Sabrina's A Little Better Today

[Gill & George]

from Tiendanimal but after that last debacle with it taking a month for me to get my order and me having to hunt it down myself I stopped ordering from them

I had trouble with tiendanimal, it took them ages to ship, I waited over 2 month for a delivery of them.

Zooplus uses Correos express here on the mainland. I hear your courier problems and empathise, I've managed to train the local couriers, I have their mobiles and liase with them. You may have an option when you place the order with who you can use. I choose Correos Express, have a good working relationship with them, but zooplus also use Seur (don't get me started on them), sometimes stuff comes with them even though I prefer Correos Express.

they tested it in house only.

What did they test for? some have quite extensive testing available in house to them?
One of the vets we have used (not exactly local to us over an hour away) has an in house system and tests for quite a lot of parameters, he always gives me a report from the machine in his practice..
I think a lot of vets here in spain just don't expect their clients to go that extra mile for their cat, in the same way they might for their dog.


Good news on the weight and the eating, hope you can now start to cope with the home testing and run some curves.
How is your girl though? still lethargic? or has she pepped up a bit.

 

[BriniWeenie]

Yes, it's Seur here too, they are awful. If Zooplus gives me a choice, it'd definitely be Correos Express.

I think they only tested to confirm the diabetes. Normally blood tests get sent to a lab in Gran Canaria for testing. They can do scans and x-rays and that kind of thing there but analysis is only basic and anything more detailed gets sent out. I think they had no intention of ever sending it to the lab because they wanted to euthanize her. My friend messaged me a while ago, asking about Sabrina. She was the one I referred to that clinic before. She said her cat hates the day vet and wants to know where the one she replaced went to. So I guess it's not just me who gets bad vibes off her! But that's fine, all I really need now from the vet is the insulin, the rest I can do myself at home.

Sabrina has phases she goes through during the day where she will walk around and periods where she is lethargic and stay in one spot for hours. There are small improvements that I've noticed, like even though she might only take a few steps before she rests, her legs are a little more steady than a few days ago.

I'll update my profile and Sabrina's information later today. It's so much to learn all at once. I haven't slept for days and now that I got today over with I finally feel like I can relax a little, knowing that she's going to get better.

Edit: Oh, I meant to add, she is on I guess one unit? It's the very very first mark on that syringe. The smallest dose possible.

Here's a photo I took today, her coat is pretty poor and she's got dandruff. But this will give an idea of what she looks like right now.

 

[Deb & Wink]

Oh! The unkempt fur, the dandruff, the dull dry coat! Takes me back to memories of my foster cat Wink when he first came to my home. It will get better.

Take a siesta, it's a nice warm mid-afternoon where you are. Maybe Sabrina will snuggle with you.

Catch you later. If you are able to, take a picture of the syringe for us to look at. Later. When you are rested a bit.

 

[Gill & George]

It's the very very first mark on that syringe. The smallest dose possible.

The syringes you got from the pharmacy, did they come in some packaging? Can you take a pic of that please? and post it
I don't think that's an insulin syringe that you pictured above and I can't see the markings. If you can get a better picture of it and the packaging the syringes you got came in, I can work out the dose you have been giving her.
It's just a bit of maths, but we have had the problem where folk have been given wrong info about the syringes they have been given, resulting in them giving much more, or not enough insulin.

Did you happen to discuss the different insulin options with the vet?
Vetsulin/Caninsulin is quite fast acting and for a lot of cats not long acting enough so a lot of folk find it's tough to achieve good regulation with it. Lantus and Lev(the long acting depot insulins), as a general rule, have a better reputation for helping a CG getting a kitty well regulated. My vet started us on tablets (which are useless in cats), I took that opportunity, 2weeks, to research and swap George from his HC dry diet to a soft LC diet, so when we went back I decided to ask directly for Lantus, my vet wanted to start with vetsulin/caninsulin but was OK with prescribing me Lantus, one thing I have found here, which is a positive, is that the vets are open to try new things, they don't get stuck in their ways.
They usually start with Caninsulin/Vetsulin, because of some EU protocol, I found that out more latterly.

Just bear the above in mind. No need to worry about the insulin type at the moment. First see how you girl does with it, if you are not getting the results you hope for/want know that there are other options, some insulin types work better than others depending on the individual cat.

Keep us posted
Look forward to seeing some curves for your girl.

ETA
Download the US spreadsheet here in Spain we use the same units as the US for bloodglucose levels, I've no idea why

 

[Gill & George]

OK...those look to be U40 insulin syringes but the syringe barrel is too big. It holds 1ml (up to 40 units)

View attachment 51020

View attachment 51021

I don't think it's those Chris, knowing how things work here, I think it's probably unlikely the vet had U40 syringes in stock (nor will the pharmacy) (probably just used the smallest syringes they had, and and added a regular needle, just looking at the size/colour of the needle barrel it looks like the ones I have used to inject antibiotics/anti inflammatory into the cats and dogs here. Probably a much larger gauge. Also the numbers are in black not red, like your pic.

they look more like this to mehttps://zootecniasl.com/jeringas-tuberculina/15954-jeringa-injekt-tuberculina-1ml-sin-aguja.html

They hold 1mm(40 units per full syrninge) total and go up in 0.01ml graduations (the small lines)(each small line being 0.4 units).
If we can see the packaging or manufacturer on the syringe it will be easier to figure out. In the meantime, just keep dosing the amount the vet showed you on the syringe, assuming that the vets syringe and the pharmacy syringes are exactly the same. We can figure out how many units that is once you can give us info, send some more pics.

 

[Shellcat]

Yes, it's Seur here too, they are awful. If Zooplus gives me a choice, it'd definitely be Correos Express.

I think they only tested to confirm the diabetes. Normally blood tests get sent to a lab in Gran Canaria for testing. They can do scans and x-rays and that kind of thing there but analysis is only basic and anything more detailed gets sent out. I think they had no intention of ever sending it to the lab because they wanted to euthanize her. My friend messaged me a while ago, asking about Sabrina. She was the one I referred to that clinic before. She said her cat hates the day vet and wants to know where the one she replaced went to. So I guess it's not just me who gets bad vibes off her! But that's fine, all I really need now from the vet is the insulin, the rest I can do myself at home.

Sabrina has phases she goes through during the day where she will walk around and periods where she is lethargic and stay in one spot for hours. There are small improvements that I've noticed, like even though she might only take a few steps before she rests, her legs are a little more steady than a few days ago.

I'll update my profile and Sabrina's information later today. It's so much to learn all at once. I haven't slept for days and now that I got today over with I finally feel like I can relax a little, knowing that she's going to get better.

Edit: Oh, I meant to add, she is on I guess one unit? It's the very very first mark on that syringe. The smallest dose possible.

Here's a photo I took today, her coat is pretty poor and she's got dandruff. But this will give an idea of what she looks like right now.View attachment 51057

I know it's hard not to be a 'Hover Mother', but if my sweet boy DIDN'T lay in one place for hours at a time, I would think something was wrong. Let us not forget, Cats Spend Most of the Day Sleeping. I do get a bit concerned of he's sleeping in a new or unusual spot. I understand being financially strapped, as well. I worry often about cost and when I'll need supplies for him. It's ALOT, but you're doing what you need to do to help Sabrina get better. Good On Ya!!

 

[Deb & Wink]

ETA
Download the US spreadsheet here in Spain we use the same units as the US for bloodglucose levels, I've no idea why

Well now, that sure does help to know that. Probably why members Mayka Otto in Spain and Teo in Argentina use the US spreadsheet version.

Found this link, old from 2016 that lists which countries use mg/dL and which use mmol/L
"Out of the countries listed, it looks like the USA, Central and South America, India, Japan, the Middle East and parts of Europe use mg/dL. Canada, Australia, South Africa, Northern Europe, China and the rest of the world use mmol/L." From this facebook page https://www.facebook.com/diavergeDi...asurement-of-mgdl-which-use-/625561337626529/

 

[BriniWeenie]

Ok, so it sounds like she is on .4 units because the dose is the very first mark. I have a few of the green ones the vet gave me today, and the pharmacy sold me a different kind.

We will want to change insulin at some point but she did give us a bottle for free. It's normally €8 a bottle so every little bit helps. I thought we would have some resistance from the vet today and I was actually surprised she was helpful. She did say she thought Sabrina only had a small chance of getting better, but yeah--that remains to be seen. My friend said earlier that she felt that some vets are really quick to euthanize here. I know of two other vets in the area who are what I call "trigger happy"so I never go to them.

And I probably am being a Hover Mother. Sabrina is aloof and independent as it is so she kind of hates being fussed over. Before she got sick, she'd prefer to find a spot apart from the other cats, normally the highest shelf she could jump up onto in the house. I used to joke that she liked sitting up on her ivory tower so she could look down on us peasants. It's why I have less photos of her than my other cats. She's a solitary cat and prefers to keep to herself. I am trying to tell myself not to fuss so much over her. I know what needs to be done now and I can just focus on getting into this routine and I don't have to worry so much. Getting the vet to work with us today was a huge relief.

As the lighting in my house is bad at night, I found photos of the two syringe types.
This is the type we got from the vet, it's Injekt F Leur Solo .01ml-1ml

The ones I got from the pharmacy are BD Plastipak 1ml 25g x 5/8 (.05x 16mm) and they come with needles on them.

 

[Deb & Wink]

And I probably am being a Hover Mother.

We are used to "Hover mothers or dads" here. Kind of like "helicopter parents" with their human children.

Caninsulin is a U40 insulin.
I think those are both U100 syringes.
Not sure if either one of those are insulin syringes.
Does it say "insulin" or "insulina" (Spanish for insulin) on the barrel of the syringe?

Tagging @Gill & George for their feedback.

There is a way to use U100 insulin syringes with a U40 type insulin. There is a conversion chart that is used.
It gets complicated though. It can be done.

 

[Deb & Wink]

Conversion chart for using U100 insulin syringes with a U40 insulin.
http://www.felinediabetes.com/insulin-conversions.htm

NOT recommended for those who can get U40 insulin syringes instead.
Until you are trying to measure those tiny doses. It's too easy to overdose your cat if you mix up the syringes.
For advanced members ONLY.
Or those living in the Canary Islands where insulin supplies are difficult to come by.

 

[BriniWeenie]

That's what the pharmacy gave me too, but the clear ones. The green ones are from the vet. This is the sort of place you've got to live in to see for yourself because so many things aren't readily available and then of course they make things as difficult as possible to get things sent here from elsewhere. Well, I can just order the proper ones from somewhere if I can't get them locally. Or maybe ask my regular pharmacy to order the correct ones.

The vet showed us on the green ones what line to go up to, it's the very first mark on the syringe, it's the very minimum you can do I think, so whatever that converts to. Again, I apologize for the terrible lighting in my house at night. Here's a photo of the real one and I arrowed to the line the vet told me to fill it to.

 

[Deb & Wink]

That's what the pharmacy gave me too, but the clear ones. The green ones are from the vet.

So you have U100 syringes?

That looks like it may be a 1 unit dose from your picture.
1 unit in a U100 syringe of a U40 insulin = 0.4 Units of that U40 insulin.
U40 dosage multiplied by 2.5 gives you the dose to measure and draw up in your U100 insulin syringe.

A 1 ml insulin syringe holds 1 cc (cubic centimeter) of insulin or 100 units maximum.
In other words, one milliliter (1 ml) is equal to one cubic centimeter (1 cc)
The 1.0ml line on the syringe is 100 Units.

The 0.1 labeled and marked line on the syringe barrel is 10 units.
The 0.2 labeled and marked line on the syringe barrel is 20 units.
The 0.3 labeled and marked line on the syringe barrel is 30 units.

• Cats need a very tiny dose, so starting at the very first line on the syringe, 1 unit looks about right.
• You are trying for consistency on dosing.
• Always get a pre-shot test.
• No-shoot BG number when starting with Caninsulin should be set at 200 mg/dL
• Feed 20-30 minutes before giving insulin.
• So it's pre-shot test, feed, wait 20-30 min, shoot.
• Try to get a test in the middle of the cycle. Somewhere between +4 and +7 hours into the "every 12 hour dosing" cycle. Vary the times for those tests. To see how low (the nadir) this dose of insulin brings your cat.
• If too low, under 100, you might want to post on the board for help.
• If under 50 mg/dL during the cycle, you will want to feed Sabrina some food to bring those numbers back up. You may need to do this for quite some time. So that Sabrina does not suffer from hypoglycemia. She is already weakened from the weight loss.
  
• Caninsulin may only have a duration in cats of 8-10 hours. It's the best you can do for now.
• Simply don't be surprised if the BG readings at Pre-shot test times are high.
  
• You record the U40 insulin dose on the spreadsheet, not the amount drawn up in the U100 syringe.

For some of the basics when using Caninsulin, this document will help guide you.
Beginner's Guide to Caninsulin (Vetsulin)

p.s. I lived on one of the remote islands in the Bahamas in the late-1970's. For only 1 month. Special college level course. I can imagine where you live now is similar but with some modern amenities, like internet service and cell phones.

 

[Gill & George]

Injekt F Leur Solo

https://www.bbraun.com/en/products/b/injekt-f-solo.html
Just as I thought a regular syringe from the vet's is the same one my vets use. A whole syringe is 1ml and it is graduated in

BD Plastipak 1ml 25g x 5/8 (.05x 16mm)

This one is a U100 insulin syringe. Though in the picture I am linking the graduations go up in units not ml unlike the picture you posted. So each large division is 10u (of U100 insulin and the small divisions are 1u.
the pic I posted is not so good but you can see it better on this website https://www.doctorshop.es/Prodotti/...con-aguja-montada-25g-x-58-05-x-16-mm-9400031

The vet showed us on the green ones what line to go up to, it's the very first mark on the syringe,

That very first mark is 0.01 ml.
With a U40 insulin
there are 40 units in 1ml
4 units in 0.1ml (divide by 10)
0.4 units in 0.01ml (divide my 10 again)

Those BD syringes (at least the pics I find when I google it) are calibrated in insulin units for a u100 insulin for easy of use. The whole syringe contains 1ml or 100units of U100 insulin, or if using a U40 insulin 40units in the whole syringe.
Since there are 100 of those tiny marks on the syringe (at least the one I pictured) each of those tiny marks is 40u/100 =0.4u.
So to continue giving the same dose the vet started you on, you still just go to that first mark, it's just the same.

While you are using the U40 Caninsulin, you can just continue with what you have. But if you do decide to change to a U100 insulin, those syringes are too big to dose accurately. But you should not have a problem getting these syringes made by BD, I just took the info to my pharmacy and she ordered them in for me. As your pharmacy already has BD syrniges I feel sure they will be able to get them in.
Bd Microfine+ demi


If you are finding it difficult to dose your Caninsulin with what you have, these are the syringes for caninsulin

Caninsulin Syringes U40

VetUK does ship to europe, other members have used it, in finland and Slovenia, that I recall, because they couldn't get certain supplies in their country (it's not just Spain and the Canaries) I would show the pharmacist, pictures on the web, I've found all the local pharmacists to be extremely sympathetic and helpful, my local lady, always keeps a couple of packets of the BD microfine demi in stock for me. (even though george has been in remission)

If you can't get the insulin syringes, but want/need to be able to dose more acurately, get the BD microfine+ demi but you will need to remember to use a conversion for the graduations.

Hope all that makes sense.

 

[Gill & George]

Hey Lori When I saw the pic of your little panther Sabrina, she reminded me of another little panther, BK, a legend round here, especially on the Lantus forum. Sadly BK went to the rainbow bridge a little while back, but not before beating FD and remaining in remission for 6.5years.
So I just wanted to share his story with you, here is Sandy's last post but in it she shares a tribute video where you can see some before and after pics, BK turned up on her doorstep in quite a state, her vets (in us) also recommended Euthanasia.
The vid makes me smile and cry.http://www.felinediabetes.com/FDMB/threads/10-23-black-kitty.220786/

 

[BriniWeenie]

I eased off on the Hover Mothering a little. Even before she got sick, she liked to be by herself and had her favorite hiding spots. One of them is in the wardrobe, she's currently on the bottom shelf (with the door slightly open) so it's easy for her to come and go as she pleases and gives her her space. I have the litter box a short distance outside of the wardrobe so she doesn't have to go too far. The other cats don't bother her in there but when she wants their company she will come out and cuddle with them. She's been purring and making little chatty noises so she seems happy enough. I bet she can't wait until she's back jumping up on the cupboards and fridge again, and I can't wait to see it again either. I know that's a long way in the distance but she will get better and better every day.

 

[Deb & Wink]

I bet she can't wait until she's back jumping up on the cupboards and fridge again, and I can't wait to see it again either. I know that's a long way in the distance but she will get better and better every day.

My diabetic foster cat got there in about 6-8 weeks. Then he started to eye jumping from the floor straight up to the top of the 6 foot tall bookshelves. Scared me to death.

 

[BriniWeenie]

That's what she used to be like, she was such a high jumper. She would launch right from the floor to the highest spot she could find. She loved spending the day sitting up there and looking down on the rest of us, haha. I really do hope it's weeks away before she gets some of her mobility back. Right now, she rests a lot but gets energy bursts throughout the day where she walks around for a bit and sometimes climbs up on the bed. I think she already looks a tiny bit steadier on her back legs.

 

[Gill & George]

I think she already looks a tiny bit steadier on her back legs.

That's great.

How have you got on with the Spread Sheet? managed to download it? Do you need help with it?
If you have it set up do you think you could share it on your signature?

How have the ear pokes been going? any luck getting a reading?
I forgot to mention, if you do place an order from zooplus or anywhere else, look for some freeze dried treats to use a treat for the ear pokes.
I've used Cosma snackies and Orijen freeze dried treats, George goes crazy for them. (zooplus.es don't stock orijen anymore, but I have used Miscota.es, not as reliable as zooplus with their deliveries)

 

[Deb & Wink]

How has Sabrina been the last 2 days?

 

[Deb & Wink]

Briniweenie, Please remove your time zone and country from your user "signature". I mistakenly asked for you to include that info and it should not be there. Thanks and apologies for the confusion.

 

[BriniWeenie]

Sorry I haven't updated in the past few days. We had difficulty getting the ear pokes but we got one tonight. It was 388, but maybe we didn't do the test at the right time/too soon after eating. We had been trying to get a reading for days and tonight was the first time we got one with enough blood for the meter to read. My husband's machine is a One Touch Select Plus, so I don't know how good or bad it is either. I looked at the lists posted here and didn't see that model on them. I suppose the other thing we can do is take ours to the vet when she goes for a checkup and compare theirs to ours. They use an animal meter, so I do know the readings can be slightly out when using a human one, but I don't know how accurate my husband's is, but he does get normal readings for his own tests. I just don't know how it could have gone up, unless our timing was wrong when we finally got a successful reading. I wish we could have gotten more readings apart from this one to go on.

 

[Gill & George]

They use an animal meter, so I do know the readings can be slightly out when using a human one

It can be very different, I wouldn't even bother checking it won't tell you anything, your vet will try to get you to buy the petmeter, the strips will be expensive and it's an unnecessary expense. You can use a human meter to keep your cat safe when administering insulin, until fairly recently petmeters for home testing were not widely available. Also bear in mind that the dosing methods and guidance on this site all reference human meters, since there is no way of converting numbers from a pet specific meter, to a human meter (there is no formula) I would recommend sticking to a human meter.

We had been trying to get a reading for days and tonight was the first time we got one with enough blood for the meter to read. My husband's machine is a One Touch Select Plus, so I don't know how good or bad it is either.

It requires a fairly large sample size at 1microlitre,. I think you will find the one's recommended on the list (I haven't looked in ages) require smaller sample sizes, making it easier to get a test, especially in the beginning when the capillaries don't give up much blood and when you are still learning.

The pharmacy in my town just gave me one FOC ( a Freestyle Freedom lite), with 10 free strips to get me started, they didn't have any to sell as such. I just told them it was for my cat, but if you thought that was not going to get you anywhere, just say your Hubbie needs a new monitor and you would like to try a different one, see which ones they have and whether there are any on the list.
The freestyle freedom lite is very easy to use, has a tiny sample so very easy to get a reading, my friend/petsitter uses this one when she looks after my guy for me and has no trouble, I use a different one usually (cheaper strips)

How is Sabrina feeling?

 

[Larry and Kitties]

It requires a fairly large sample size at 1microlitre,. I

I use a One Touch Ultra (w/B\GenUltimate strips since genuine One Touch Ultimate strips cats about the same as AlphTrak stripps) strips since for two of my cats. It requires 1uL. In the past I have used a meter that require 3uL. It depends it you cat is a bleeder.

 

[BriniWeenie]

She's not a bleeder, the vet had said something to us about that when she did the test during last Monday's checkup, that she was difficult to get blood from. In fact, we poked her about 8 times. One test read as "error" and we wasted a couple more strips trying to get enough blood for the meter to register it. It was 326 the last time, about 4 hours after her shot. We're running out of strips but have enough for today. My husband gets the strips and meter for free from the nurse at the medical center because he is diabetic. He doesn't remember when they replaced his old meter last, but maybe it's time for an update. Could be the more current ones require less blood.

She had a bad day on Friday. She was in a bad mood. She swatted at me a couple of times while I was trying to clean her eyes. Her eyes are a bit runny, and sometimes when she eats, she buries her whole face in the food and makes a mess. So I clean her face throughout the day and that day she wasn't having it. She's not an aggressive cat, she's normally quite relaxed. So I thought something must be off if she's acting like that. I also comb her out a few times a day, and clean her bum because she's not feeling well to do these things for herself.

I noticed she hadn't done a poo all that day, she usually goes in the morning and at night but she hadn't gone in the morning. I put her in the box a few times, she wouldn't go. Later that night, she ended up pooing all over herself and her blankets. She couldn't get up to go and I felt terrible. While she did pee on herself a few times during the first few days of her diagnosis, she hadn't peed on herself most of the week and she had never not gotten up to poo until that day. Up until then, it looked like she was making improvement to her movement . On Saturday, I noticed neuropathy in her front legs, which she didn't have before. So it's very disappointing to think that she's getting better, only to see she's having set backs. We got different needles, they are still U100s but they say "insulin" on the side. We have 1 left, so I'll take a photo of it before we use it later. We have other needles but my husband bought a couple of these ones from a different pharmacy to see if they were any better than the ones we had.

She seems okay today, she's walking better, the front legs aren't bending. She takes a few steps, rests, takes a few steps, rests. But she is able to get around better today and she made a few happy meow noises and purred this morning, something I hadn't heard for a couple of days. She looks better than she did the past couple days, but I am worried about her. She's still eating a lot, she eats about 5 or 6 tins of food a day, for the most part they are 100g each, but she also ate some that were 75g. But she has a healthy appetite and she doesn't act as thirsty as she used to. But she's still very thin.

She is due for a checkup tomorrow but we can hold off if we want to but I am curious as to how much weight she's put on.

 

[Deb & Wink]

Do you think she may be a bit dehydrated? Testing for that here.
"These include listlessness, refusal to eat, panting, sunken eyes and dry, tacky gums. A good test to see if your cat is dehydrated is 'skin tenting'. To do this, take a pinch of skin around her shoulders and gently pull it up - if she is adequately hydrated it should ping straight back into place."

If you have a scale you use to weigh yourself (lots of women do), then hold her in your arms, let her down, note your weight and subtract to get an approximate weight for Sabrina.

2 steps forward, 1 step back, 2 steps forward, 1/2 a step back............................................... You are doing the sugardance with Sabrina. Give it time.

 

[BriniWeenie]

We have been checking the skin around her shoulders and noticed an improvement. I don't have scales at home so I guess we'll take her for a checkup tomorrow and see what's up. I don't want to take her back there tomorrow but I want to know how much weight she's put on this past week. She still feels pretty bony but she eats often. Without being able to get regular ear pokes, it's hard for us to monitor her as often as we would like. She seems better today but those two days she had made me feel so heartbroken for her. We are going to try another ear poke before her last shot of the day, hopefully it's successful and won't take 8 attempts.

 

[Deb & Wink]

Slow and steady on the testing. Double poke close together to get a larger blood drop. Give the blood drop time to form and be big enough for the Onetouch to read. It takes a big blood drop, 1 microliter.

Try looking in this document for an idea of the blood drop size. Could not copy only the blood drop sizes. http://main.diabetes.org/dforg/pdfs/2017/2017-cg-blood-glucose-meters.pdf

 

[BriniWeenie]

A dozen pokes for the pre-shot test and not one of them produced enough of a blood drop. I'll have my husband ask at the medical center if there's a meter that requires a smaller drop. It could be that this is the only model they issue for free, but it's super handy to get free strips too. If it comes down to it, I'll ask the pharmacy what they've got. It doesn't have to be anything fancy, just something that doesn't need as much blood. It's hard because we're juggling finances as it is. We want to buy B12 for her too and another blood tester is an extra expense when we have a perfectly functional one, but this one just isn't working for Sabrina. It's very frustrating.

 

[Gill & George]

Hi I'm sorry your girl had a bad day, sometimes it can be a case of one step forward two steps back, I hope that it was just a glitch and that she starts to feel better.
Have the vets looked at her teeth? What have they said about them?
Has she ever had them cleaned? wondering if a tooth infection, might be at the root of her problems.
If they haven't mentioned them and you take her in today, ask them directly what they think of her mouth?

When you mentioned the watery eyes, and the pooey mess, I'm just getting flashbacks of George a couple of years ago, he started off being iffy, coat unkempt, dandruff, BG went up from normal (he was in remission at the time) then watery, slitty eyes, then went off his food (he's a very good eater, never says no to food). My regular/local vet run some bloods to the lab, nothing conclusive, so she just wanted to wait and see, wouldn't give me anything, blood tests didn't show signs of infection, but apparently that is not uncommon with teeth infections.
Anyways he got worse even had a couple of mini seizures, and I decided to go for a second opinion to a vet over an hour away who had treated another of my cats for a rather serious gunshot wound. By this point I was suspicious at any rate that it was Georges mouth.
Well the second vet said George had a hideous mouth infection/gingivitis, and wondered why I wasn't giving him AB's, to which I responded 'Other vet said there was nothing to be done, and had refused to give me AB's when I had asked'
Also he asked me why he hadn't had his mouth cleaned ...'Well other vet said the risks of the dental outweighed the benefit to George' To which he said, we either do a dental, or we will loose this cat.

Long and short, George was started on AB's anti inflammatories for pain, then once infection had cleared with the AB's he went in for dental. Had a lot of teeth removed he just has his canines and a couple of molars, but he recovered well from his op and is still with me now, a very senior kitty at the age of 20.

When I nest saw my regular vet, she asked me how George was, I said fine, I took him to see Dr M, and he had a major dental, lots of teeth extracted and now he is fine. To which she replied, well yes his mouth was a mess. I had to bite my tongue, I was so furious, she knew what the problem was but didn't discuss it with me, basically she didn't feel competent to do the dental and have a good outcome so she just didn't tell me he had teeth problems, I would have had much more respect for her had she said to me 'It's his mouth, but I don't want to operate because of x,y,z'
Sorry for the long story, but just wanted to illustrate, that over here, sometimes they might not give you all the information, for fear of upseting you, especially if they feel that there isn't anything they can do to help, and can be reluctant to refer you on to someone that might, for fear of losing your custom.

I use a One Touch Ultra (w/B\GenUltimate strips since genuine One Touch Ultimate strips cats about the same as AlphTrak stripps) strips since for two of my cats. It requires 1uL. In the past I have used a meter that require 3uL. It depends it you cat is a bleeder.

Sure the meter I use is 1ul, but George bleeds sufficiently, and I've had a lot of practice, my friend/petsitter struggles with that so she uses the Freestyle Freedom lite finds that much easier.

A dozen pokes for the pre-shot test and not one of them produced enough of a blood drop.

Have you read the tips on home testing? take a look at the videos on how folk test, I found that watching the videos of different people doing the testing really helped me when I started out. Everyone has a slightly different 'style' so something might just click for you, it did for me when I watched the videos. We all struggle at first.
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
Here's a link to a picture of the part of the ear you need to try to aim for.
http://www.felinediabetes.com/images/laur_danny_famoussweetspot.jpg

This post by Marje covers a lot of the salient points
http://www.felinediabetes.com/FDMB/threads/testing-and-shooting-tips.85113/#post-1377750

What gauge are the needles you are using for the poke? (they come in different sizes if the one your hubby gets fine then that might be the issue) new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed; then progress to a 31g or 33g which are finer. ( I use a 29, but I have a 28 for my petsitter, again it gives her a bit more blood to play with and that's easier.
Really do the ear warming thing, I use my hands (I always have very warm hands) and I just tickle George and warm his ears with my hands, he loves me messing with them, but you can use a warmed rice sock. I know if I fail to warm Georges ears up, I will not get enough blood for a poke.

 

[BriniWeenie]

We just got back from the vet,we went in the evening and had the 2nd vet. She still wants to put Sabrina to sleep. Sabrina hasn't made any improvement in the past week. Her weight is the same, her BG is the same. It was 386, so it looks to me that that's the high and low numbers because they are more or less 324 or 386 when we have managed to get a drop. The vet said to increase the dosage to 4 notches and to call her if the reading is too low. I know her dosage was very low before but I am pretty nervous about upping it, but clearly the small dosage isn't enough for her. She did check her teeth today and said there wasn't any problem, but I know how she feels about Sabrina and us wanting to continue with treatment too. I'll take it with a pinch of salt for now.

My husband has two lancets in his case, but they are both the same.

Here is the syringe that we've got now. It's a U100 and she told us to increase it to 4 notches.

 

[Larry and Kitties]

That syrine looks like a 1ml syringe that is marked every unit like this one
https://us.bbraunoem.com/en/products/b/omnifix-syringe-f1mlls.html
It is not really an insulin syringe since insulin syringes include a non removable. Your syringe is OK but you really can't constantly draw the same dose. Using 3/10 ml (30 units) human syringe would be better. You can likely get those in Spain marked in 1/2 unit intervals. The human insulin syringes would be less expensive than the syringe/needle shoin the in image. Increasing to 4 notches (0.04ml) would be 1.6 units oy your U40 Caninsulin.

When was the 365 measured in relation to the time you gave the previous shot.
Same for the 324 that you obtained at home.

 

[BriniWeenie]

The last test was done about 6 hours after the injection. That's the syringe the vet gave us, we still have a couple of the insulin U100s, it has measurements of 20, 30,, 40, etc. They're similar to this: https://cdn.shopify.com/s/files/1/1...Scale_Syringe_-_309629_large.png?v=1526510070

 

[Larry and Kitties]

I have no objection with increasing to the 4 mark wihinis 1.6 units of Caninsulin. It would be helpful to get a BG right before feeding and shot and then about 5 hours after shot. About 5 hours should be the lowest BG for Caninsulin.

 

[BriniWeenie]

Pre-shot reading is 335. I'm going to try getting a spreadsheet set up now. I think or hope we got the magic spot on her, it only took two pokes this time and the first one was our mistake because the meter wasn't turned on first. Second poke, got blood right away. Got two nice drops from each. Hopefully testing will go much smoother from now on.

 

[BriniWeenie]

Ok, I got the spreadsheet set up (I think) but it wouldn't let me input the info at the top but all that info's in my sig anyway. There were no issues to report with the insulin increase. I have several bills that have to be paid this week (phone, car insurance, water bill) but I should have that taken care of in a few days. Once that's out of the way I'm going to order B12 to help with her neuropathy. I know it has to be methyl and has to contain no sugars/fructose, etc, yes? It'll probably be much cheaper to order the syringes too. I'm trying to do everything I can to help her, it's just at the moment we are juggling finances like crazy so I can't always buy things immediately but I should be able to order a few things by the end of the week.

I just feel bad that the dosage the vet told me to give her last week wasn't enough and she got worse, and the vet we saw last night still doesn't think she can be saved. It makes sense now though, why she was feeling so down towards the end of the week. Without being able to get regular ear pokes I had no idea where we were really at, but that was last week, this week will be better.

Should I continue in this thread, start a new one, or should I be moving over to the Caninsulin section now? I'm still new to all of this

 

[Deb & Wink]

Still new, you may stay here in the Feline Health forum for a bit longer.

If you start a new thread, please link this one into the top. At the very beginning. So we have some history to follow.

Eventually, you should move over the the Caninsulin ISG forum. But we usually don't suggest that until people are more successful with the home testing, low carb food, good insulin.

Understand on the financial situation. Most of us here are in the same boat. Trying to bail a leaky boat with a tin can, and one foot over the hole in the bottom of the boat.

 

[BriniWeenie]

I'm really worried now, her BG keeps going up. It was 439 for her pre-shot reading. None of her other readings have been that high before, but it wasn't until this week did we manage to start getting more regular tests. We are doing at least twice a day, and have tried more. We try to get at least 4 tests a day but sometimes too much time passes between when the blood drop forms and the machine turns off, and sometimes we try to take it too quick and it doesn't read. So we've had as many failed readings as we have successful ones. I don't really know if she's ever been in the 400s before but I don't think so. Her readings keep going up and up instead of down and it's really freaking me out. She seems to be doing better but the BG tells me otherwise. I don't know what more we can do that we aren't doing already.

 

[Shellcat]

I'm still pretty new myself, but...439 is high, yes, but don't freak out. Weenie can 'Feel' you freaking out and it stesses her too, and that affects her BG. My Mr. has been over 400 lots more than under 200. Keep doing what you're doing. Relax. Put on your favorite song and Jam Out or watch some Kitty Videos on YouTube. Just get your mind to calm down. I've been frustrated plenty myself. It does get easier. You got this. It takes time and I've found the more I'm stressed out about it, the more difficult it is.

 

[Juls and Billy]

If the meter turns off, can you turn it back on with the strip still inserted? I don't know that meter, but on mine, if it goes off before I get the drop ready, I can hit a button and it comes back on, ready to go. You might want to do a dry run, let it turn off, and see if there's a button that will turn it back on.

 

[BriniWeenie]

I'll have a look at the meter and see if there's a button to reactivate it because that's happened more than a few times already, wasting strips and also having to poke again. That and sometimes the blood drop isn't quite enough for the meter to read. Other times she will flick her ear or move her head, causing the blood to drip off or rub into the hair on her ears. Maybe she is sensing stress/anxiety off of us too. It was a shock to see it in the 400s and of course I don't want to do anything to cause her BG to spike. The ear pokes are still something we're getting used to and sometimes they go super easy and other times they don't. I know it eventually gets easier once you get into the groove, it just feels like a lot of fumbling around right now.

 

[albertresidence]

@BriniWeenie, ...Let me start of with that I'm so proud of you for being Sabrina's advocate and fighting for your girl despite of what your Vet's original opinion was. I know that animal welfare and care is different in each country. I'm German, living in the US with my husband, we are retired Military. Part of my family lives in Spain six month out of the year for the past 33+years.

I'm new to FD myself even though I've been doing Kitty Rescue work since 2007 her in the US. Never had a diabetic Foster Kitty before. Everything I was told how to treat Edith's diabetes by the Vet when I took her in December 8th, 2019 was so wrong. Well, I didn't know until I was on my mission to educate myself about the new endeavor about FD and I found this board. FDMB was a blessing to me and Edith!

You are on the right track, you are the captain on Sabrina's ship along with your hubby and her feline friends and we are here to support you all the way!

 

[Bron and Sheba (GA)]

Lori you are dong a great job looking after Sabrina. It takes time for any real improvement to be seen. Don't let the vets put you off looking after her. Try not to worry about the higher numbers. Sheba was in really high numbers for weeks and weeks and she eventually came down to the lower numbers.

 

[BriniWeenie]

We've been rescuing cats since about 2004 and Sabrina is my first diabetic cat too. She and her brother have been with us since 2005, since they were kittens.

We just did another pre-shot test and it's down to 395. There were only 3 strips left so it was important that this test not end up turning into another fiasco. The lancet was turned down to 4 this time, it might have been set too high before. Got a nice big drop in one poke. My husband has an appointment with the nurse in the morning to get more strips and lancets so those will be restocked tomorrow.

I was also looking into switching to human insulin somewhere down the line. It seems I can just ask for it at the pharmacy without a prescription, so it is something I will consider for the future. Especially if this vet continues to badger us into putting Sabrina to sleep and it's going to be like this every time we take her in for a checkup. She's going to see the spreadsheet and give me that disapproving look like she did last week.

The one vet has known us for a few years. One of my oldest cats died last summer, he had liver disease. He was about 17/18 and lived a good long life. But he was in pain and I knew it was his time, so when she had that talk with us regarding him, I knew it was the right thing to do. So I'm not in denial about Sabrina if that's what she thinks, I have no history of being a difficult client. Well, not until now anyway, ha!

 

[Bron and Sheba (GA)]

If you live in Canada you can get Lantus over the counter......oh I see you live in Spain, so I have no idea if it is freely available there.
Lantus is a MUCH better insulin for cats than caninsulin and Sabrina may well do very well on it. Definitely worth thinking about soon.
Just say to the vet.....'please do not keep telling me to put Sabrina to sleep. That is not an option at the moment'.
Did the vet check to see if Sabrina is dehydrated? Some SubQ fluids would help if she is dehydrated..
The dandruff and the dry fur are very much signs of a diabetic cat. Those things will improve greatly once you can get on top of things.
Just make sure she is eating and drinking well and getting her insulin. And keep up the good work with the SS
Are you testing for ketones?

 

[BriniWeenie]

I think I can get Lantus without a prescription here, I did a bit of googling, but unsure of the current price. The list I saw was a bit outdated, but it's good to know I can buy it over the counter. I haven't tested for ketones yet either, I need to get the strips. Every time I go to the pharmacy I forget to ask for something. They didn't even have separate needles to sell me at the one I went to the other night. I left there thinking, "What kind of pharmacy doesn't sell needles?" but that's pretty typical of my everyday life here. Maybe I'll be a bit luckier if I went to the pharmacies in the tourist areas, they might be better stocked.

Her appetite is good, she's drinking water regularly and isn't acting like she's constantly thirsty anymore. However, it's very disheartening that her BG was high, when outwardly she looked like she was doing better. She still has dandruff, I comb her out gently a couple of times a day and her nails feel dry.

 

[Bron and Sheba (GA)]

Please make the effort to get the Ketostix or Keto-Diastix from a pharmacy and test the urine for ketones. It is very important you do this. Especially in the beginning when the BGs are high.
That is very good her appetite is good.
Just keep doing what you are doing and you will get there. Her BGs won’t come down overnight and the dandruff won’t go away quickly either. So try not to dwell on those things. Concentrate on making sure she is eating and drinking well, testing before every shot and inbetween shots, giving the insulin, testing the urine for ketones and looking into getting Lantus.

 

[Ann & Scatcats]

@BriniWeenie

At which Canary island are you on?

 

[BriniWeenie]

I'm in Lanzarote.

The nurse gave my husband a new monitor today, it's a Contour XT, but he has to make an appointment with the doctor to get the strips put on his prescription. He has some to get started, though. He said he might get the strips for the One Touch added to his prescription instead of this new device. We haven't tried it out yet, so I guess we'll figure out which one works better for us on Sabrina. This time, the nurse didn't ask for the old monitor back so now we have two. I think the big difference was the setting the gauge was on because the last pre-shot test went pretty drama-free too.

He said he asked the pharmacist about Ketostix but I think he must have asked for the wrong thing because she said they cost €70. I thought it was something like 50 strips for €10? Bah, I should have written it down for him.

 

[Ann & Scatcats]

Oh Lanzarote, my Isla Bonita. I worked there in 1986 in Puerto Del Carmen, and then there in 1987, 1989 when I also fed many homeless cats every day. Last time I was there in 1998. The owner Toni of restaurant Capri in Puerto Del Carmen is my old old friend since 1986.
Not the most populous island and the few towns spread out. So I see that you are having a hard time.

What if you tried to get the Urine Ketones test strips on prescription too from the vet? Would that help the pharmacist and give a lower price? In Sweden, which is member in EU, the brands are called Keto-Diabur-Test 5000, 50 strips, and Keto-Diastix, 50 strips, see picture.

 

[Deb & Wink]

Ann is a work traveler and has lived so many places in the world. She is a good resource and we love that she is here helping people and their diabetic cats.

p.s. Simba and Gustav enjoy their valentine flowers and cards?