Pausing daily tests + dosing woes

arthur-kitty

arthur-kitty

Member
Long time without an update here. My partner has been one the primarily taking care of Arthur as I started a new job with a long commute, so I'm gone 11-13 hours a day 5 days a week. I am a fairly young adult and both of my abusive parents died this year, so I've been having a bit of a hard time. I mention this because I know many here will be disappointed or upset that his dose hasn't been increasing as much as it likely should have or at the lack of glucose curves, so I'm just asking for gentleness right now.

With both my partner and I making more money we have switched over to using the Alphatrak for the accuracy. We have discovered something we don't know to remedy that is causing me to consider pausing the tests.

Arthur is having a lot of anxiety surrounding tests, and what has happened is that all of the numbers are extremely high due to this. Hissing, hiding under the bed, and generally becoming more and more resistant to primarily the ear pricks but also the shots. Occasionally we will test and for whatever reason he doesn't panic - and his numbers are more normal. The value of these tests when I'm affecting his mental health so severely and his stress artificially inflating these numbers to the point that they feel absolutely useless. I've noticed the pattern of when he is not fighting the test - we get a more normal reading.

I think for a week or so we are going to stop doing the ear pricks to allow him to start trusting us again and not fearing us. Then going to start rebuilding his trust and really working on how we can make him feel safe again. I love him so much, and my partner and I have been extremely gentle and loving towards him. I think he is just confused as to why his people are "poking" him. If I keep testing him in this state I'm afraid that those artificially high numbers will lead to an inappropriately high dose of insulin.
 
Notice the absolutely random blues and greens :( surrounded by red and black

I feel like the readings are all showing how scared and upset my cat is and not his actual BG
 
I’m sorry for all the stress you and your kitty have right now. I’m a beginner so take what I say with that in mind but: I don’t think the black and red are from stress. Studies done on cats being stressed don’t show numbers that high. Those may I think be a “bounce” from the lows that appear to precede them. I’m sure a more experienced person will know and have a better opinion. They may have a little trouble knowing for sure since there are some empty spots but I understood your reason for that.

if you need to take a break for your sanity I get that—in my beginner opinion however I’d say discuss with your vet if she can make sure the dose is low enough for you to either do no testing, or perhaps monitor as we used to do before hand held blood tests were a thing: we monitored urine for glucose and ketones. Or perhaps get a Libre for your kitty.

here’s my concern: Arthur has had some lower numbers (idr, maybe 80 ?) on the AT. Numbers on an AT are very close to real actual lab numbers, with some variation. Under 100, the real value is plus or minus 15 from the meter number. So an 80 could be any number between 65 and 95. So I’d be a bit concerned how low he’s been going and could go and say see what your vet thinks. There are alternative to you sticking an ear —and while he’s got the Libre or you’re checking urine it gives you time to rest and regroup
 
Ok yes it was a 76 on the AT. That could be as low as 61. It the highest looks to be 500-600. I couldn’t find any reference that put stress hyperglycemia that high. All called that diabetes—most topped stress somewhere between 300 and 400, most between 200-300 from stress. But there are other ways to monitor Arthur that will give you both a break from daily pokes

the reason i asked about meds for asthma is they can affect BG and diabetes
 
When I read this last night, I was thinking that a Libre sensor would perhaps be a good option for a while. I think we may have discussed it before though.
 
Interpretation of the spreadsheet is nearly impossible because there aren’t any mid-cycle tests. I understand that you have not been able to test him (hence the recommendation for a Libre sensor.) If you are not going to test for a few weeks and are not going to use a Libre either, then I would recommend cutting his dose down to make sure he won’t drop too low.
 
We do know that stress can elevate BG,but it’s usually not going to be as high as what you’re describing. We have such an incomplete picture with no mid-cycle tests. We don’t know what his nadir is or when it usually is. Since the regular daily doses are based on the nadir, it’s really a problem to know what to do for him.

I am very sorry for everything you’ve been through lately. Perhaps Arthur has picked up on some of your stress as well.
 
Thank you so much to you both for responding. It's been good the past few days to see Arthur be happy and playful again, and I'm hoping that we can start testing again soon. I like the suggestion of possibly cutting his dose down too to avoid some of the risks. He was tolerant of the tests for awhile, so I think he got "fed up" but he's starting to act more normal.

Regarding his asthma dx - after Arthur was diagnosed with asthma I started using a high-powered air purifier in the area he spends the most time. He has had ZERO asthma attacks since then even when running around and being very playful. Not sure if the asthma dx was accurate or if it was allergies.

We did get a Libre installed at the vet, but Arthur defecated and urinated himself from the stress. Then when we got home he was able to rip the Libre from his body which seemed painful for him as the needle was bent and the skin badly irritated.

I should soon have 2 days out of the week work from home once I'm finally out of my very long training period, and I should be able to do more curves then and just taking 1 weekend day while I'm doing chores to do a curve. It's just been hard, but I know I can start again.

I think I need to go back to the basics on how to test Arthur and make sure I'm doing in the comfiest possible way for him. Part of the issue that I think may have caused this is sometimes when we poke Arthur's ear he jerks his head away and then this creates more pain, more blood, and of course more discomfort.
 
I’m glad you and Arthur are both feeling better, and it’s a good idea for you to rethink how you’ve been testing. I’ll post below some of my hints and there’s plenty on the web. I’m also glad Arthur isn’t on oral asthma meds or inhalers. But I would again like to stress that you let your vet know you’ve stopped testing and what his AT readings have been. YOU MAY NEVER HAVE TO DO BLOOD TESTS but you would need to do urine tests. What you shouldn’t do is lower his dose by your guess (or worse yet stop giving), or keep giving insulin without at least testing his urine.

decades ago, before we had meters, cats got insulin and were monitored by regularly checking their urine for glucose and ketones by dipping a stick in their urine. Urine was collected by putting Saran Wrap over the litter—now a days you can use special plastic bead litter instead.

I’m sure your vet could estimate a safe dose for Arthur to take for as long as you want to check urine rather than blood. I treated my diabetic cat for three years that way. While not as good as the control you have with blood testing it is good enough to let you and Arthur take a break and re-think how you test for best success.

if you just guess at a dose, and don’t test his urine, you may either leave him with too much, or too little. Too little puts him at risk of DKA which could kill him or leave you with thousands of dollars in vet bills to treat. So I very strongly encourage you to ask your vet for a safe dose and how often you need to test his urine for glucose and ketones and get the sticks to do it.
 
This is what I’d suggest for testing. Start with a place that will be his testing spot. Give him low carb treats there, and only there. Start by giving the treats at the time you would test. Praise him when he starts coming to the spot. Once he’s learned that spot means treats he may even go sit there to ask for one. Praise him and give him one.

once he knows he gets treats there am and pm, put all your testing supplies there set up like you’d use them. Don’t touch them though. Call him over (may take a bit of treat waving). Give treat. Repeat for a few days until he ignores your testing set up. Meanwhile you can watch videos, rehearse how you’d test (imaginary cat or stuffed toy)—just not in front of Arthur.

once you are more confident and he’s certain he will get a treat, you can try a test (more below on that)—if successful great, praise and give treat. If not, fine, praise and give treat. Don’t get mad at him or yourself, don’t keep poking. Try again in 12-24 hours, or a couple of days. This is a marathon, not a sprint. You will get it I promise. I was terrible. Thought I’d never get blood. Was sure my cat would die because I was incompetent. NO ONE got it the first time or many times after wards. I promise. But you will eventually get it.

With more sticks his ears will bleed more easily. You will become more confident and have a better idea of how it works best with Arthur. He will figure out he has a treat at the end
 
There are lots of videos on testing and every cat is different but my thoughts on what’s worked for me: methos has always hated his ears being touched (my other cat loves ear massages, go figure). And all cats hate being restrained. Once Methos knew he’d get treats, and I was ready to poke, I figured this out for him—while you’re getting Arthur comfy you may figure things out for Arthur.

I kneel with Methos sitting his back to me so he can’t back up. My supplies all laid out on a box I keep in the spot—I put a test strip in the meter but not pushed in all the way so meter not on yet. I take the cap off the lancet (I don’t use the lancing device/pen, it’s harder for me to see what I’m doing and the noise startles methos). I open the 2x2 (or put out cotton ball). Actually set it all up first then call over cat. To avoid restraining him i loosely circle my left arm around him so he can’t go forward. Can’t back up bc im behind him. With my arms encircling him I push strip fully into meter and put down. Put 2x2 in left hand and pick up lancet in right. Hold 2x2 under ear while holding ear and poke (I hold ear as briefly as possible because it make him want to jerk…be confident and bold in your poke, it’s not the end of the world if you pierce his ear just have a 2x2 or cotton ball so you don’t poke yourself also). Immediately I put down lancet and let go of ear while shifting my hand so I’m holding his head still. I keep my thumb near base of ear to try to prevent him flicking ear and scratch his chin while holding it so he thinks he’s getting a chin scratch.

I drop lancet, pick up meter and test. As soon as blood is collected I put 2x2 on poke spot for a few seconds and give treat.

I know you can do this, you just need a short break. Or it can be a long one —just check his urine while you perfect your blood testing skill.
 
Thank you so much for the breakdown. I think part of it is with me working more he likely feels neglected which I'm going to work on fixing. Especially if the testing and shooting is a must-do and then the other stuff falls away when life gets this crazy.
 
arthur-kitty said:
Thank you so much for the breakdown. I think part of it is with me working more he likely feels neglected which I'm going to work on fixing. Especially if the testing and shooting is a must-do and then the other stuff falls away when life gets this crazy.
Click to expand...
I hope life gets better—you and Arthur deserve it. Good luck and I know the two of you will figure out a testing scheme that works
 
You must log in or register to reply here.
Back
Top