RASCAL Diagnosed 3 Weeks Ago On PZI Need Advice

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J

JUNE & RASCAL

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Hello,

My name is June. I was on the main site and saw your group. Since my Rascal is on PZI I felt this would be the better place to post. Rascal was diagnosed with diabetes 3 weeks ago. His highest reading was 391 since diagnosis.

The first week we had him on an all wet diet only, printed Binkys List and have been feeding him a variety of food,.
Back to the vet the next week, numbers were still in the high 300's and started him on 1 unit PZI BID. Was told I didn't need to test him the first week on insulin.
Back again this past Monday he was at 351. Dosage was changed 2 units BID. Was told I could start testing him this week.

On Monday he had 1 unit before we went to the vet. 2 units in the evening.
Tuesday I had an out of town meeting and being new to this was scared to give him the 2 units in the am, so I gave him 1 unit, but gave 2 units last night. Today will be the first day he will be on a regular schedule 2 units BID.

Rascal had som teeth out about 4 months ago and all his pre surgery blood tests were perfect. This came on suddenly and am glad I caught it quickly.

He is almost 18 years old. Tough little guy who has gone through alot. Lost a leg from cancer and an eye from glaucoma. I have to say I was almost relieved when I found out he had diabetes, because I knew I could manage it. I thought he was in renal failure.

My question is when should I start testing? How soon do you usually see a difference in their numbers? He is eating fairly well. in the morning I leave the bowl out with the left over wet.. At noon my daughter comes home, throws out the morning leftovers and gives him fresh wet. And then in the evening he has wet food until I go to bed.
I know everyone says no dry, but would it be ok to leave some Purina DM dry during the night? Also is it good to make sure he is constantly eating? How will that affect his numbers good or bad? My other question is if he was to drop, how soon after his dose would he start to get into trouble? I am watching him constantly when I am home, and am nervous. Also because of his age and his disablity, he does not move around as much and sleeps more, so what signs should I look for?

Rascal weighs 10.5 and has been holding his weight since his diagnosis. He orginally lost 2 pounds when weighed.. We are seeing the vet again on Monday. Was told that if he has any symptoms of hypo not to give him his next dose of insulin and to call her. Actually gave me her cell #. I have Karo. My spare bedroom look like a hospital room, but her seems very content there.

So sorry for the long e-mail. Looking forward to any advice that can help me help him.

Thanks so much!
 
Hi June and Rascal,

Welcome to our PZI family.

Wow what a tough guy Rascal is, a real trooper.

You should start testing him right away. Were you given the supply list in health?

We'll need to help you set up a spreadsheet too so we can all see his bg numbers. Sue & Oliver is our resident expert at spreadsheets.

Glad you joined us, others will be by soon. Gotta get back to work now.
 
Welcome June and Rascal! We look forward to getting to know you and helping you out with Rascal. Wow! Sounds like he has been thru a lot.
I can run thru a couple things with you here. There will be more people by later that can help you out with dosing, and I am sure you will have more questions along the way.
This forum is busiest first thing in the morning and then again in the evenings.

First off, we always say to test before shooting any insulin, so yes, test now, you don’t have to wait until the vet says it’s ok to do so.
It’s good to test before you feed the cat mornings and evenings so you get a reading that is not tainted by food. We tell new people not to shoot insulin if the cats bg is under 200. Later when you have more data, you might do that, but initially, it is a good rule to stick by.

It is also good to test sometimes mid day. If you work, you can do this at night or on weekends. You want to get an idea how low the cat’s blood sugar goes when he is on the insulin and when he hits the lowest point, called the nadir. I usually don’t test before +3 hours after shooting or +4 hours. For a couple hours after you shoot the insulin, the food raises the blood sugar. Usually ProZync nadirs anywhere from +6-+8 hours after you shoot. And I say usually. The mantra around here is ECID, every cat is different. But you’ll need to figure this out for Rascal.

You will meet Sue here soon and she is an expert at helping people set up a spreadsheet, if you haven’t done that already. This will help people advising you as to dosage along the way. It keeps track of your dose and readings each day. After awhile you will see patterns and this will help you make the best decisions for Rascal.

Most folks here feel that diabetic cats are best on wet food only. I see you have checked out Binky’s list, that is great :) If you need to leave some food out during the day you can mix it with some water so it doesn’t get dried out, or mix with water and freeze small portions (like in a muffin pan) and it will thaw as it sits out during the day. I mix water with my cats food even though they eat it right away. Water is good for them and many cats don’t drink.

I hope that addressed some of your questions. Check back in tonight if you can. More folks will be around then. Again welcome! :YMHUG: cat_pet_icon
 
Just wanted to welcome you, too.

Start testing as soon as you can, and we'll help you figure things out. We don't usually increase that quickly, so the sooner you can start testing the easier it'll be to keep Rascal safe. Do you have a meter yet or do you need recommendations?
 
Welcome June and Rascal! This forum is a real family and we are glad to have you and Rascal join us. You have gotten great advice already.

Since they are literally starving when unregulated, we generally feed more at first. Then, when fine tuning, you can reduce the amount or vary when fed. You can leave out the frozen food day and night.

It is very scary at first. The numbers will give you confidence and a feeling of safety as you'll know your dose is safe and you can see how the insulin is working. Have you seen this letter from a cat?

http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=33671

Tell us how we can help with the testing. We all have things that helped us.

And yes, I am the resident spreadsheet nag. When you want dose advice, we want to see the recent history of numbers and doses. The spreadsheet is accessed through Google. Sign onto Goggle, then Google docs. Then search Templates for FDMB spreadsheet. I have helped lots of people step by step over the phone, so if that will help, just send me a PM.
 
Thank-you everyone who has reponded to me so far. I do have a testing kit and new strips. I am going out to buy a pen for testing. After watching all the videos it looks easier to handle. I only have lancets right now.

Rascal is on a 7 am and 7 pm schedule. So I try to stick very closely to that.

My sister had a diabetic cat and recommended this site. She was on in 1996 I believe when it was fairly new and has made many life long friends here. Her name is Valerie and her kitty Tyro lived to be 21 years old. She said some of her friends still are here helping others.

My vet and I are hopeful that this will not be permanent. Not sure what the verbage is on this site. But OTJ is my goal for him. I have alot to learn!!!

I will try to test him before he eats this evening. A little nervous, but I guess the first time is the hardest.

Hopefully I will be successsful and will have a BG number later.

Wish me luck!
 
Don't feel bad if you aren't successful on the first try. The kitty in the video is an old hand at this. We poked poor Oliver for an entire weekend before we got a drop. The two things that were the most important for us were to heat the eat (up to a minute with a rice sack or pill bottle filled with hot water) and having a big enough lancet ( new diabetics may need 25-28 gauge instead of the lancets used by most human diabetics- 30 gauge)

And three tries earn a rest and treats for both human and cat. :mrgreen:
 
Testing is something that is daunting at first but soon your kitty will come to you when he hears the testing supplies coming out ;)

Always give a treat after testing, it helps the kitty learn to “enjoy” the experience. I always tell Asher what a good boy he is and pet him and make a fuss when we test. He purrs the entire time now.

I test on the floor with Asher between my knees. Initially it was to hold him in one place, but now he puts his head on my leg and rubs it and purrs. I hold his ear and the side of his head against my leg with my left hand and my right hand uses the lancet. I change the lancet for the meter with a strip loaded once I have a drop of blood.

I don’t know where you live, but if it’s chilly there, you may want to put some rice in a sock warmed in the microwave for a few seconds, or some warm water in a pill bottle to hold behind the ear as you poke with the lancet. The warmth will help the ear bleed a little easier. And it saves your fingers from getting poked too.

Carl posted this diagram for someone else the other day and I thought it might be good for you to check out too. It shows the “sweet spot” where it’s best/easiest to test:


Good luck and ask if you have questions or things you have problems with.
 

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Welcome you two!

Some of us don't bother with the pens- mine, even at the highest setting, had no needle poking up unless it was barely in the socket. I've been free-handing from the first.

But learning the sweet spot took me a while. Finally- after doing curves all weekend long, Sneakers just huffs at me and lets me do my thing.

A trick I learned from Teresa and the Poopster was to scrape a fingernail and let the blood bead up on that and test from the nail. So much easier! I can press the ear with the cotton ball to get it to stop bleeding and test once or twice from the nail without having to poke a second time.
 
Welcome June and Rascal
At first we know how overwhelming this can be...
As Sue always says, "don't forget to breathe"
and it is true, just take it one day at a time
and know that we are all here to help with anything you need...
You have come to the best spot you could be right now
I am looking forward to getting to know you and rascal :mrgreen:
 
He is looking at me saying wheres my dinner? I did buy the pen. Warmed his ear. 5 tries and not a drop. I am looking at the diagram and then trying again.
 
What size lancets? Does the pen let you see right where you are aiming? We liked the pen with the cover off so we could see the lancet and put it right where we wanted it.

Do you have something to poke against? We used a small make up sponge. Other people like a folded kleenix or paper towel.

If you want to share your steps maybe we can find something that will help.
 
Well I figured out what I needed to do and was able to get a drop of blood. I had borrowed he monitor from my girlfriend and she did use it to test him a few weeks ago. When I put the strip in the machine it said err. Tried a new one to see if anything would happen(without the blood and the screen is blank).

He wants to eat and it is almost time for his insulin. Should buy a new one and hold off. I work tomorrow so don't want to get off schedule. He gets his shot at 7. Help
 
Welcome to the FDMB family, June and Rascal. cat_pet_icon

The trick about getting the blood scooped up on the back of your nail is great, especially in situations like this - meter not working, kitty wanting to leave, all that great stuff. :-D

It will get easier, honest! :smile:
 
ProZinc is more flexible than some other insulins. 30 minutes or so late wouldn't be a disaster. What are you thinking - taking the meter and asking the pharmacist for help or getting a new meter?
 
I tend to be cautious so I would do one unit. And tell us exactly what you are doing from beginning to end when testing. We should have some suggestions. Maybe you can get a test later tonight.
 
Ok not sure if its the pen or me. The first time I got a drop of blood was when I reset the pen, that was after 3 tries. Its the drugstore brand. I did get some blood on other attempts, but bleed into the gauze and didn't pool like the first time.

I put a piece of gauze under the ear to support it as they did in the video. Put the pen tight against the ear and that was it. The room looks like a diaster area. Gauze and lancets all over the place.

I did give him one unit per your advice. What time should I try later. I am now off an hour and usually feed and give him the insulin (do I say shoot?) at 7. Does he get his regular 2 units tomorrow? I leave for work at 7:30. My daughter comes home at twelve to let the dogs out and give him a can of food.

Just worried about the time and the amount of insulin both being off. What do I do tomorrow morning. What time should I try to test again tonight?
 
I knowhow hard this is at first....take a deep breathe,
I would give Rascal a break for a little while, maybe 2 hours and then try again
As for the morning shooting, I believe you shot 1 hour late tonight, is that correct,
If that is correct then could you shoot say 7:30 tomorrow
and if so I would stick with one unit unless you can get some blood
Hang in there
 
Let's see if we can get a number. That will help your am decision.

What setting is the lancet? You can try the deeper setting. And often in the beginning, it's because we are too cautious. You can double poke - a quick second poke in the same spot? You're warming the ear, right?

Sometimes it helps to put a very thin smear of Vaseline in the place you are going to poke. (use a flashlight to find those small capillaries going off the vein, toward the edge of the ear.). The Vaseline can help the blood bead up.
 
I'll try again in a few hours. I leave for work at 7:30. He was on 1 unit for a week with high sugar, which is why my vet took it up to two units This is the first day he would have been on 2 units am and pm. He had one unit yesterday am, 2 units pm and 2 units this morning. Now one tonight. Should I give him one in the am at 7 and bring it back up to two units at 7pm?

Three days of 2 and one. I have to run an errand. I will see if I can find a better pen. For now that is easier for me. I will also use a flashlight. Great idea. I was trying to find the best spot per the diagram.
 
Am back! Bought a different pen while I was out. Can anyone answer my questions from my last post? I need to know what I should do tomorrow. I gave Rascal his shot about 7:45-7:50. 2 hours ago. I am going to try to see if I can get a reading. Hope someone on to advise.

Thanks!!
 
I'll be around. Denise and shakes are looking at a hypo so I will be checking in. Getting a number makes tomorrow's decision much easier.
 
Sue, I don't know what else to do or what I am doing wrong. He is being such a trooper and I know I am sticking him. Just no blood. 4 trys. I am so frustrated. Tried the vaseline and flashlight.
 
I set it at the deepest. Double poke? Not sure what that is. I actually put a lancet in both pens. Of course the new one doesn't match the box of lancets I bought. Figures Am frustrated and feel sorry so sorry for him. What else can I do to warm his ears?

Am tired and feel like I am not following what my vet told me to do. Though she said test, but give him two units. She is an excellent Vet and I trust what she tells me. I guess because its late and I am going to work tomorrow. Am off his time schedule and am afraid to give him the 2 units now.
 
This is hard, June. We are just people on the Internet. But we are confident in our protocol of wet low carb, insulin and hometesting. And we like to start low and go slow. But Rascal is your cat and you get to decide on his treatment.

I do think that getting some numbers will make you feel so much better. You can fax them to your vet and get his advice. We just hate shooting blind. To us, it is really scary.

Have you tried the lancet on yourself? That might make you more confident.

I would take a pill bottle and fill it with hot water. Hold it up next to his ear for a minute or more. You can also leave it up next to his ear as something to poke against.

Double poking means poking once, then a quick second poke in the same spot.

Have you seen any blood at all? the other thing you can do is aim for the vein. It isn't a good practice for every day but it may get you blood.
 
Did the water bottle. Double poked. And poked him with just the lancet. Nothing. He just layed there nd purred away. I will get up early and try again. Probably give him one unit even if I manage to get something until I can talk to you all in the evening. Worried about givimg him the 2 units and being away tomorrow.
I trust what you all are telling me. And my vet can't be there 24/7. But the advice was to test him this week. If he looks like he is in trouble not to give his next shot and to call her.

Its just my inexperience and fear I guess. I want you to know how much I appreciate all your help and staying online with me.

I have been through alot with so many of my pets the last few years. This is the first with diabetes.

One of my dogs had neck surgery, slipped disc. She would have episodes of terrible spasms where she would scream. it was awful. Then things started to get better and we lost her from heart failure.

8 months ago i lost another one of my kittys from cancer and a year before that Rascals best friend Cody. It was a two year battle with small cell lymphoma.

Guess its late and just having a down moment.

Thanks to you and everyone who was there for me tonight.
 
June, if you want to tell us your city and state, there might be someone who lives nearby and could help get that first drop.

For tonight, just get a good night's sleep. Maybe tomorrow will be the magic day when it works.
 
Good Morning! Second try got some blood. Put it in the machine. Avia accucheck plus. Just was blinking 4 straight lines.

I can't win. I am taking the machine to the pharmacy to check. Thought this was be a start of a good day. Anyway, will give him one unit in the am. Still off schedule. And will let you know how I make out tonight.

Thnaks!!!!!


I am in NJ. Suburbs of Philadelphi
 
I am an hour and 15 from Philly center city. Denise is in Jersey I think? I don’t know if it’s north or south tho.
Keep me posted. I can get down there if needed.
I’m off to help my Mom today but will be checking in tonight.
 
It takes a while- its a technique that everyone has to learn- I'm better at it than my vet.

At least Rascal is okay with the pokes- it is a lot harder when you have to chase them down- those four legs are FAST :lol: and they can get into smaller spaces than you can.
 
Some blood is worth celebrating, June! Now to get the meter figured out - the pharmacy seems a great place to start.

It would be wonderful if Denise or Donna were close enough to help.
 
Hi June,
I hadn't dropped by to say "welcome to PZI!" yet, and last night when all this was going on, I was on another thread or two. You're already getting lots of input on the meter and poking and all I can add is the reassurance that "that part" of this dance will get very much easier. Hard to believe right now, perhaps, but trust me.

I wanted to talk about the dose and the numbers your vet saw....
First off, you might already be aware that "vet numbers" tend to be higher than reality. Some people see numbers 100 points lower at home, due to the comfort level of the cat in their own environment. Generically, we call it "vet stress", and any kind of stress will raise BG.
That said, the numbers you are getting from the vet tests? They really aren't bad at all. Many of us, me included, saw numbers in the 450-600 range when we found our kitties had diabetes.
You said that after a week, you went back for another test, and that number was actually about 40-50 points lower than it was the day Rascal was diagnosed? I guess I am wondering what prompted the vet to double his dose based on those numbers.

I just wanted to tell you that I think that if you were to just continue with the 1 unit doses day and night, it would be fine to do that. Once you are able to get the meter and strips and Rascal's ears to all work together, then you will have real data that will tell you just how well (or not well) that dose is working. But leaving his shots at 1 unit for few more cycles is not going to cause him any big problems. It will be much safer actually, for him. Just in case the 2 units is too much.
If you are concerned about what the vet will say if he discovers you aren't shooting 2 units, then I think you should ask him this:
"If your infant daughter was diagnosed with diabetes, and the doctor told you to double her insulin dose one week later, and she had absolutely no way to communicate to you that it made her feel better or worse, and there was a chance that you could cause her serious harm.....would you do it?" The vet will probably say something like "well of course not, she's my daughter, I'd want to know the treatment was safe before medicating her blindly...!!!". Then just ask him "then why would ask me to do that to Rascal?" In my opinion, your vet should not ask you to up the dose until he knows for certain that you are able to home test successfully. Once a week tests, whether at home, or at the vet, tell you absolutely nothing about how well the insulin is working.

Carl
 
Hi All,

Thanks for all the great advice. So heres where I am tonight. Moved Rascals time back this morning and this evening and fed him and gave him his shot. I was home a little later then usual and was so frazzled last night and wanted to get him back on schedule, since I wasn't sure what was happening with my glucose monitor or if I would be able to test at all tonight.

I did decide to give him a little more then one unit more like one and a half and will check him in a few hours.

I got the meter situation straightened out so I am ready to go. Hopefully I will get some blood quickly. Not sure why I found it so difficult.
Sue, I think you told me to check 2 hours after his shot last night. if this is not correct, please let me know.
Based on what his number is I think you said this would give me an idea as to how much to give him tomorrow morning. Hopefully I will get better and be able to test him as hes eating before his shot, which is the best time to do so.

Am very curious as to what his numbers will be. I was told that the test strips can't sit out more then 3 seconds by accu check so my reading may be off. In the videos they say to put the strip in the machine and then insert it all the way when have a blood sample. She said they contaminate quickly???? But I don't see any other way to do it.

Thanks for your advice Carl, I had to laugh when about him running away on his four legs, he lost a leg from cancer about 5 years ago. He does move around pretty good on the three he has though.
 
Fingers and paws crossed that you will have success tonight. With my meter, I could put it in the slot, but not all the way. Then when I got blood, I quickly pushed it in the rest of the way and was ready. Will yours work that way?

Actually, it would be good to get a number about 3 hours after the shot to see where he is heading and then somewhere between 5-7 hours, when that's possible. We want to put a picture together with the numbers to see how the insulin is working, how low it takes him, when he starts to go back up, how long it lasts. All that info will help you see how the dose is working.

If you have read some of the other threads, you will know you are not alone. Ask Theresa to tell you the saga of Poopy and getting blood. :-D
 
I'm glad to hear you finally got some blood. With my old one I would put it in just enough so that it sat there but not in enough to start the meter going.
Now that I put the blood drop on my fingernail- pinkie, usually, I take the strip out and lay it on top of the meter, poke the ear and get the blood, and then insert the strip and let it pull up the blood- all around, less than 30 seconds.

I just got home and still had blood on my finger after getting her reading and thought- maybe my ketone meter had come already and ran outside holding my pinkie in the air to check the front porch and mailbox for packages. Nope, not yet- but I bet that was a sight for someone who didn't know what was going on, holding my hand out and not letting anything touch it :-D :lol: .
 
I think I can help clarify. After the blood goes onto the strip, you have a short amount of time to get a reading. That may be the 3 seconds someone told you about. You can take a strip out of the container and do a blood test even an hour later and it's OK. The strips are exposed to air every time you open the container anyway, they don't immediately go bad. What I do is get everything ready - get a strip and the meter out and prime the lancing pen, then I warm Scout's ear, then I put the strip in the meter and make sure it says it is ready for blood, then I poke her ear, then I put the blood on the strip.

I'd recommend you test your own blood sugar a few times to convince yourself that you have the procedure down and are getting consistent readings. In nondiabetic humans, fasting blood sugar (no calories consumed in 8+ hours) is 65-99 and normal blood sugar if you haven't had a meal or sweet drink in the past 2 hours it should be below 140. Two tests on yourself within a few minutes should have no more than a 20% variance.

I'm going through this with Scout now (dxed 3 weeks ago) and sometimes it takes so many tries to get blood. Her poor ears are bruised but I'm successful about 75% of the time now. The one thing I noticed is if I don't warm her ear enough, I will not get blood. The warmer the better!

I am glad I am testing though because the vet started her on 3 units and 3 weeks later after a change in diet she is doing well on 0.5 U. If I'd been shooting blind she would probably have hypoed by now.

Good luck and let us know how it's going. You are doing great so far!!!

Lori
 
Re: Lancet pen usage

I didn't read thoroughly through the posts, but I noticed that there may be some confusion about how the lancet pen works.

When I first tried the lancet pen, I was confused because I couldn't see the needle through the hole in the pen. This is normal. When the lancet is completely seated and the pen cap is on, you won't see the needle. When you "fire" the lancet, the needle pops up through the hole, but it's so fast that you can't see it.

I find the pen to be much easier to use than freehanding the lancet. However, the pen is not designed for precision. Until you've had a lot of practice (and even after!) it's difficult to get it exactly where you want it. On Melville, I find that he bleeds most easily at the tip of his ear. I use a folded piece of napkin to provide pressure on the inside of his ear, and put the pen on the outside. Frequently, even on the lowest setting, it goes through his ear.

I don't know if this will be helpful for you, but I wanted to document how the lancet pen works.

Good luck, and please keep the group in the loop! :)
 
Most of the time I can get blood the first poke...but not always. Early on, I learned to scoop the blood up on my fingernail and test from there. It comes in very handy when I have to poke more than once, not to mention it helps prevent the ear flicks and smears across the ears.

After I have the blood on my fingernail, I then seat the strip in the meter, sip the blood up when the meter is ready, and away we go. If I need to test again, and I still have enough blood, I can do so without having to poke Poopy again. He likes that part! :lol:

While you are learning the meter, scooping the blood up may be helpful for you. :smile:
 
I hold a pill bottle with warm water in it on Asher’s ear in the winter. Once its warm, I just hold my finger behind the ear at the hole of the lancet pen. My finger is rounded so I can aim pretty good this way. I can see a folded paper towel would work this way too. My partner Tom just keeps the warm pill bottle back there when he pokes.

I was awol later this past week with Mom stuff I had to take care of, but if you need me to come down there to visit/help early next week let me know. You can PM me or post here. Like I said I am about an hour and 15 from center city Philly. If you are just over the bridge in Jersey, that’s not much more really.
 
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