Newly joined and currently giving insulin - how to "start over"?

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Lucy was not having it all this morning - I've come to find she is very, very difficult to test prior to feeding first thing in the morning because that is when she's most hungry and she gets pretty aggressive (not in a mean way). Once I finally managed to get her to stay still in the burrito for two seconds, both of the test strips gave me Error messages :mad: Then, once they did work, they wouldn't take a reading from the blood drop. So...very unsuccessful this morning but I am going to try to get some more readings from her today. She is definitely very tired after this change to 1U so am keeping an eye on her today.
 
hellolucy said:
Lucy was not having it all this morning - I've come to find she is very, very difficult to test prior to feeding first thing in the morning because that is when she's most hungry and she gets pretty aggressive (not in a mean way). Once I finally managed to get her to stay still in the burrito for two seconds, both of the test strips gave me Error messages :mad: Then, once they did work, they wouldn't take a reading from the blood drop. So...very unsuccessful this morning but I am going to try to get some more readings from her today. She is definitely very tired after this change to 1U so am keeping an eye on her today.
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You can try feeding her some or all of her meal if she eats quickly and then test the minute she finishes. It can take 20 minutes or more for food to affect BG. Better than no test at all.
 
Kris & Teasel said:
You can try feeding her some or all of her meal if she eats quickly and then test the minute she finishes. It can take 20 minutes or more for food to affect BG. Better than no test at all.
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I didn't know that! I thought it was immediate or absolutely had to be done before she ate. This will probably help a lot, especially before her dinner tonight. Thank you!
 
hellolucy said:
I didn't know that! I thought it was immediate or absolutely had to be done before she ate. This will probably help a lot, especially before her dinner tonight. Thank you!
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It's bending the rules but ya gotta do what ya gotta do!! Is she a fast eater? You could try giving only half of her meal, test her with the edge taken off her hunger and then give the rest of her food.
 
That was a very nice blue last night though :cat: Also, the more you get the routine with her, she'll know if she behaves for a test she will get her meal. Maury's had a couple occurrences where he "sings the song of his people" but he knows I have to poke first ;)
 
Kris & Teasel said:
It's bending the rules but ya gotta do what ya gotta do!! Is she a fast eater? You could try giving only half of her meal, test her with the edge taken off her hunger and then give the rest of her food.
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Lucy, eats? Noo. Lucy, inhales? Yes! ;) She eats pretty darn fast most of the time. I think letting her eat a bit and testing her right away will help a LOT so will let you know how that goes!
 
hellolucy said:
Lucy, eats? Noo. Lucy, inhales? Yes! ;) She eats pretty darn fast most of the time. I think letting her eat a bit and testing her right away will help a LOT so will let you know how that goes!
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The fact that she inhales her food will really help here. It's a huge bonus to have a kitty that's a good eater when you're treating diabetes. My guy is really fond of his grub too. :)
 
So I am getting ready to take Lucy's pre-dinner test in a little bit and also want to try to take another before going to bed. Before I give her the shot after dinner, I just wanted to see if you all think there is any significant risk or negative side effects of dropping Lucy such a large amount on insulin? I guess we will know in a few days after one cycle how it's working for her but wanted to ask in the meantime. She was tired again today but did get up and move around, etc. Just being a paranoid mom!
 
hellolucy said:
So I am getting ready to take Lucy's pre-dinner test in a little bit and also want to try to take another before going to bed. Before I give her the shot after dinner, I just wanted to see if you all think there is any significant risk or negative side effects of dropping Lucy such a large amount on insulin? I guess we will know in a few days after one cycle how it's working for her but wanted to ask in the meantime. She was tired again today but did get up and move around, etc. Just being a paranoid mom!
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You'll know in another cycle or two if 1 u is too low and then you can increase to 1.25 u (eyeballed on the syringe). There's no need to linger longer than 3 cycles or so on an ineffective dose. That should prevent her from being too high any longer than necessary.
 
Since you can move up fairly quickly, I agree with Kris...there shouldn't be a problem with it. Just make sure you're getting ketone tests in when you can.
 
Kris & Teasel said:
I suggest you give 1.25 u today. You'll have to eyeball that on the syringe. Do yours have half unit marks? They would help.
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I don't :( But I can eyeball it and give just over the 1U mark and get some more of the numbers when I get home. Do you suggest increasing based on her recent readings? I tried to get another test in before going to bed last night and went through 4 strips. Argh :( I am also going to try to sneak in her catbox room with her and one of the ketone strips. Thanks everyone for all of the advice to date!
 
hellolucy said:
I don't :( But I can eyeball it and give just over the 1U mark and get some more of the numbers when I get home. Do you suggest increasing based on her recent readings? I tried to get another test in before going to bed last night and went through 4 strips. Argh :( I am also going to try to sneak in her catbox room with her and one of the ketone strips. Thanks everyone for all of the advice to date!
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Yes, I think she's ready for what we'll call 1.25 u. It doesn't matter if you eyeball it perfectly, just aim for a consistent level in the syringe dose to dose. If she's still high after 3 doses or so, you can go to 1.5 u. It's important not to leave her in what could be too low a dose range any longer than necessary.
 
Back at work and have been getting scattered measurements but her numbers are most definitely lower than what I've previously been getting at 4U! I'll be doing another test in about 4 hours since I have the weekend off and more mid-cycle tests this weekend. Haven't been able to successfully catch her with a ketone strip yet. I have a question about testing her I've been slightly nervous to ask for fear that I've been doing it wrong as sometimes a significant blood drop forms (and very quickly) and other times it is minuscule and doesn't even register on the AT2. Some articles say to poke the actual vein that goes around the ear. Other articles say to poke in between that vein and the edge of the ear. Which is correct?
 
Well, technically you can poke anywhere that bleeds. I just saw a tutorial where they poked right in the middle of the ear. However my understanding is that it hurts the least on the edge between the vein and the outer edge. And if you hit the "sweet spot" you'll usually get a good-sized bead of blood, but then can still get it to stop with a little pressure. If you hit the vein, it will bleed longer.

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Djamila said:
Well, technically you can poke anywhere that bleeds. I just saw a tutorial where they poked right in the middle of the ear. However my understanding is that it hurts the least on the edge between the vein and the outer edge. And if you hit the "sweet spot" you'll usually get a good-sized bead of blood, but then can still get it to stop with a little pressure. If you hit the vein, it will bleed longer.

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Thank you! This is helpful. I'll have to pay more attention to what spot was poked that bleeds the most. I am trying to switch up spots on her poor ears right now. Sometimes, the blood spot is tiny and I have to repoke and other times I get a little freaked out by how quickly and how much blood comes to the surface ;(
 
That's pretty normal to have some variation depending on exactly where you poke. I rotate spots as well so one place doesn't take too much "abuse".
 
I used to do 2 quick pokes right next to each other at first to help the blood drop get bigger...so if you get something small, might poke again next to it and milk the ear a little. I try to avoid the vein as it can be a bit painful and it bleeds a LOT sometimes...but if that's where you have to go for blood, do it! And you'll hit it by accident sometimes...still stops bleeding, just needs pressure a little longer.
 
Thin layer of ointment and pressure on the poke spot helps the ears heal nicely too :). We know the mid-cycle tests are difficult to get if you work full time but the AMPS and PMPS are mandatory, to make sure she is safe to get insulin. She is responding much better to the lower dose, so definitely looks like 4U was too high :cat:. Looking forward to seeing her first curve results!
 
Hi everyone - something is up with Lucy. I went out of town twice this past week for work so am having trouble figuring out where it all came from (a family member lives about 2 minutes away from me and was taking care of her and giving her shots). She seemed fine last night before we went to sleep. She threw up a few times in the middle of the night last night. She ate breakfast this morning (but not much) and then threw that up. She's thrown up twice since then. I'm taking her glucose readings for a curve now and putting them in the spreadsheet. I'll be taking the next one in about 20 minutes once the 2 hour mark hits from her last reading. I've had a large plastic trash bag in her litter box since this morning waiting for her to pee so I can use the ketone strip and will post the results ASAP once she uses the bathroom. She seems pretty tired and not herself. These are all the same symptoms she had when I had to take her in for pancreatitis. I have a feeling this is what's happening but wanted to see if there were any other tests (besides the ketone strip) I should be using right now to determine what's going on.
 
Is she throwing up clear, food, hairballs? And was the 307 a pre-shot test, or was that one hour after insulin? Are you almost at +2 in the cycle right now? So she doesn't really have food in her today? Sorry for all of the questions...
 
Sorry to hear Lucy isn't feeling well, and of course on a holiday weekend :(. I'm not familiar with pancreatitis symptoms so hopefully one of the experienced members will chime in. Sending healing vines!
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Djamila said:
Is she throwing up clear, food, hairballs? And was the 307 a pre-shot test, or was that one hour after insulin? Are you almost at +2 in the cycle right now? So she doesn't really have food in her today? Sorry for all of the questions...
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She threw up very small amounts of clear liquid last night. There was one spot that was larger. Her throw up this morning after she ate was a large amount, liquid, and had her food in it. 307 was one hour after the insulin - the pre-shot test came back 3 times with an Error and just a failure and I got too emotional. I'd say she's thrown up a majority of the food she ate which wasn't very much this morning in the first place. I just added her +3 hour shot in to the spreadsheet (287). She didn't seem to care much when I poked her ear for this one which is strange. It did wake her up though and she walked over to her wet food to eat some more. She also seems to have lost a bit of weight while I was gone. Is it possible she is back in her pancreatitis state due to the quick drop in insulin dose even though her numbers were looking a lot better?
 
I don't know a ton about pancreatitis, but my limited understanding is that it can flare up at anytime without a lot of "reason." Is your vet open today? Can you call and see if they recommend the anti-nausea med? I think some people also ask for an appetite stimulant as well. You might also post over on the Main Forum where more people with experience in this can help out.
 
Djamila said:
I don't know a ton about pancreatitis, but my limited understanding is that it can flare up at anytime without a lot of "reason." Is your vet open today? Can you call and see if they recommend the anti-nausea med? I think some people also ask for an appetite stimulant as well. You might also post over on the Main Forum where more people with experience in this can help out.
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Thank you - I just posted over in the Main Forum with all of the details. Crossing my fingers!
 
So I ended up taking Lucy in to her normal vet because...fur baby paranoia love! Copying and pasting my update from the Main Forum here:

"Thank you everyone for your quick replies! They did a ketone test twice and she had a 'small' amount based on the strip color (15 mg/dL). They also did a test on her pancreas (I believe it was a blood test but can't remember the name) and said it was not indicative of pancreatitis. The vet also felt her abdomen and said she did not feel particularly swollen, etc. So...good that she doesn't have pancreatitis but still confusing as to why she has ketones in her urine. They did a BG measurement there (at +5 hours, probably semi-inflated due to the stress of being at the vet) which I've added to her spreadsheet. They gave her fluids as well as an anti-nausea injection and said to continue doing ketone and BG testing. She peed on the garbage bag in the litter box as soon as we got home so at least I know she'll use that method now!

Also, the missing measurements in the spreadsheet are just due to missed readings, definitely not missed shots. I haven't missed a shot with her one time since she was put on insulin back in December. I've adding her insulin shot amounts (on the days with recorded readings - she is given insulin 2x every day) to the spreadsheet just to clear that up.

I guess my question is...what the heck is causing her to have ketones in her urine if her BG readings aren't crazy high (although still higher than ideal) and her pancreas seems normal?"
 
I believe ketones are possible anytime the BG is high -- it doesn't necessarily have to be crazy high. That does seem to indicate that it's time to get busy with finding some better numbers though!

Also, add a bit of water to Lucy's food to keep her extra hydrated going forward - important for any cat, but especially if you have one that may be ketone prone.

So here is what I would recommend:
1. Test right before each and every shot. No more exceptions. The reason for that is we have to see how much the insulin is bringing her number down. We can't tell if we don't have the first number. Dosing is based on the pre-shot number, the nadir, and on the movement between the two. Which means to make wise dosing decisions we need the data.
2. Keep getting mid-cycle tests during the day. You're doing a good job with those!
3. Start getting a before-bed test every night.
4. Start posting regularly for advice on possible dose increases. Her numbers aren't red and black, but they are too high. It seems like you've done enough testing now (even if it still isn't exactly fun) to be able to start managing her diabetes a bit more aggressively. And it seems like she may be telling you she needs that.

How does that sound? I know it's a shift from what you've been doing, and we are all here to help in any way possible. Ketones just aren't something you want to mess with.
 
Oh I'm so sorry to hear that Lucy isn't feeling well! Glad you took her to the vet...I would have done the same. Better to catch what's going on ASAP.

Djamila has given you a great plan going forward...will you be able to follow it? I know it's a lot, but with ketones on board, you want to get things under control fast.

:bighug: because after the day you've had, I think you probably need some hugs!
 
Djamila said:
I believe ketones are possible anytime the BG is high -- it doesn't necessarily have to be crazy high. That does seem to indicate that it's time to get busy with finding some better numbers though!

Also, add a bit of water to Lucy's food to keep her extra hydrated going forward - important for any cat, but especially if you have one that may be ketone prone.

So here is what I would recommend:
1. Test right before each and every shot. No more exceptions. The reason for that is we have to see how much the insulin is bringing her number down. We can't tell if we don't have the first number. Dosing is based on the pre-shot number, the nadir, and on the movement between the two. Which means to make wise dosing decisions we need the data.
2. Keep getting mid-cycle tests during the day. You're doing a good job with those!
3. Start getting a before-bed test every night.
4. Start posting regularly for advice on possible dose increases. Her numbers aren't red and black, but they are too high. It seems like you've done enough testing now (even if it still isn't exactly fun) to be able to start managing her diabetes a bit more aggressively. And it seems like she may be telling you she needs that.

How does that sound? I know it's a shift from what you've been doing, and we are all here to help in any way possible. Ketones just aren't something you want to mess with.
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Yes, I can do this. I will start taking her pre-shot numbers more seriously and manage my emotions with them (I will admit they stress me out but that's not an excuse to not to do them whatsoever). As for the before bed test, would you say that is 1 - 3 hours after she's been giving her shot, or what time frame should I be shooting for with that? I am gone at work most of the day and home for a few hours before going to sleep so want to make sure I get it rig inght. I will also add water to her food - I did that earlier this morning in an attempt to get her to eat and she seems to like that when she's not feeling well. I am also going to keep putting new trash bags down in the cat box and continue ketone testing to make sure she is not getting worse. I am taking her pre-shot measurement in about an hour and will be adding it to the spreadsheet. Thank you everyone so much for your support and patience with me.
 
I have that same thing - sometimes it's just emotionally hard to do the test, even if Sam isn't that bothered by it. You're not alone in that, and we'll send you hug emojis whenever you need them! :bighug::bighug::bighug:

As for the evening test, it really depends on your schedule and what you can manage. The closer you can get to +3 or +4 the better. I usually aim for the test to be the absolute last thing I do before turning out the lights: test, give him a treat, then go to sleep. At +1, the number is food influenced and the insulin hasn't really kicked in yet. At +2, you can sometimes see a little drop, but not much yet. If you can't stay up until +3, some people will set an alarm every few nights to grab a test later in the cycle, but I wouldn't recommend that until you are comfortable testing because your sleep is important too. However, if you tend to get up during the night anyway, it's a great time to grab one.

Never hesitate to ask questions or even just vent here. We have all benefited from this community and are more than happy to help others when we can.
 
Djamila said:
I have that same thing - sometimes it's just emotionally hard to do the test, even if Sam isn't that bothered by it. You're not alone in that, and we'll send you hug emojis whenever you need them! :bighug::bighug::bighug:

As for the evening test, it really depends on your schedule and what you can manage. The closer you can get to +3 or +4 the better. I usually aim for the test to be the absolute last thing I do before turning out the lights: test, give him a treat, then go to sleep. At +1, the number is food influenced and the insulin hasn't really kicked in yet. At +2, you can sometimes see a little drop, but not much yet. If you can't stay up until +3, some people will set an alarm every few nights to grab a test later in the cycle, but I wouldn't recommend that until you are comfortable testing because your sleep is important too. However, if you tend to get up during the night anyway, it's a great time to grab one.

Never hesitate to ask questions or even just vent here. We have all benefited from this community and are more than happy to help others when we can.
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Thank you! I can do a 3 - 4 hours bedtime shot. I was just getting ready to do her pre-shot test and realized I was out of my original AT2 test strips. Does anyone know anything about these? Here is my dilema:

- My AT2 came with the testing solution and strips. The strips have a code of '7' for cat on the tube of strips. This is what I've been using on the meter for her tests with the accompanying test solution. I ordered 50 more strips from Amazon. These strips have a code of '8' for cat on the outside of the tube and did not come with any new test solution. Do I keep the AT2 set at the original code of '7' or do I reset it to '8' and use the code '7' testing solution? Is the testing solution universal and it more depends on the code the meter is set with and the results match to the ranges on the tube of test strips? Thank you.
 
I don't use an AT2, but I know from reading other's posts that you need to update the code. I'm pretty sure the testing solution is universal.
 
hellolucy said:
Do I keep the AT2 set at the original code of '7' or do I reset it to '8' and use the code '7' testing solution?
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For AT2 you would use the new cat code from the new bottle of strips :). I believe the control solution can still be used but @Kris & Teasel can verify that part ;). I know you can order more control solutions and I don't think they ask what code is on the strips.

Djamila said:
The closer you can get to +3 or +4 the better. I usually aim for the test to be the absolute last thing I do before turning out the lights: test, give him a treat, then go to sleep.
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Same here, it's part of my "winding down" routine :cat:
 
hellolucy said:
Thank you! I can do a 3 - 4 hours bedtime shot. I was just getting ready to do her pre-shot test and realized I was out of my original AT2 test strips. Does anyone know anything about these? Here is my dilema:

- My AT2 came with the testing solution and strips. The strips have a code of '7' for cat on the tube of strips. This is what I've been using on the meter for her tests with the accompanying test solution. I ordered 50 more strips from Amazon. These strips have a code of '8' for cat on the outside of the tube and did not come with any new test solution. Do I keep the AT2 set at the original code of '7' or do I reset it to '8' and use the code '7' testing solution? Is the testing solution universal and it more depends on the code the meter is set with and the results match to the ranges on the tube of test strips? Thank you.
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You reset the cat code (if needed) on your meter with every new vial of AT test strips. However, you'll see that many vials have the same cat code on them. I believe there are only half a dozen or so different codes. The control solution is universal. Just test a strip from each new vial to see if it gives a reading in the "cat" range shown on the solution bottle. The solution needs to be replaced 6 months (I think - check instructions) after it's been opened.

Congratulations on conquering the testing monster. It bothers all of us but does get easier with time and practice. Just keep the idea of Lucy's safety in the forefront of your mind as you do it. Ketone testing is essential too and you've found a way to do that. I always add enough warm tap water to Teasel's wet food to make a stew. Hydration is key to washing out ketones. Enough calories and insulin are key in preventing them, along with addressing any other infection/inflammation that might be going on.

You're doing great! This will all become far more routine over time. We can help along the way.
 
Thanks everyone for all of the support! I took another BG reading from Lucy this morning and it was lower. I added some water to her breakfast and she ate most of it and hasn't thrown it up (yet). Waiting about 5 more minutes to make sure she doesn't throw up before giving her the insulin. However, I did do another ketone test this morning and her ketone level has increased :( Yesterday, at home and at the vet, her reading was 15 mg/dL. Her level today is between 40 and 80 mg/dL (more towards 80). How long does it take for ketones get out of her system?

Also - does it mean her insulin needs to be increased if her ketone levels are higher?
 
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Whoa! That's quite an increase...I don't know enough about ketones to tell you what it means, but I would think vet attention was necessary. By chance, does the vet have a number you could call to ask? Might also post on the main forum for help since others there will have experience with this.
 
Rachel said:
Whoa! That's quite an increase...I don't know enough about ketones to tell you what it means, but I would think vet attention was necessary. By chance, does the vet have a number you could call to ask? Might also post on the main forum for help since others there will have experience with this.
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I agree :( I think it might be time to take her to the ER...I followed up on my previous post in the Main Forum yesterday so am hoping to get some guidance there too.
 
I agree. I hate to say it, but I think that's the best plan. That way, at least you know she's taken care of...and the earlier you get this looked at the better.

Sending tons of healing vines!
 
Sorry to hear you may have to go back to ER :(. Hopefully, Lucy will get the attention she needs to help flush those ketones. Is it the same ER as before? That way they have a little knowledge of her condition before. Don't let them make you wait too long :bighug: Sending healing vines
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Getting on top of this sooner than later is the best way. It's easier to reverse if she's not too far down the ketone road.
 
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