Smiffy's eating routine

[Looby & Smiffy]

Hello girls!

This thread is strictly about Smiffy's eating routine at the moment and not about what type of food she eats, type of insulin I give her or whether or not I home test ...... I need to get the routine modified for the future so would really appreciate any ideas on what I could do differently:

First to all to those of you that don't know her she does not like to be cuddled or picked up and only likes to be fussed on her forehead, under her chin and her ears.

I have already studied and practised on her the desensitising methods that have been recommended here.

We live in a small house which is all open plan downstairs, there are two small bedrooms upstairs and Smiffy's eating place is just next to the stairs. Our other cat Pasha eats on the other side of the room (we had to separate their bowls as Smiffy used to bully Pasha away from her food and eat Pasha's! Tinker - she loved to eat before she was diagnosed).

Smiffy understands the word 'biscuits' and 'treats'. She is 14 and not very active.

So we are at the stage now where I call out biscuits and Smiffy comes and sits on the first step of the stairs and I put the bowls down for both cats ..... Pasha eats whilst Smiffy just stares at the bowl (she likes the biscuits - that is not a problem).

I have already at this stage got the needle ready and the treats out .....

I make one little move towards Smiffy and she runs upstairs either under the bed in the front room (so I have to shush her out from the other side of the bed) then and or she goes to the back bedroom where there is not much floor space because of the furniture (she can get under the chair and the two small tables ..

So I have followed her upstairs with the bowl of food, the insulin pen and a treat.

If I am lucky and get her into the back bedroom and I can just slip the injection in and she hardly notices it and I give her a treat and tell her what a good girl she is and rub her head. I put the bowl of food down and leave her to eat and sit quietly on the stairs or downstairs and listen out for the crunch of the food as she eats it.

Sometimes she won't eat so I have to go back upstairs to give her a bit of encouragement and leave her again .... she eats a bit and then decides she has had enough but she hasn't eaten all of it so I go upstairs and bring the food downstairs and put it in her proper feeding place and then she will come down in ten minutes or so and eat some more and then I can relax ... she may or may not finishe it either in the morning or the evening.

She is on a slimming diet of 35g in the morning and 35g in the evening. If she leaves a bit in the morning, I give her a mid cycle snack ... if she leaves some in the evening, I keep it for the next day or throw it away ...

I think she is getting used to the idea that she doesn't need to graze on food all day like she used to (which is why she is nearly 6kg). Actually I am surprised she is not heavier!!!

HOW DO YOU THINK I could modify this pattern so that she eats in her proper eating place so that I can inject her whilst she is eating (Injecting her after she has eaten seems not to be an option as she goes upstairs or out to the garden after she has finished eating)? I am constantly worried that she is not going to eat after I have injected her (have to told the Vet and he suggested some relaxants so I have put feliway upstairs each or every other day (no room for an infuser I have just discovered as you can't put it on a two way adaptor as I was hoping .... and I have just got today some zylkene capsules to sprinkle on her food in the morning).

DO YOU THINK her body has now got used to not eating so much and that she has realised that she doesn't need to eat so much for the amount of exercise that she does which is pretty well none really ... a little walk in the morning and a little walk in the evening?

I give her the occasional freeze-dried treat during the day but I am thinking I should just keep them to feeding times now?

Thank you

PS Sorry if you saw some of these details on another thread yesterday that was supposed to be about her weight loss ...

 

[Squalliesmom]

Hi Looby, sorry you are having such troubles. When I had to change my kitty's eating patterns, and get him to cooperate for testing and shots, I cut out all treats except for the ones he got at those times (and it was very hard for me to do, as he really loves his treats!). I picked one low carb treat he was most particularly fond of and used that one exclusively. Once he fell into a routine with it, I started giving low carb treats at other times, as well, but not the same ones I use for tests and shots - they are reserved for that excersise only, so he knows if he wants them he has to let me get all the poking done!

It's a shame that you don't have a small room downstairs where you can lead her and close the door so she doesn't run and hide. How about a bathroom, even if it is upstairs? If you can close the doors to the other rooms will she go in there? That might save you some of the hunting and coaxing from beneath furniture!

I go upstairs and bring the food downstairs and put it in her proper feeding place and then she will come down in ten minutes or so and eat some more and then I can relax ...

I would make a habit of this until she learns that she needs to come downstairs to eat. Maybe let her have a few mouthfuls upstairs for the time being, to reinforce good behavior with the shot, but then take it back downstairs and let her come down to eat in her usual spot.

Our feline friends are so sweet and lovable, but they are also very crafty, lol! They learn very quickly how to modify OUR behavior to suit THEM! And because we love them so much and only want the best for them we let them do it or, worse, don't even see that they are doing it, lol!

Hope some of these tricks may help you! Good luck!

 

[Looby & Smiffy]

Hi Looby, sorry you are having such troubles. When I had to change my kitty's eating patterns, and get him to cooperate for testing and shots, I cut out all treats except for the ones he got at those times (and it was very hard for me to do, as he really loves his treats!). I picked one low carb treat he was most particularly fond of and used that one exclusively. Once he fell into a routine with it, I started giving low carb treats at other times, as well, but not the same ones I use for tests and shots - they are reserved for that excersise only, so he knows if he wants them he has to let me get all the poking done!

It's a shame that you don't have a small room downstairs where you can lead her and close the door so she doesn't run and hide. How about a bathroom, even if it is upstairs? If you can close the doors to the other rooms will she go in there? That might save you some of the hunting and coaxing from beneath furniture!



I would make a habit of this until she learns that she needs to come downstairs to eat. Maybe let her have a few mouthfuls upstairs for the time being, to reinforce good behavior with the shot, but then take it back downstairs and let her come down to eat in her usual spot.

Our feline friends are so sweet and lovable, but they are also very crafty, lol! They learn very quickly how to modify OUR behavior to suit THEM! And because we love them so much and only want the best for them we let them do it or, worse, don't even see that they are doing it, lol!

Hope some of these tricks may help you! Good luck!

I think leaving her treats out for the rest of the day is a good idea - just for the time being - thanks ...
We have our tiny bathroom downstairs .... Just thinking ...... the trouble is her normal eating place is by the stairs and ther is nowhere else that it can be (Pasha has the other spot) ....
I rang the Vet today and spoke to the Diabeties nurse as injecting her BEFORE she eats is really not good especially if she were not to eat afterwards one day for some reason (danger of hypo) and she has suggested that, even though she doesn't usually like wet food, to mix a bit with her biscuits for the next few days to make it smell a bit more scrummy and see if that will stop her from running away as soon as I put down the food - worked a treat and although she wouldn't eat on her mat, she started to eat it whilst she was on the second step of the stairs and I was able to inject ear a little way into her meal and she didn't run away so that was a bit better .... I didn't use treats so will hold offon those as you say whilst I am using the wet food for the next couple of days ...... The she will have to go back to her just biscuit diet (until such times as we may change to wet permanently but that is another story and thread!) ..... I will then just use the treats only at mealtimes as you suggest ....
I also got some zylkene relaxant capsules in the post today so when she goes back to just biscuits I could try them sprinkled on her food .... have already sprayed the food area and the bottom of the stairs with Felliway!
If all that fails, I could try the bathroom maybe - if I could get her to go that way ... Thanks ...will let you know how I get on in the next few days On this thread

 

[Squalliesmom]

I think leaving her treats out for the rest of the day is a good idea - just for the time being - thanks ...
We have our tiny bathroom downstairs .... Just thinking ...... the trouble is her normal eating place is by the stairs and ther is nowhere else that it can be (Pasha has the other spot) ....
I rang the Vet today and spoke to the Diabeties nurse as injecting her BEFORE she eats is really not good especially if she were not to eat afterwards one day for some reason (danger of hypo) and she has suggested that, even though she doesn't usually like wet food, to mix a bit with her biscuits for the next few days to make it smell a bit more scrummy and see if that will stop her from running away as soon as I put down the food - worked a treat and although she wouldn't eat on her mat, she started to eat it whilst she was on the second step of the stairs and I was able to inject ear a little way into her meal and she didn't run away so that was a bit better .... I didn't use treats so will hold offon those as you say whilst I am using the wet food for the next couple of days ...... The she will have to go back to her just biscuit diet (until such times as we may change to wet permanently but that is another story and thread!) ..... I will then just use the treats only at mealtimes as you suggest ....
I also got some zylkene relaxant capsules in the post today so when she goes back to just biscuits I could try them sprinkled on her food .... have already sprayed the food area and the bottom of the stairs with Felliway!
If all that fails, I could try the bathroom maybe - if I could get her to go that way ... Thanks ...will let you know how I get on in the next few days On this thread

Just for clarification, I wasn't suggesting that you give Smiffy her insulin before she eats.

They certainly are creatures of habit, these sweet kitties of ours. I know it can be very difficult to change their routines! Wishing you the best of luck!

 

[Looby & Smiffy]

Just for clarification, I wasn't suggesting that you give Smiffy her insulin before she eats.

They certainly are creatures of habit, these sweet kitties of ours. I know it can be very difficult to change their routines! Wishing you the best of luck!

No I absolutely know that ...... That is the main problem I was talking about ... I couldn't get her to settle down to eat so that I can inject her whilst she is eating eg after she has eaten at least three quarters of her food .... That was the whole point ... She is running away before she starts to eat and running away after so it has got to the stage where I have no choice but to go after her and inject than coax her into eating as soon as possible ....... I wa really trying hard to make that clear ..... The problem is I need her to settle down to eat without running away so that I CAN inject after not before! As you say she has led me into a far from ideal routine and I need to get control back - that's the problem ...... The wet food mixed in with the dry worked nearly tonight so will try to build on that over the next couple of days then go back to just biscuits and only use treats at feed time as you suggest

 

[Looby & Smiffy]

Well @Squalliesmom and @Elizabeth and Bertie (to keep you up to date - if you would read this tread Elizabeth please?), the wet food got her interested even though she didn't eat it!!! She loved the smell and ate the biscuits and left the wet food but came down to eat eventually in her normal eating place .... when I approached her after stroking her a few times, she ran up a few steps but I managed to inject her so she was not injected on an empty stomach as has been happening for the last few days ... that was last night ...

This morning I did the same and the same happened but she was less stressed and I had her at the top of the stairs quite calm and went to put the shot in but did a fur shot - gutted!!! Have to try to get it right tonight ..... she now has a Feliway infuser in the bedroom so that hopefully will help her to be a bit calmer ... this morning she was on the bed that I had sprayed with Felliway and was purring like she used so I think it is helping .....

Will let you know how I get on tonight ..... any other suggestions from others would be very much appreciated ........

 

[Misterbeesmom]

i dont have any suggestions. just wanna cheer you on! you're doing a good job!

 

[Looby & Smiffy]

That's good enough for me ... thank you

 

[manxcat419]

What a lovely update this morning Looby. I'm so glad you've found something that works, at least for now. Try not to worry too much about the fur shot - we all do those from time to time and missing one shot that way is still a much better situation for any diabetic cat than not being on insulin at all! I've even managed to fur shot Rosa's sub-q fluids before now (when the needle goes all the way through) and I've had years of practice with those! Missing once isn't so bad and the great thing is that she let you give the shot to begin with!

 

[Looby & Smiffy]

What a lovely update this morning Looby. I'm so glad you've found something that works, at least for now. Try not to worry too much about the fur shot - we all do those from time to time and missing one shot that way is still a much better situation for any diabetic cat than not being on insulin at all! I've even managed to fur shot Rosa's sub-q fluids before now (when the needle goes all the way through) and I've had years of practice with those! Missing once isn't so bad and the great thing is that she let you give the shot to begin with!

Thanks ..... Didn't 't go so well tonight .... She stared at the food again despite the smelly wet food on the top and wouldn't come down the stairs for ages .... So had too coax her down one step at a time (took ages!) til I had to settle for the second step up ... Left her to eat then went in and got the shot ..... This time I didn't keep stroking her neck so that she ate most of the meal withou me touching her which she preferred ..... Anyway better than before ...... Haven't given her any treats today as you suggested so saving them for just meal times once I have stopped putting the wet food on top of the dry and she goes back to her strict slimming diet! Thanks for your support xxx

 

[manxcat419]

As long as you're making progress - two steps forward and one back is better than the other way around! Take every little step forward as a win - and soon you'll have her in the routine you need.

 

[Looby & Smiffy]

@Misterbeesmom and @manxcat419 and @elizabeth & Bertie
Smiffy update ...... just to those of you that are following us ..... stopped the felix on top of the food this morning but sprinkled some Zlykene on the top instead ... all was going well and she was munching away on the bottom step of the stairs and then stopped eating and went to the top of the stairs .... I put the food a bit further up as she had not eaten enough for me to shoot her and she ate a bit more so I had to go to the top of the stairs to shoot her ...she hissed but didn't lash out ..... she continued to eat a bit but hasn't finished her 35g but I went up to give her a treat and told her what a good girl she was ... not ideal and again - one step forward and one step backwards ... does anybody have experience of dosing 75mg of Zylkene and its efffects - immediate or over time .... says on the packet that dose is safe for her weight - in fact she is over 5kg so she could have two a day but it also says on the box not to use for over a month? xxx

 

[Elizabeth and Bertie]

Copying reply from FB:

Hi Looby, I've used Zylkene quite a lot, sometimes with my own cats, but also with foster cats (to try to relieve their anxiety when they first come into a new environment).
So far I've never seen an adverse reaction to it. (But it doesn't seem to work for all cats. Some people have not found it to be effective.)

It seems to me that it did take a couple of says to have an effect. So, I've sometimes found it helpful to start giving it to a cat a couple of days before something stressful happens (especially if that involves some changes/challenges to their environment, or work being done in the house etc.).

Zylkene is derived from casein (a milk protein), and it is, apparently, a more concentrated form of the substance that helps new born animals to feel 'warm and fuzzy' after being fed. ..I've never used it 'long term' (more than a few weeks) so can't comment on that...

Edited to add:
I've not tried it on Bertie (he's a very laid back cat...) so I don't know about the effect on a diabetic cat's blood glucose.
But given that Smiffy is already eating dry food I'd have thought that any additional carb effect from a little Zylkene capsule would be pretty negligible...

It might be worth doing a forum search for 'Zylkene' (see top right of page) to see what others have said about it previously?

Eliz

 

[manxcat419]

Hi Looby

I'm really glad Eliz has some experience with Zylkene as I had never even heard of it! I did look it up though, and the manufacturer website seems to support giving it for longer than a month if the stress is likely to be ongoing - at the bottom of the page here http://www.zylkenepet.co.uk/learn-more-about-zylkène.html so it may be that the one month only warning is a bit like some of the ones you see on human medicines where it should only be used for a limited time unless you have doctor (or in this case vet) approval. I would definitely, as Eliz says, give it a couple of days to take full effect - as Smiffy has to digest it for it to work, I'd imagine it will take longer than one meal for it to really get to work on her anxiety. It does appear to be free of side effects so if you find it's working well for you, it would definitely be worth speaking to your vet about keeping her on it for longer than a month.

 

[Looby & Smiffy]

Hi Looby

I'm really glad Eliz has some experience with Zylkene as I had never even heard of it! I did look it up though, and the manufacturer website seems to support giving it for longer than a month if the stress is likely to be ongoing - at the bottom of the page here http://www.zylkenepet.co.uk/learn-more-about-zylkène.html so it may be that the one month only warning is a bit like some of the ones you see on human medicines where it should only be used for a limited time unless you have doctor (or in this case vet) approval. I would definitely, as Eliz says, give it a couple of days to take full effect - as Smiffy has to digest it for it to work, I'd imagine it will take longer than one meal for it to really get to work on her anxiety. It does appear to be free of side effects so if you find it's working well for you, it would definitely be worth speaking to your vet about keeping her on it for longer than a month.

I'm self medicating it really ..... At about 3.oopm today Smiffy went into what I thought was a hypo - staggering and bumping into the chair and losing her balance (six hours after her shot .... I immedatly shoved some honey into her mouth or tried as she was biting but think I got some in then held her as
I offered her some whey food in gravy but she wouldn't eat it so I called the Vet and got a Nurse out .... I put her in her cage for safety ... Luckily I was on Facebook and Elizabeth & Bertie and a few other really helpful girls was thereon the Feline Diabetic page so talked it through with them ..... Smiffy is at the Vets over night and they are doing a curve tomorrow ..... She was 13.4 BG by the time she got to the Vet so maybe the honey worked or her liver kicked in to help ..... Waiting to find out what they think might have caused the symptoms tomorrow - might not have been hypo but I'm confident I did the right thing .... Poor Smiffy .... Glad to get a second opinion though as vet on duty is not her normal vet ... Know the curve won't be like doing it at home but they should take that into consideration ...... Let you know more tomorrow ... Just glad I acted quickly and she is safe .... Late here now so off to bed .... Nit nite xxx

 

[Elizabeth and Bertie]

Looby,

I know it's not 'certain' that it was a hypo, but something caused those symptoms.

Let's look at the evidence from yesterday:
1). The symptoms occurred 6 hours after the Caninsulin shot.
2). Smiffy 'staggered and fell over' (?), and 'rolled around like she was drunk' (?)

Those things in combination could certainly point to hypoglycemia.
So, in the circumstances you did well to act quickly and give some honey.

Subsequently, the vet could not find any other obvious cause for the symptoms.
The blood glucose was not low when the vet examined Smiffy. But the honey would have elevated it somewhat. And it may be that Smiffy's body released stored glucose to bring up the level. Also, by +7 the Caninsulin should be past peak.

It is a real shame that we can't know for sure what happened, because that will make it difficult to know what action needs to be taken.
Obviously, in the event of hypo, the insulin would need to be reduced.

This is just the sort of situation where it would have been great if you could use your glucose meter. You could have found out for sure whether the blood glucose was low.
I know we can't turn back time. But you could use this experience to spur you into learning how to use your glucose meter now. That way, this experience may have a positive outcome in that you will be better prepared to be able to deal with any emergencies in the future. And the 'future' may mean tomorrow if it was hypoglycemia and the insulin dose isn't reduced.

You can do this.

Eliz

 

[manxcat419]

I agree with Eliz - if you're seeing hypo symptoms and there is no other obvious cause, then treating as if it's a hypo is definitely the safest course of action. Better too high for a day from giving honey or syrup when it wasn't needed than too low for a moment!

Cats are very good at bringing their own numbers back up out of hypo territory provided they have enough glycogen stores in their liver. But we can't rely on them having enough stores or on their liver reacting fast enough so we act quickly for them and treat when it seems as though it's needed. But by the time you got to the vet, a combination of your fast action and Smiffy's own defense mechanism would have brought her back into safe - or even too high - numbers. I think if I had to make a choice, I would reduce the insulin dose at least for the moment until you are able to get Smiffy to allow you to start testing her - above all else when you can't test, you will want to make sure Smiffy is safe even if that means she's running a little higher.

You absolutely did the right thing under the circumstances, regardless of whether the vet thinks the honey was needed or not - you did what you had to to make sure Smiffy wasn't going to stay in hypo numbers. Great job.

 

[Critter Mom]

Members assisting Looby:

As you all may know, to date, Smiffy has been dosed 'blind'. With with the worry over the display of aggression - another potential hypo symptom - reported here a few weeks ago on one of Looby's earlier threads I would be concerned over the level of glycogen stored in Smiffy's liver at this time: if Smiffy has been fighting too high a dose for a period of time I would worry whether those levels may currently be depleted. (Note: The aggressive display was NOT at injection time.

(NB: This is a one-off contribution to the thread which I hope will be helpful to Looby and those seeking to assist her. I'm really ill and I can't run with this.)


Looby:

If I observed the clinical signs described above in my cat I would regard them as signs of a symptomatic hypo and I would have treated it as an emergency and therefore administered glucose or honey to quickly ramp BG back up to safe levels. Looby, you did exactly the right thing given your current situation; well done for acting promptly to help Smiffy. You also did well to get Smiffy to the vets straight away. Never let ANYONE try to tell you that you were wrong about that decision; it is a decision that further protected Smiffy.

In the absence of any other clear cut causal factor (e.g. a cardiovascular issue) if it were my cat I would want this incident to be handled "as if" it were a hypo.

1. You had a fructosamine test done but, as Sophie kindly pointed out before, it is useless as a diagnostic aid when used standalone: in the absence of any home testing one MUST find some way to get a picture, however compromised by stress, etc., to gauge how low a dose may be taking a cat. Fructosamine tests have ZERO use in the determination of actual dose safety.

2. You have had your vet do previous spot check BG tests, the lower of which was in the 17 range - vet-influenced and with normal eating schedule. Today's vet-influenced reading of 13.4 is lower than the previous low of 17 BUT that was in an even more stressful scenario AND it was shortly after administration of what I assume probably was a reasonable amount of honey; with BOTH of those elevating factors in play and yet a lower BG level this is another strong argument in support of the position that Smiffy was dangerously low when she was bumping into things and drunk-walking and that therefore a dose reduction is necessary.

3. Another new variable is the recently-introduced Zylkene calming treatment. Firstly, if stress elevates blood glucose levels then it is reasonable to consider whether a calming treatment intended to reduce stress levels may also lower blood glucose levels. The active ingredient in Zylkene is casein which comes from whey. There is research which indicates that whey may lower blood glucose levels. (I would also wonder whether casein may have an impact on the normal counter-regulatory hormone cascade triggered when a cat is on too high a dose and needs protection from hypoglycaemia.) I recommend that you ask your vet to enquire with the manufacturer's technical department about the effect Zylkene may have on blood glucose levels. Until such time as this is known, if it were my cat I would stop giving the supplement as a safety precaution.

Looby - please can you clarify to the people helping you on this thread exactly what you mean by "whey food". Members need to understand what Smiffy is being fed in order to make sound suggestions to you.

4. I am relieved to hear that, at last, a vet run curve is booked. While not as reliable as data gathered in the normal environment (vet stress influence) when a cat is being dosed 'blind' (as has been the case for the last few weeks) a vet-run curve is better than no curve at all. Any dosing decision based on the curve should be highly conservative at this time and should allow for a nadir target set high enough to create some form of safety buffer to accommodate uncontrollable or unpredictable factors (e.g. Smiffy not eating enough at dose time or during the rest of the cycle).

If this were my cat I would insist on a dose reduction.

Going forward, either home testing needs to start NOW or else the vet needs to get much more involved with dose monitoring, if possible doing home visits to check BG - nadir being the most important value to obtain. At minimum Smiffy would need regular curves run at the vets if no home testing happens, especially if anything is introduced into Smiffy's regimen where its impact on blood glucose levels is an unknown.

Looby, to get helpful and safe input here you MUST be straight and realistic when reporting your cat's symptoms and status. I know it may be tempting to endeavour to soothe your own anxieties by trying to lessen the significance of Smiffy's worrying clinical signs and behaviours - and they are worrying - but it is unfair to the people trying to help you if you fail to give them honest and accurate information. I am sorry if that sounds a bit harsh but I care about the needs and safety of advice givers as well as advice seekers and their cats. Clear, concise, and open communication helps keep everyone safe.


Mogs


EDITED TO ADD:


IMPORTANT NOTE: If Smiffy did have a symptomatic hypo yesterday then her body may become MORE SENSITIVE TO INSULIN as a consequence; another reason for a conservative approach to dosing going forward.

.

 

[Looby & Smiffy]

I have just spoken to the Nurse .... they took

Looby,

I know it's not 'certain' that it was a hypo, but something caused those symptoms.

Let's look at the evidence from yesterday:
1). The symptoms occurred 6 hours after the Caninsulin shot.
2). Smiffy 'staggered and fell over' (?), and 'rolled around like she was drunk' (?)

Those things in combination could certainly point to hypoglycemia.
So, in the circumstances you did well to act quickly and give some honey.

Subsequently, the vet could not find any other obvious cause for the symptoms.
The blood glucose was not low when the vet examined Smiffy. But the honey would have elevated it somewhat. And it may be that Smiffy's body released stored glucose to bring up the level. Also, by +7 the Caninsulin should be past peak.

It is a real shame that we can't know for sure what happened, because that will make it difficult to know what action needs to be taken.
Obviously, in the event of hypo, the insulin would need to be reduced.

This is just the sort of situation where it would have been great if you could use your glucose meter. You could have found out for sure whether the blood glucose was low.
I know we can't turn back time. But you could use this experience to spur you into learning how to use your glucose meter now. That way, this experience may have a positive outcome in that you will be better prepared to be able to deal with any emergencies in the future. And the 'future' may mean tomorrow if it was hypoglycemia and the insulin dose isn't reduced.

You can do this.

Eliz

I have just spoken to the Nurse and will be talking to the Vet later ..... they took her BGs throughout the night .. she ranged from 12 point something to 26 point something under so a bit lower than that I suppose but I don't know by how much the stress factor makes a difference ...... I she did fall over and she staggered and bumped into the chair ..... I have put all my concerns to the Nurses and to the Vet last night ..... one of the things I wondered was if she was really relaxed upstairs with me on the bed and then tumbled down the stairs after me, had a little snack and then fell over etc because she had low blood pressure? You know as we do if we stand up too quickly? I have put that to the Vet ....(by the way I really find it more easy to write on Facebook still) ..... I have told them that I think she is not given enough of a ration of her food or that the insulin is too high for her or that the Caninsulin doesn't agree with her .... I didn't give them her diary so I am really cross with myself for that ..... but I have told them that she lies around a lot and she is not her usual self yet ...(have to remember she is really missing her Daddy too at the moment) .... I will also mention later again that she is really difficult to inject and to get her to eat at the bottom of the stairs so that I can inject her with no stress involved ... it went quite swimmingly yesterday morning .... now I am a bit concerned that she is going to be even more needle shy now that she has been at the Vet with all the testing etc ... they are going to take her bloods again too ....... there is no way I can home test until I can get the needle in much that I want to ..... it takes a circle of about 30 - 45 minutes for me to do the injection and for her to eat her food every morning and every evening ....

I will try to learn how to do it at our next session at the Vet or with the help of my husband if he can spare us the time but the main thing is for me to get her insulin in ....

I mentioned as I said that I was not happy with the tiny amoung of food she is given (70g per day) and that she is used to eating throughout the day - at least one little snack and the Nurse said something about they would have to check the latest research on grazing for Diabetic cats .....

I have only just got up ... but I have my notebook and pen ready here for questions for the Vet later today when she calls at 2.30 - 3.00 .... I only went to bed at 4.30 this morning so now I go back to bed after I have looked after the cats for a bit of a catch up and then I am down for 2.30 again ...... if you can think of any more things that I need to ask - I have made a note to ask when her lowest BG is and what her preshot number is ......

Do you think it could have been low blood pressure after all the felliway floating around and the Zylkene I gave her? She was really relaxed when she was on the bed with me ....

I will be on Facebook later ... will start a different thread here now so that I know where to find any information for future reference ...... thanks Elizabeth

 

[Looby & Smiffy]

I asked the Vet and Elizabeth and BErit

Members assisting Looby:

As you all may know, to date, Smiffy has been dosed 'blind'. With with the worry over the display of aggression - another potential hypo symptom - reported here a few weeks ago on one of Looby's earlier threads I would be concerned over the level of glycogen stored in Smiffy's liver at this time: if Smiffy has been fighting too high a dose for a period of time I would worry whether those levels may currently be depleted. (Note: The aggressive display was NOT at injection time.

(NB: This is a one-off contribution to the thread which I hope will be helpful to Looby and those seeking to assist her. I'm really ill and I can't run with this.)


Looby:

If I observed the clinical signs described above in my cat I would regard them as signs of a symptomatic hypo and I would have treated it as an emergency and therefore administered glucose or honey to quickly ramp BG back up to safe levels. Looby, you did exactly the right thing given your current situation; well done for acting promptly to help Smiffy. You also did well to get Smiffy to the vets straight away. Never let ANYONE try to tell you that you were wrong about that decision; it is a decision that further protected Smiffy.

In the absence of any other clear cut causal factor (e.g. a cardiovascular issue) if it were my cat I would want this incident to be handled "as if" it were a hypo.

1. You had a fructosamine test done but, as Sophie kindly pointed out before, it is useless as a diagnostic aid when used standalone: in the absence of any home testing one MUST find some way to get a picture, however compromised by stress, etc., to gauge how low a dose may be taking a cat. Fructosamine tests have ZERO use in the determination of actual dose safety.

2. You have had your vet do previous spot check BG tests, the lower of which was in the 17 range - vet-influenced and with normal eating schedule. Today's vet-influenced reading of 13.4 is lower than the previous low of 17 BUT that was in an even more stressful scenario AND it was shortly after administration of what I assume probably was a reasonable amount of honey; with BOTH of those elevating factors in play and yet a lower BG level this is another strong argument in support of the position that Smiffy was dangerously low when she was bumping into things and drunk-walking and that therefore a dose reduction is necessary.

3. Another new variable is the recently-introduced Zylkene calming treatment. Firstly, if stress elevates blood glucose levels then it is reasonable to consider whether a calming treatment intended to reduce stress levels may also lower blood glucose levels. The active ingredient in Zylkene is casein which comes from whey. There is research which indicates that whey may lower blood glucose levels. (I would also wonder whether casein may have an impact on the normal counter-regulatory hormone cascade triggered when a cat is on too high a dose and needs protection from hypoglycaemia.) I recommend that you ask your vet to enquire with the manufacturer's technical department about the effect Zylkene may have on blood glucose levels. Until such time as this is known, if it were my cat I would stop giving the supplement as a safety precaution.

Looby - please can you clarify to the people helping you on this thread exactly what you mean by "whey food". Members need to understand what Smiffy is being fed in order to make sound suggestions to you.

4. I am relieved to hear that, at last, a vet run curve is booked. While not as reliable as data gathered in the normal environment (vet stress influence) when a cat is being dosed 'blind' (as has been the case for the last few weeks) a vet-run curve is better than no curve at all. Any dosing decision based on the curve should be highly conservative at this time and should allow for a nadir target set high enough to create some form of safety buffer to accommodate uncontrollable or unpredictable factors (e.g. Smiffy not eating enough at dose time or during the rest of the cycle).

If this were my cat I would insist on a dose reduction.

Going forward, either home testing needs to start NOW or else the vet needs to get much more involved with dose monitoring, if possible doing home visits to check BG - nadir being the most important value to obtain. At minimum Smiffy would need regular curves run at the vets if no home testing happens, especially if anything is introduced into Smiffy's regimen where its impact on blood glucose levels is an unknown.

Looby, to get helpful and safe input here you MUST be straight and realistic when reporting your cat's symptoms and status. I know it may be tempting to endeavour to soothe your own anxieties by trying to lessen the significance of Smiffy's worrying clinical signs and behaviours - and they are worrying - but it is unfair to the people trying to help you if you fail to give them honest and accurate information. I am sorry if that sounds a bit harsh but I care about the needs and safety of advice givers as well as advice seekers and their cats. Clear, concise, and open communication helps keep everyone safe.


Mogs
.[/QU I asked about the Zylkene and both Vet and @elizabeth & Bertie don't think it would have made a difference but I wonder if she was so relaxed on the bed with me that when we both got up and she tumbled down the stairs her bloody PRESSURE might have been a bit low .... anyway I have expressed all my concerns to the Vet and said I am not convinced she has been given enough to eat or that her dose is too high .... they did her BGs throughout the night and it ranged from 12 point something to 26 point something ....

I am going to start a new thread on this so I know where the information is ....

 

[Looby & Smiffy]

Hi Looby

I'm really glad Eliz has some experience with Zylkene as I had never even heard of it! I did look it up though, and the manufacturer website seems to support giving it for longer than a month if the stress is likely to be ongoing - at the bottom of the page here http://www.zylkenepet.co.uk/learn-more-about-zylkène.html so it may be that the one month only warning is a bit like some of the ones you see on human medicines where it should only be used for a limited time unless you have doctor (or in this case vet) approval. I would definitely, as Eliz says, give it a couple of days to take full effect - as Smiffy has to digest it for it to work, I'd imagine it will take longer than one meal for it to really get to work on her anxiety. It does appear to be free of side effects so if you find it's working well for you, it would definitely be worth speaking to your vet about keeping her on it for longer than a month.

MyVet is the one that recommended it .... With a Felliway diffuser in her bedroom (my bedroom!) she should soon be very very relaxed hopefully ...... Doesn't seem to mind the taste of the zylkene on her food either

 

[manxcat419]

As your vet recommended it, I'm sure they can tell you whether or not they're happy for you to keep using it if it's working for you. I know not everyone likes the diffusers, but I used one for a while when Regan went through a phase of over-grooming when she was younger and it helped her a lot. It's not an immediately obvious effect, but over the first week or so she just got gradually calmer and calmer - it definitely worked for us!