Nigel

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Lorraine + Nigel

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My cat, Nigel was diagnosed with heart disease in September of 2010. In November he was admitted to the Vet clinic with a glucose reading of 493. After five days, he returned home with a reading of 122, I believe, and sent home on 3 units of Humilin insulin twice a day. After weekly and monthly rechecks and his glucose seeming to stabilize between 107-120, my Vet decided to skip a month between checks of his glucose. His checkup that was skipped would have been yesterday(Monday). That night around 10 p.m., Nigel had a violent seizure that lasted close to or a bit beyond a minute. I was unaware that seizures can happen to diabetic cats. Not anymore. I talked to the Vet on call and was told to watch him through the night and give him his regular meal and insulin at 6 a.m. and bring him to the office at 8 a.m. I went to work and my husband dropped him off for me. When my Vet called me at 9 a.m. Nigel's glucose was 33, his pancreas was inflamed, BUN/Crea were elevated and his liver enzymes were up (I think) Had some other highs and lows also on his bloodwork. And fluid in his chest. He was put on a dextrose IV and by noon was up to 8o on the glucose and later in the day 220. I was able to bring him home only because he hates the Vet office and gets so stressed there. Came home with metoclopramide and amoxicillen and instructions to STOP the insulin until he goes in for a glucose recheck Friday morning. Does this make sense? I am MONTHS late in joining a support group for this disease. I thought "how hard can it be giving insulin shots twice a day?" Had I had some of your knowledge, Nigel might have been spared last night and any other ill effects he may have suffered. Any suggestions will be greatly appreciated. Thanks. Lorraine
 
Welcome Lorraine and Nigel!

The most important thing you can do for Nigel is to learn to test his blood glucose levels at home. Cats get stressed at the vet (strange noises, smells and animals) and stress raises bg levels. Doses based on vet numbers can be too high once the cat gets home and relaxes. We suggest you test before each shot to make sure it is safe to give insulin in the dose you have planned and mid cycle to see how the insulin is working.

Humulin can be a difficult insulin to regulate with. It is harsher than some of the other insulins and tend to hit faster and not last as long. Here is some info on how it works: viewtopic.php?f=19&t=303

Here is a video that shows how we hometest: Video for hometesting If you want to learn how, we have taught hundreds of people how to do it over the internet.
 
I went through a similar scare a couple months ago. My cat Mali had been on insulin for 5-1/2 years, we didn't home test, just took him in for regular curves and fructosamines. Then in December he lost a tooth so we switched him to wet food (he'd been eat all dry until then), not realizing what an effect that could have on his BGs. Well, he went into hypo and had a seizure, I thought he was dying. Rushed him to the vet and he was put on a glucose drip (his lowest # was 26, then shot up to around 340).

Until that point I hadn't done anything really proactive about his diabetes, I didn't know there was much I could do. But I did a LOT of research, learned about nutrition, found this forum, and started home testing. And now he's off insulin and doing great. He does have some occasional twitching though, it appears to be a bit of neurological damaged caused by the seizure.

I would highly recommend you start home testing, you can get the Relion meter from Walmart for $9, 20 test strips are $9. It can be a little tricky at first, but once you get it down it's really easy. Then you'll always know what his BG levels are and can avoid another hypo seizure. And it will save you a lot of money because you won't have to keep bringing him to the vet for check-ups.

If you can start home testing before Friday that would be great. But if not, I think skipping the insulin for a couple days is probably the safest way to go. You could also pick up some ketostix (available at most drug stores) to test his urine for ketones (this will tell you if his numbers are getting too high).
 
Hello,Jen and Sue -
Thanks for your replies. When Nigel was coming out of the violent twitching of his seizure I whispered softly to my husband "I think he is dying". I was sure he was dying and I had somehow caused it. It was horrible. Now I am feeling overwhelmed by all the info I am reading. I question if I can even do this. I watched the video one of you had posted on taking the blood for a glucose reading. How often do you need to do that as far as daily, occasionally, before every shot? Doesn't the ear get scar tissue building up? I also read the info on Humilin. I have always fed Nigel and given the shot while he was eating. Should I not be doing that? I guess I have to learn and relearn now. I am familiar with the glucose monitors as I work in a personal care home with several diabetics. I have to say--I HATE NEW THINGS!! I have no confidence that I can do this. I also think it is safe to say that I need to start all over at the beginnning with this. Hope there are lots of people willing to help me out there. Will be leaving for Walmart shortly to find a meter..... Lorraine
 
Here is a shopping list for you:


A human glucometer. Any one that sips and takes a tiny sample is fine. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 25-26 gauge is good. Any brand will work.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

This is a very steep learning curve at first. But we promise, soon you will feel like you have control over what is happening because you will know what his numbers are and how the insulin is working.

You should probably feed a little while before the shot. With Humulin, it hits hard so you want food on board before you give insulin. With the longer lasting insulins that are less harsh, you can shoot while he eats.

We test our cats before every shot to make sure it is safe to give the insulin we are planning on and in midcycle to see how the insulin is working.

We will be here to help and support you on this sugar journey. Trust us, after the first few days of confusion, it gets easier!
 
Hi, Sue-
Thanks so much for the list of necessities for my boy. I have it sitting on my counter and once in a while I look at it. It would be so much easier to have someone at my side for this initial testing but that can't be. My Vet, I can say, does not see the need in this as I mentioned it to her awhile back that some people actually test their cats at home. She said "How would you like someone poking your ear several times a day?" I think that reply says alot. It isn't that I don't see the need for this. I see a great need after Monday night and that seizure. I'm just really nervous. I will probably go watch a few more videos of the technique and sleep on it. Nigel has not quite been himself since Monday evening. He still cries when he knows it's close to his mealtime and when he wants a treat--not a sad cry. Just a persistant feed me now cry. But I can tell he is not happy. I would like to go somewhere and collapse into tears. I need to do whatever I can to give him the best care though so becoming a blubbering mass would not serve that purpose. It's good to know that you and others are out there to get me through this. I just hope I can do it. Lorraine
 
Lorraine, if you'd like to, you can tell us what city you live in and we can see if one of us is close enough to help you learn to test. and don't worry, we do this all the time. i myself have gone out and taught at least half a dozen people in my area. don't post your street address or phone number or specifics like that. this is the web and anyone could see it. just your city and if we know someone closeby, we'll hook you guys up and you can exchange contact info privately.

fwiw, i've been testing Mousie since October 2006. she's been tested at least twice a day every day since, sometimes as much as half dozen times. i've actually done the math from time to time and i swear to you, you cannot tell by looking at or touching her ears that they have been poked over 3000 times :-)
 
You can free feed Nigel and give him more than he usually eats. And you can free feed wet - lots of us freeze it and leave it out to thaw. Unregulated diabetics are literally starving because their bodies don't process the food well. When Oliver was first diabetic, we added an extra can of food. When he got regulated, he wasn't so hungry and we went back down.

Cindy is right - give us your city and state. Maybe someone leaves nearby. If not, we will walk you through it. We poked poor Oliver for an entire weekend before getting a drop of blood. We would come back on and ask for more tips and advice and try it again. But what a great feeling when you get that first number and know you have some control over this whole thing.

A few cyberhugs. :YMHUG: :YMHUG: :YMHUG: Don't get discouraged. You have a team of people here pulling for you and Nigel to succeed.
 
Sue and Cindy -
Thanks for the support. It helps knowing others were nervous at first. I actually did watch a few more videos last night and thought about trying out the monitor only to find that I had purchased the wrong strips---didn't know they had to match the monitor--duh. So, I recently returned from Walmart with the correct strips. Trying to set up the monitor was frustrating. Made one mistake and couldn't get back to where I needed to be so I called the 24 hr help line and was talked through setting up the time, etc, But when she found out it was to be used on an animal, she said I had to call another number to calibrate it. Some "About Animal Health Care #". I am still waiting after 45 minutes for a return call. In the meantime, I have an appt this afternoon for 3:15 with my Vet. Nigel is just laying around and smacking his lips--nauseaous, I'm sure. I do not like metoclopramide which is what he was sent home with. It did not help my pancreatitis cat and my Vet needs to get some good nausea medicines. Why do they not want to search out new areas and drugs??? Frustrates me. Nigel doesn't travel well. My Vet is two miles away and he stresses horribly during the ride. Otherwise, he would be going to a better Vet clinic 18 miles away. That is where my cat with pancreatitis ended up going. Great Vets there. But I don't seem to have any alternatives right now.
I live in Derry, PA. Very small town. There are a variety of Vets in the area but no one has office hours after hours or on weekends (except my current Vet.) Any one with an emergency is sent over a half hour away to an emergency clinic that wants money up front. I will write with an update when we get back home. Thanks again! Lorraine
 
Hi Lorraine,

A friend of mine called me last night and mentioned that I might see you here, she knows you from the hypert group I believe.

So I wanted to stop in and say hello and also tell you that you are going to do just fine. It's really scary in the beginning, but in time things do get so much easier.

Why did the vet give metoclopramide? Isn't this for belly aches? What did the vet say about fluids on the chest? Any lasix or xrays for that?
 
oh boy have you hit the jackpot! there's quite a conglomeration of members on here in your area. enough actually that they get together from time to time for xmas or plant exchanges or whatnots. i'll send some messages out to some of them and point them here to see if they can help you get started with all this.
 
the monitor does not need calibrated for a cat. we use all kinds of monitors and anyone will work just fine as is
I believe I am about an hour or so away from you. I am in PGH. I can try and get there or you can come here. I am pretty good at getting lost but i can try my best. there is someone closer but she just had surgery so cannot ask her. could try for tomorrow if we do not get all that snow
 
Dian- Thanks so much for that info!!! Perhaps that is why the Vet at the animal health line has never called me back. Lorraine


Cindy- That is great news!!!! Yippee!!!! I thought that I was on a sinking ship being out here in nowhere land. Will be awaiting any help that comes my way. Thanks so much! I truly can't believe this. You guys are awesome! Lorraine
 
soooo. you want me to come out tomorrow. today is out. have 2 fosters that test and shoot at 4 and I have trouble driving in dark plus the wet stress. cannot see. send me directions via PM. click on my name and it will take you to where you can send me a pM or I think there is a PM under my avitar
 
My cat Max was diagnosed in early January. Tears rolled down my cheeks at the vet and I cried when I got home. It can be really overwhelming at first, but you've come to the right place. The advice I've received here has been invaluable and has really helped me turn Max's health around. I never thought I could give my cat a shot (you already know how to do that) or prick his ear to home test, but I learned. Once you get the hang of it, it's not hard and you feel empowered knowing what BG level your cat is at. So glad you've got some help. The people on this board are wonderful!
 
Hi Lorraine...just dropping in to see what was going on. I'm one of the gals from Pittsburgh that Cindy (& Mousie) told you about. I was chatting w/Dian earlier today and she said that you would like to have some help w/home testing. I will be coming down with her if she plans on coming tomorrow. I work Saturday and Sunday so can't make it this weekend.
I guess Dian is just waiting for a heads up from you. So...maybe see you tomorrow, weather and you permitting!
 
Well, it seems that my earlier post that I worked so hard on, never got posted. So, I will try again. Nigel saw the Vet this afternoon and his glucose was 100 after no insulin since Tuesday morning. His Vet seems to think it is because of the pancreas being inflamed and it may change after the pancreas settles. In the meantime, no insulin for now. I am to call on Monday with an update. And if everything is going well, she will see him the end of the week for another glucose. Yes, it is another $47.00 but I am not strong enough to exert my independence yet. Or whatever that word is. She also sent him home on Centrine for nausea. Not knowing anything about that drug I will need to do some research on it before I give it to him. Why is it that some Vets will not explore more areas and drugs??? There are GOOD pain meds out there. GOOD nausea meds. GOOD GRIEF. Before I left the office I did brooch the subject of home testing. Told her that I bought a glucometer(?) to try testing him at home. When her mouth opened to speak I said "wait, I already know about the meters for humans not correctly giving the true numbers for animals". And yes, that Vet from the animal health line did call back before we left the house this afternoon. He told me that Davis University in California did a study and found human meters to be 20-40% off--that being that the true number would be higher than the reading on the human meter. He gave me a for instance--say the number came up reading 200. It would really be anywhere from 280-350. (Which I thought was a really big stretch especially using the 20-40%.) I told her all of that. Anyway, for now, I told her that I just want to try a curve and I could do that with this meter. She actually told me how to do that. Oh, that phone line Vet also told me that I would need the AlphaTrak meter which was only available through a Vet. When I asked my Vet if she could get me one she said that she would have to put it through the Vet who owned the practice (I'm pretty sure I will get shot down with that). And this is where Nigel and I am at for now. I would like his diabetes to just go away. Until that happens....I will be welcoming two good souls to my home in the morning from this site--providing the winter storm fizzles out--to teach me how to poke Nigel. All of you are so helpful. Many,many thanks to you. Lorraine
 
Holly- Thanks so much for your reply. I still feel lke crying. When Nigel was diagnosed I looked at the Vet and said "why not? I've not had that to deal with yet!!!" The shots were scarey but he didn't even notice. I still fear I will hit a vein and then what? Sometimes his fur gets in the way when I pull back on the syringe to check and try as I might, I can't see anything. I actually thought I might have done that the night he had the seizure. The seizure was four hours after his shot. When he bottomed out the next morning, my guilt lessoned. So, it still is not smooth sailing for me. Now I must tackle the ear pricks!! New things are always scarey. But we do what we have to do for our pets. They are better friends and family than the real ones we have. Max is fortunate to have you. Lorraine
 
Lorraine said:
..."How would you like someone poking your ear several times a day?" ...
Click to expand...

That is when you ask the vet "How would you like watching your cat die from either hypoglycemia or diabetic ketoacidosis?"

You can't tell by looking what the blood glucose is as even at extremes, the symptoms you observe could be from something else.

If you're going to keep going to this vet, you may want to think of oh so very carefully sharing veterinary journal articles (don't say you found it on the internet, as that is discounted!) about contemporary diabetes management. Several are posted on this site. Something to think about once the initial chaos calms down and you are feeling more confident (and you will - the support here is terrific!)
 
Hi, BJ- When I told my husband what she said even he said "don't people poke themselves several times a day?" Your reply was on the money as in November when Nigel was admitted to the clinic his diagnosis was diabetic ketoacidosis and he spent fours days there very ill and then we go back to last Monday night and he was suffering with hypoglycemia. I will NEVER forget that horrible seizure and I NEVER want Nigel to experience another one so I am determined to do what I need to do now to treat him correctly and if she would refuse to work with me, I will find a Vet who will. I can't tell you how much everyone's support has meant to me.
I forgot to mention on my post last night that when my Vet said that Nigel's ears could get very sore I told her that one member online said that her cat had been tested from 2006 and estimated that to be about 3,000 pokes and her cats ears were just fine. She had no reply. I sure hope I can win over my Vet to work with me! It would save me alot of valuable time. Lorraine
 
This is just my personal experience on the glucometer comment. I tested Max at home right before his vet appointment with my meter and got a 140 (no insulin and no food since the vet tests Max fasting for the pre shot #). We then drove a 1/2 mile to the vet and tested Max in the office less than 10 min later and got a 127 (with a blood draw, not another poke). To me that's within the range of the meter and shows they test pretty close. My vet was a little leery about the home testing too, but, as long as I brought Max in so they could check him periodically, they were fine.
 
Hello, and welcome! So sorry to read about Nigel's path to getting here, but so glad that you have found this site and now are in a better position to be an advocate for his care!!

About the Alphatrak.... I will tell you that you do not need it, but I understand completely if you do go ahead and buy one... I did, at my vet's insistence, and abandoned it after a month because I just couldn't afford it, I found it was more difficult when I needed advice here (as almost everyone uses a human meter), and I had to really plan so that I was never out of strips.... the only place locally that sells them are vets, and if they are closed, well, you're out of luck.

If you decide to go with one, don't buy it from the vet. They will most likely charge you $200-250 JUST for the meter, not including any strips. You can get a kit on Amazon for $207 which includes the meter, control solution, 50 strips and a lancet device with 10 lancets. Entirely Pets has a meter for under $100, with strips costing $60 for 50 strips. American Diabetes Wholesale also has several configurations, all of which will be far cheaper than what you pay at the vet. I use their site regularly, and always link through mrrebates.com, which gives me an additional 8% cashback. They will occasionally have coupon codes as well, although there haven't been many lately. The cheapest I've found the strips is on ADW for around $0.80/strip. In comparison, the Relion strips from Walmart are $0.40/strip (with a meter cost of $9), and the Advocate strips I'm currently using are $0.15-0.17/strip (I get them on ebay). With the Alphatrak, if you have a day where you have low numbers and are testing frequently, you can easily spend $10+ on just test strips alone.

Good luck!! And welcome to the best place you wish you never had to be. :)
 
Holly- Thanks for your post. Sometimes I teeter and it's with info such as yours that I can see things clearer. As far as home testing Nigel, I'm not doing so well right now. Not sure I'm ever going to get it but I keep trying!

Christie- Thanks for the welcome and for relating your personal experience with the Alphtrak. I have had some other opinions on it and yours has closed the deal. How kind of Vets to push their meter at such a great expense to their patients. I may have to switch to another meter since mine is a ReliOn Ultima and I can't get the bigger drops of blood out of Nigel it requires...yet. Most times I can't get any! I may age tremendously through this adventure with home testing. Lorraine
 
You do not need to pull back on the syringe to check for blood when shooting. We all just tent and shoot. Also, Mishka has been having her right ear only tested b.i.d. minimum every single day for the past 7.5 years.......you wouldn't be able to tell it. I learned to test back in '98 and have never given one shot of insulin since without testing first. You will get the hang of it.
 
hope, deb and I went to lorraines andshowed her how to test nigel. even with the stress of us being there, he only tested in the 80's. when Lorraine tried, (AND SUCCEEDED) he was in the 90;s. she will triumph, I am sure
 
Hope- Thanks for your vote of confidence. I am failing miserably with this. Just jabbing away at Nigel. I will probably watch some more videos of this. Dian and Deb were great when they came to my house yesterday to help me with this but I am floundering on my own....I wanted to write you mainly to ask you where you got that name Mishka??? My daughter brought a kitten home almost 13 years ago and named her Hayley. I told her one day "That cat doesn't look like a Hayley. She looks like a Mishka." Don't even know where that came from but I have called her that ever since. My daughter still calls her Hayley. At the Vets she is named Hayley/Mishka. I need to get that changed around. She is the sweetest, petite-est black girl. Talks like crazy. Anyway, I was quite surprised to see her name on your post. And thanks again for your reply. Lorraine
 
I had a dog named Haley(GA) and Mishka already had that name when I adopted her. She was to be PTS at age 5 because of diabetes and was close enough to me that I just drove down and got her. I usually end up calling her Meeeeeeeska or Meesk :-D
 
Paws crossed that Nigel stays in those nice green #'s. Did you say he hasn't had insulin since the hypo?

Some kitties train easy on the testing and some take a little time. Testing was hard for me at first. My hands would even shake a little, but I've gotten a lot better with practice. Max has also gotten better at it too. ;-) Warming the ear and rubbing base to tip before poking have been my tricks for getting that bead of blood. Good luck and don't give up.
 
Hi, Holly-
Yes, no insulin since Tuesday morning March 8th. This past Thursday the 10th he had his glucose checked at the Vet and it was 100 and that was around 3:15 in the afternoon. Then when the friends from this forum came on Friday it was 88 and 95, I believe. I did not try to test him at all yesterday (Sunday). Just too stressed even thinking about it. Ready to start again this evening after work. I'm not sure I'll ever catch on to this. But I have to keep trying. Thanks for the good wishes.
 
That's great news Lorraine! Sounds like Nigel may be in remission (anti jinx). When I changed my cat's diet to low carb wet food, he went into remission too (or you could say diet controlled). Paws crossed for Nigel. I still test Max every couple days to make sure his numbers are staying where they should, since he's newly in remission, but so far so good.
 
Hi Lorraine! You will do just fine with the testing. Remember....stay calm and Nigel will be calm. Love him up before you test, warm his ears the way Dian showed you. Nigel is having some good numbers lately, who knows, you may not have to test very long and Nigel may be going into remission!!
 
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