Previous member, New kitty [Sadie] Need Advice

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SandyS

SandyS

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Good morning,
I was a member in 2016 with my late cat, Macy-who was able to be fully controlled by changing her to a low carb diet. Flash forward to 2023 when my other cat, Sadie, was diagnosed with Asthma. Unfortunately the prednisolone I was giving her for that apparently caused her to develop diabetes. She has been on Lantus from the beginning, 2u twice daily. Thought she was in remission Feb 2024 and was taken off insulin for a short time but she relapsed. Taken off again after an ER visit in late August, then restarted at 1 u twice daily mid-September.

She is on home cooked food with EZ complete added, so super low carb and has been the whole time she has lived with us [since late 2017].

I am very interested in learning about this disease and how to adjust her insulin down if needed. I did a glucose curve [on her spreadsheet] for her internal medicine doc and he said she's doing fine, just leave it at 1 unit twice daily but I feel like her glucose is too high and wonder what I need to do about it. Her last 2 fructosamine levels were within normal limits [9/9/24 324 [range 143-373] and 2/22/24 222 [range 191-349]

My other big issue is that I have SUCH a hard time getting blood from her for her glucose checks. Occasionally I will get blood in one or two pokes but honest to goodness it is like 10 pokes normally. I warm her ear first for 30 seconds. I have tried her toe pad and got literally nothing there. How do y'all do it? This morning I got a specimen after about 5 pokes, so I gave her her food and then turned back to the glucose monitor to find that it errored out. So I gave up since she had already started eating. I know stress like going to the vet can impact their blood sugar--how soon does that happen, like is her glucose when I have to stick her so many times likely to be elevated from that or does it happen more slowly? It is probably around 5 minutes that I am working to get her glucose level each time.

Sorry for so many questions if you are still reading, thank you. :)
 
SandyS said:
Good morning,
I was a member in 2016 with my late cat, Macy-who was able to be fully controlled by changing her to a low carb diet. Flash forward to 2023 when my other cat, Sadie, was diagnosed with Asthma. Unfortunately the prednisolone I was giving her for that apparently caused her to develop diabetes. She has been on Lantus from the beginning, 2u twice daily. Thought she was in remission Feb 2024 and was taken off insulin for a short time but she relapsed. Taken off again after an ER visit in late August, then restarted at 1 u twice daily mid-September.

She is on home cooked food with EZ complete added, so super low carb and has been the whole time she has lived with us [since late 2017].

I am very interested in learning about this disease and how to adjust her insulin down if needed. I did a glucose curve [on her spreadsheet] for her internal medicine doc and he said she's doing fine, just leave it at 1 unit twice daily but I feel like her glucose is too high and wonder what I need to do about it. Her last 2 fructosamine levels were within normal limits [9/9/24 324 [range 143-373] and 2/22/24 222 [range 191-349]

My other big issue is that I have SUCH a hard time getting blood from her for her glucose checks. Occasionally I will get blood in one or two pokes but honest to goodness it is like 10 pokes normally. I warm her ear first for 30 seconds. I have tried her toe pad and got literally nothing there. How do y'all do it? This morning I got a specimen after about 5 pokes, so I gave her her food and then turned back to the glucose monitor to find that it errored out. So I gave up since she had already started eating. I know stress like going to the vet can impact their blood sugar--how soon does that happen, like is her glucose when I have to stick her so many times likely to be elevated from that or does it happen more slowly? It is probably around 5 minutes that I am working to get her glucose level each time.

Sorry for so many questions if you are still reading, thank you. :)
Click to expand...
@Suzanne & Darcy
@Sienne and Gabby (GA)
@Bron and Sheba (GA)
@Bandit's Mom
 
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Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also.Just keep rubbing the ears with your fingers to warm them up
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6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming
Look at the lancet under a light andyou will see one side is curved upward, that's the side you want to poke with

Try putting a thin layer of Vaseline on the ear so the blood will bead up

@SandyS
 
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Can you also add this to your signature
I saw you said
Sadie has asthma, arthritis, obesity


0.5ml gabapentin [25 mg] twice daily;
Flovent inhaler daily

Can you also add what she is eating

I also suggest to try and get some more tests in during the day and definitely at night after you test her PMPS BG . You are only seeing half of what's going on

@SandyS
 
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I see a 92 on her spreadsheet so definitely do not increase the dose at this time.
The day you ran the curve (9/28) it looks like she was bouncing from lower numbers the previous day so it’s not much helpful information there (it happens all the time - not your fault) except see how her PMPS the night previous to curve day was blue. That blue may have been enough to cause her body to react by bouncing and she may have gone down from there into lower numbers. In order to really make sense of what is going on, you will need to get some more tests done on different days at different times of day. Try to get a +6 one day and a +4 on another day. You can hopefully build up to being able to test more. Some cats will drop lower at night, too, so at least getting a before bed test is important to make sure everything looks okay for the night (not too much of a drop) — especially helpful when you’re learning your cat’s patterns.
 
Diane Tyler's Mom GA said:
Can you also add this to your signature
I saw you said
Sadie has asthma, arthritis, obesity


0.5ml gabapentin [25 mg] twice daily;
Flovent inhaler daily

Can you also add what she is eating

I also suggest to try and get some more tests in during the day and definitely at night after you test her PMPS BG . You are only seeing half of what's going on

@SandyS
Click to expand...
Thank you, will do
 
Thank you, will try that. I just am struggling so much with getting blood. I have ordered some 26 gauge lancets that will be here tomorrow, hopefully that will help. I will read the information that Diane Tyler's Mom linked as well.

Suzanne & Darcy said:
I see a 92 on her spreadsheet so definitely do not increase the dose at this time.
The day you ran the curve (9/28) it looks like she was bouncing from lower numbers the previous day so it’s not much helpful information there (it happens all the time - not your fault) except see how her PMPS the night previous to curve day was blue. That blue may have been enough to cause her body to react by bouncing and she may have gone down from there into lower numbers. In order to really make sense of what is going on, you will need to get some more tests done on different days at different times of day. Try to get a +6 one day and a +4 on another day. You can hopefully build up to being able to test more. Some cats will drop lower at night, too, so at least getting a before bed test is important to make sure everything looks okay for the night (not too much of a drop) — especially helpful when you’re learning your cat’s patterns.
Click to expand...
 
Suzanne & Darcy said:
I see a 92 on her spreadsheet so definitely do not increase the dose at this time.
The day you ran the curve (9/28) it looks like she was bouncing from lower numbers the previous day so it’s not much helpful information there (it happens all the time - not your fault) except see how her PMPS the night previous to curve day was blue. That blue may have been enough to cause her body to react by bouncing and she may have gone down from there into lower numbers. In order to really make sense of what is going on, you will need to get some more tests done on different days at different times of day. Try to get a +6 one day and a +4 on another day. You can hopefully build up to being able to test more. Some cats will drop lower at night, too, so at least getting a before bed test is important to make sure everything looks okay for the night (not too much of a drop) — especially helpful when you’re learning your cat’s patterns.
Click to expand...

my intentional curve was 9/22---the 9/28 curve was kind of accidental, i was just alarmed because her AM was so high.
 
@SandyS
Now I see it , please add SLGS to it also and
0.5ml gabapentin [25 mg] twice daily;
Flovent inhaler daily
If you can't fit this , I assume you are feeding a raw diet so you can just put Raw diet you don't have to put chicken thighs so you can fit this
 
Sandy -

What is the gauge on the lancets you're using? Higher numbers are a thinner needle, just like with syringes. Since you're having trouble drawing blood when you're trying to test, see if a thicker gauge lancet helps. I'd suggest a 28 gauge or below. Keep in mind that the thicker gauge may be uncomfortable for Sadie so give her lots of low carb treats for putting up with the poking.
 
Sienne and Gabby (GA) said:
Sandy -

What is the gauge on the lancets you're using? Higher numbers are a thinner needle, just like with syringes. Since you're having trouble drawing blood when you're trying to test, see if a thicker gauge lancet helps. I'd suggest a 28 gauge or below. Keep in mind that the thicker gauge may be uncomfortable for Sadie so give her lots of low carb treats for putting up with the poking.
Click to expand...
I'm using a 28 gauge, but just got 26 gauge today. My huge frustration today is the Relion Premier Classic monitor which keeps erroring out on me. I am ready to throw it out a window because I had to stick Sadie FOUR extra times because the first three Relion sticks errored out. I get the blood on the strip, it does the countdown, then-error. I hate this monitor. So I had one strip left for my Contour next one monitor and thankfully it worked.
 
If you hate the Relion, get more strips for the meter you like. There's nothing special about a Relion other than the strips are cheap.

Sandy -- I just noticed you're in Tampa. Please stay safe. Just an FYI, Lantus pens do not require refrigeration especially if you are going to be on the move, this may be important. Refrigerating pens may help to preserve the insulin a little longer but with a hurricane looming, just having insulin and your supplies and all of you being safe is what's important.
 
Hi, just wondering if anyone with experience would kindly take a look at Sadie's chart and provide any feedback. I feel like her levels are all over the place, but perhaps this is normal? I sent her doctor the two glucose curves and he said to continue 1u twice daily but it doesn't look to me like she is controlled?
 
I see with the hurricane you had to skip lots of testing. To see what is going on it’s important to get a test before each dose and spot checks to try and catch the nadir. Was any insulin given between 10/8 and 10/14? I’m guessing 1 unit. We don’t know if he’s staying in 200’s and 300’s or getting lower and then bouncing so I’d be hesitant to increase input til we see a few more days of testing. I hope you survived without much damage.
 
Hi,
She did get insulin but we had folks staying with us bc of the hurricane so our routine was disrupted and I forgot to record her glucose levels but I was only testing twice a day. She has been getting 1 unit twice a day [12 hrs apart] the whole time. I read that +4 and +6 are the big ones--do I need to do another full curve or should I just randomly test? Thank you
 
If you could get at least one test during the PM cycle, we'll be able to provide more input as to dose. I'd also suggest looking at the info on dosing methods with Lantus. You appear to be holding the dose longer than is necessary.
 
Hello, my apologies for late response @Sienne and Gabby (GA) . I have updated Sadie's sheet, got two pm cycle measurements on 10/16 so I must have seen your post but I don't recall reading it, yikes.
I increased her to 1.5 u on 10/21 per her vet's advice. I just feel like her glucose is all over the place. Also I just read on the facebook FDMB group where someone advised free feeding diabetics, which I hope is true bc Sadie is STARVING all the time and dropping weight. This is part of the reason I feel she is not adequately controlled. Lastly, she had been on Clavamox for 4 weeks which ended 10/28 am. Perhaps that was affecting her glucose? I am so confused. Could you elaborate on what you mean by holding the dose longer than necessary? I thought we were supposed to give it every 12 hours and I have been pretty rigid at keeping that time frame. thank you so much for any feedback.
 
Could you elaborate on what you mean by holding the dose longer than necessary? I thought we were supposedto give it every 12 hours and I have beenpretty rigid at keeping that time frame.thank you so much for any feedback

You are correct that you want to give insulin every 12 hours. By holding the dose too long that refers to how long you give the same dose before increasing. You want to increase every 7 days until you get to a good dose.

A curve is needed at least every 7 days and all I see are amps and pmps fur quite some time. We need to see how low this dose takes your cat to give dosing advice.
 
I am going to have to rethink everything I am doing. So I should do an every 2 hours glucose curve on a weekly basis? I had no idea it needed to be that frequent. She HATES it and fights me every time but if that's what I need to do I will. I may change her dosing schedule as well now that I understand that I can feed her more than twice a day. I have been testing, feeding, dosing her at 4am bc she will sit there and holler until she gets fed bc she is starving by then. But if I could feed her at 4am w then test feed and dose her at 8am maybe that would work better. I really need to find time to read a primer on feline diabetes bc I truly do not understand this at all.
 
SandyS said:
I am going to have to rethink everything I am doing. So I should do an every 2 hours glucose curve on a weekly basis? I had no idea it needed to be that frequent. She HATES it and fights me every time but if that's what I need to do I will. I may change her dosing schedule as well now that I understand that I can feed her more than twice a day. I have been testing, feeding, dosing her at 4am bc she will sit there and holler until she gets fed bc she is starving by then. But if I could feed her at 4am w then test feed and dose her at 8am maybe that would work better. I really need to find time to read a primer on feline diabetes bc I truly do not understand this at all.
Click to expand...

Yes. You can feed at 4:00 a.m. Then test, feed, shoot all within about 10-15 minutes around 8 a.m. . You can leave food out and just pick it up 2 hours before the amps and pmps.
 
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