived myself as I've been able to do everything for him at least once. I have Dysgraphia which is co-morbid with my Autism. So I've been nervous about being unable to do everything, but I was able to poke him in the ear and get a blood drop and give him a quick jab of insulin. I certainly feel better knowing that I can do these things in Vidya is not around.
 
Sorry for double posting but I'm happy that while Vidya was sleeping (and not watching/guiding) I was able to do the testing myself (I have a harder time testing than I do injecting) We do injections at 9 and 9, so 3 is the midpoint, and it's 4. His test was over 16, which is oddly comforting as I was afraid that maybe he was getting too low.
 
Status
Not open for further replies.
Back
Top