To Shoot or Not To Shoot In The Morning? (Cat just puked.)

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gorillahowl

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Quick recap: Cat diagnosed as diabetic last Saturday, sent home with prescription for 2 units of Lantus 2x a day.
I've been trying to take away his food at night so he'll eat in the morning and I can give him his shot.
He woke me up at 3:30 begging for food. I wasn't going to give it to him, but he threw up (what looks like water) and I was afraid he was going hypo.
I gave him food; he ate. He is chilling out now in his chair.

We are supposed to go to the vet at 11:30 for a blood glucose test. (She wants to see him four hours after his shot. The vet also closes every day from 12-2, so the window for getting him tested is small.) We are also going to learn how to do our own home glucose tests today, so hopefully I won't have to play this guessing game anymore.

Assuming I can get him to eat again in the morning, should I give him the shot?
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

<< Newbie here, I can't speak as the experts here do, but if it were me and I thought there was ANY risk of hypo I would not shoot at all without getting some numbers. If he was just diagnosed, he is more than likely not regulated, and one skipped shot until you're sure is not likely to critically affect his progression towards being regulated..... whereas HYPO can KILL and that is not fixable :(

Edit: I would urge you to scan the recent posts here in this forum, there are alot of good links and info on how to handle things in the early days. Yes every case is different, but it is still all very good information.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Id call the Vet and ask then what they want you to do. You may have to change your appointment time....I'm no way an expert either Hopefully others will have better ideas.
Good luck,
jeanne
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

While you are working on control and learning to home test, see my signature link Secondary Monitoring Tools for some additional tactics for evaluating him.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

- Yes, if he eats I would give his shot. However, I think 2 units twice daily is too much to start. I would cancel the vet visit since you want a blood-glucose reading under normal conditions of eating.
- Have you considered testing his blood-glucose at using a human meter? It is more accurate since going to the vet can raise BG because of stress. ALso, it is best to get a BG feore the show so you can see how mycu the BG drops
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

thanks all. I waited till he was hungry and ate again this morning and wound up giving the shot around 9. my vet doesn't take appointments so we will just go later...I had to take the full day off from work. I am going to ask her about lowering his dose; should I disregard her instructions if she still tells me to keep him at 2 units 2x per day?

the vet will show me how to take his blood and then I have his catsitter coming to my apartment tomorrow night to help me before I go solo.

I haven't bought a meter yet--I seem to have lost the link to the meter ratings. If someone can post it, that would be great.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Of course I agree with Larry but I thought since you were going to learn how to test at the same time...You could actually SEE the difference in test numbers at the Vet verses being at home.
Sorry didnt mean to confuse you.
j.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

gorillahowl said:
I've been trying to take away his food at night so he'll eat in the morning and I can give him his shot.
Click to expand...

With Lantus, you do not need to make sure he eats with his shot. It's actually better if he eats about half-way between shots when he'll most likely be at his lowest. Read here for some more info about feeding newly diagnosed diabetic kitties. The only recommendation for new users when it comes to food is to pull it up 2 hours prior to shots so the pre-shot test is not artificially inflated by food and you're not shooting a number that might be a lot lower without the food impact.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

To shoot, or not to shoot, that is the question (sorry Shakespeare!)

Options:

The conservative option is to not shoot. Of course, the cat will go high. Much better too high, than too low. The former certainly may cause problems if continued over the long haul, but the latter will kill very quickly. If you can't be home to monitor and especially if you are still getting a fix on how your cat handles insulin, this is the way to go.

Some vets, when fasting a cat overnight before a procedure, may suggest giving half the normal dose of insulin in the fasted state. This is because the insulin will be wearing off and the glucose rising, despite no eating. Vomiting might be seen as a version of being partially fasted. So a compromise dose of half the amount, or a very cautious dose of 1/4 the normal amount may attenuate the rise that will ocurr as the prior dose wears off. And, if the cat feels better and starts to eat, it will moderate some of the food-induced rise that will ocurr.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Thanks all. I went ahead and shot.
He was at 400+ at the vet, and she said that vomiting alone is not enough to diagnose hypoglycemia and none of his other behavior at the time indicates a hypo episode. She thinks he just got himself into a tizzy.

What we're doing now is switching him to dry diabetic food. I know this is counter to what so many people say here, but the truth is, he hates wet food and I am not home enough right now to work with him on getting him to eat it.

The other problem is the ear pricks. She said he has tiny veins and she herself was not able to get anything more than a pinpoint of blood out of pricking his ear. she recommended at least testing his urine with ketone sticks. So for now, for the next few weeks at least, we'll be focusing on getting him switched to the new food and getting his glucose well controlled.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Dry is OK but I would try transitioning to low-carb caned. See:
http://catinfo.org/docs/TipsForTransitioning1-14-11.pdf
A cat's ear lean to bleed and it takes practice to get blood. It is easier if you use a larger diameter lancet, like 27 gauge vice the smaller 30 or 31 gauge ones. You want tone that does not say fine or superfine on the box.
Where do you live? Maybe someone is near you and can teach you to blood test. It can be intimidating at first.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Before switching him to dry "diabetic" food, make sure it's truly diabetic-appropriate. There are a lot of foods out there that claim to be "diabetic" but are loaded with carbs. Here's a dry food list and, as you can see, the only foods remotely close to being low enough in carbs for a diabetic (really, for any cat) are the Innova EVO Cat & Kitten, the Wellness Core, and the Nature's Variety Raw Instinct. Another one not on that list is the Young Again 0 carb; it's not really 0 carb because of the way cat food companies determine carbs in food, but it's fairly low. (IIRC, I believe someone figured out it was around 5%?)

If you haven't seen it yet, here are some ear testing tips that might help. A few things that work well when first starting out are warming the ear before-hand, trying it with the lancing device or free-hand and see which one works better for you, finding a good place and position, "milking" the blood drop till it gets big enough for a reading on the glucometer, and giving plenty of treats and loving.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

gorillahowl said:
He was at 400+ at the vet, and she said that vomiting alone is not enough to diagnose hypoglycemia and none of his other behavior at the time indicates a hypo episode. She thinks he just got himself into a tizzy.
Click to expand...

This could have been a rebound number from a possible low number the night before when he wanted to be fed. Many cats show NO SYMPTOMS. The only way to know for sure is by testing him. ;-)
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

gorillahowl said:
...What we're doing now is switching him to dry diabetic food. I know this is counter to what so many people say here, but the truth is, he hates wet food and I am not home enough right now to work with him on getting him to eat it. ...
Click to expand...

Please get something better than the dry diabetic foods; they are higher in carbs than Wellness Core, Evo Cat and Kitten, and Young Again 0 Carb.

A note on blood testing - you can aim directly for the vein, if you have to get blood. It just tends to bleed profusely so you need to be ready to blot and apply pressure quickly or it will get flicked all over.

And please use supplemental monitoring tactics to help you track his health. They may not be as precise as blood measures, but you can construct a profile of the different options and see how change affects them. There is actually a protocol to use these for dose adjustment; it goes much slower because of the lack of precision. If you want it, I'll look up the link, so let me know.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Hi,

I just read your post and I just wanted to share my little bit of info.

My cat started puking about 1 to 2 hours before food time, and it was definitely scaring me. It was greenish, very liquidy and sometimes had foam. This was from his stomach being empty for a long time and bile going into his stomach, which made him puke. Basically, he was so hungry he puked. We had to up his amount of food by a quarter can each meal to make sure he was full enough until the next meal (12 hours later). After a week, we went back to his previous portion and he's been fine since.

I do think your cat may be hungry, since you said he doesn't really like wet food and may have been avoiding eating it, therefore being hungry. I would keep an eye on his appetite while you switch him to dry food (which he likes) to make sure he gets enough not to be hungry hours before meal time. Watch for the same issue when/if you change him back to wet food.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Gorillahowl, back on 4/18 you said.

The other problem is the ear pricks. She said he has tiny veins and she herself was not able to get anything more than a pinpoint of blood out of pricking his ear
Click to expand...

It's not the vein you should be trying to poke. There is a capillary rich area towards the tip of the ear, between the vein and the edge of the ear. That is the area you should be trying to poke to get a blood sample. As you poke more, my understanding is that more capillaries form in this area, making it easier for the poke to get a successful blood drop. Or as we say here, "The ears learn to bleed".

Milking the ear, by starting towards the bottom of the vein and gently pushing up along the vein can get the blood drop to form better. It takes practice, like anything new you are learning.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Well, it's encouraged to use the "sweet spot" but it hasn't worked at all for us. We went to two vets (our regular one, which is far, and one in our neighborhood) and both told us to poke on the vein. We also tried using 30-31 gauge lancets, but it didn't work so we're using 29 now, and it still doesn't work all the time. Do what works for you, just make sure you have a paper towel or something to clean up and stop the bleeding on his ear should you poke his vein directly.
 
Re: To Shoot or Not To Shoot In The Morning? (Cat just puked

Aerya said:
Well, it's encouraged to use the "sweet spot" but it hasn't worked at all for us. We went to two vets (our regular one, which is far, and one in our neighborhood) and both told us to poke on the vein. We also tried using 30-31 gauge lancets, but it didn't work so we're using 29 now, and it still doesn't work all the time. Do what works for you, just make sure you have a paper towel or something to clean up and stop the bleeding on his ear should you poke his vein directly.
Click to expand...

I agree with Aerya. When first starting out, it's a lot easier to aim for the vein if you're getting desperate (you don't want to do this long-term, however).

Deb & Wink said:
As you poke more, my understanding is that more capillaries form in this area, making it easier for the poke to get a successful blood drop. Or as we say here, "The ears learn to bleed".
Click to expand...

The scientific term for this is "angiogenesis" and after a couple of weeks, you won't have to use the vein any more (and you actually will want to avoid it because it'll give you too much blood by that point :lol: ).
 
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