Today is the day... (My thoughts/questions below)

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MiCo

MiCo

Member Since 2016
Today is Day 1, or maybe 0. :)

The husband and I go to the vet tonight to pick up Cliff's insulin and have an injection demo.

I am so nervous, and despite multiple informative emails from my vet and spending time reading this board, I am so nervous.

I am a very analytical/detail-oriented person who likes to follow instructions, so I feel overwhelmed and have lots of questions. And I don't want to "mess up." That is always my biggest fear, making a mistake.

Here's what I know:
  • Cliff is 9yo
  • 12.5 lbs (at last visit 10/27/16... Down from 16lbs at last visit in June 2016)
  • Will start Prozinc twice daily 1-unit today, this evening
  • We bought AlphaTRAK2-will arrive today
  • Vet recommends: Purina DM, but also gave me a list of OTC foods. Have PurinaPro and FancyFeasts options right now.
I don't know his baseline #s yet, but hopeful can get those at the vet tonight.

*I'm nervous about all the numbers. Reading this board and nothing makes sense right now in terms of numbers.

I'm also nervous about switching his diet. Switching their diet, because she is sensitive to change too. We have two cats, and he's historically been the picky eater who has gone through phases of eating less. In the past year, we've tried to ween them off dry food, but up until this morning they were still getting a scoop of dry food each day. Also, we were feeding wet food 3x a day (smaller meals worked better for them) and switching to 2x 12 hours apart makes me nervous. Hope the cats adjust easily. I picked up all the dry food this morning.. Here's to a fresh start!

Also, him being a picky eater, we used to "jump start" his eating at each meal with some treats. He likes crunchy. I'm worried bc the vet said no dry food. Can I give freeze dried treats to start, if needed?

Other food concerns/questions:
  • Does it have to be the *same* wet food each day for consistency, or can I have a rotation of 2-3 kinds for variety? Not sure how strict I have to be to start?
  • Can I use freeze dried treats (I've seen a recommended list posted here somewhere) to jump start his eating, if needed? Or should I avoid that to start?
  • How much should he eat before I give him insulin? Is 1.5 oz ok? This morning he ate a whole 3oz can by himself, but there are times when he eats less.
  • How much *should* he be eating each day total? 5-6oz for his current weight? He's 12.5, but that's down from 16lbs in June. :( I realize he was overweight then, but I'm not sure what he needs to eat to maintain, and if the vet wants him to maintain or gain?
  • The other cat weighs 12lbs, she needs same amount of food, right? 5-6oz. I think she's gonna be dramatic about this change and act like she's starving in between feedings without the dry food to graze on.
  • Does it have to be two feedings daily only? Can he eat 2 hours prior to pm insulin? Previously we fed at 6am, 3 or 4pm (when hubby gets home) and then again at 9pm. Gonna try to switch to 6am/6pm feeding schedule.
  • Other cat (Stella) is on denamarin for liver issues and needs to take her pill in am one hour before eating. This shouldn't be a problem to maintain with Cliff's new feeding schedule. She sometimes gets an upset stomach though if she goes too long without eating (thus, the smaller meals more frequently.)
  • Vet said to do all day 12hr monitoring 7-10 days from start. Hubby has off Monday 11/7-would it be okay to do this on Day 6? He would have had 5 full days of insulin by then. We could also probably do on the weekend, Nov 12. Otherwise, I'll have to do overnight, since I can't take off work right now (short staffed.) Trying to avoid the stress of dropping him off at the vet for this 12-HR monitoring.
I think that's all for now. Thanks for reading, if you did. :)

Have a great day!
 
MiCo said:
I am a very analytical/detail-oriented person who likes to follow instructions, so I feel overwhelmed and have lots of questions. And I don't want to "mess up." That is always my biggest fear, making a mistake.
Click to expand...

Being analytical and detailed oriented will serve you well. But - you'll also have to be kind to yourself and give yourself time to learn how to manage FD and accept that you will mess up occasionally (fur shot anyone?). We aim to keep our messing up on the side of safety (eg. too low a dose, no dose after a fur shot, etc.) rather than overdoing and risking a hypoglycemic episode.

MiCo said:
*I'm nervous about all the numbers. Reading this board and nothing makes sense right now in terms of numbers.
Click to expand...

Yes, the numbers look overwhelming. It will make more sense over time after you start logging your cat's numbers and learning what they tell you about how he's doing. We encourage new members to start a spreadsheet:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

MiCo said:
Does it have to be the *same* wet food each day for consistency, or can I have a rotation of 2-3 kinds for variety? Not sure how strict I have to be to start?
Click to expand...

Any wet food that's low in carbs is fine. I feed Teasel prescription DM mixed with a variety of Fancy Feast or Friskies pate flavours for variety. If your kitty likes variety and his tummy can tolerate it you can feed that way.

MiCo said:
Can I use freeze dried treats (I've seen a recommended list posted here somewhere) to jump start his eating, if needed? Or should I avoid that to start?
Click to expand...

I don't see a problem using freeze dried meat/fish treats this way unless you find that they need to be your tool to reward test and shots. Maybe wait to see how he reacts to those procedures first?

MiCo said:
How much should he eat before I give him insulin? Is 1.5 oz ok? This morning he ate a whole 3oz can by himself, but there are times when he eats less.
Click to expand...

We recommend testing then feeding then giving insulin. ProZinc is slower in onset than some insulins so he'd likely be OK eating only a partial meal. You'll learn more about his reactions over time with testing and logging data.

MiCo said:
How much *should* he be eating each day total? 5-6oz for his current weight? He's 12.5, but that's down from 16lbs in June. :( I realize he was overweight then, but I'm not sure what he needs to eat to maintain, and if the vet wants him to maintain or gain?
Click to expand...

Your kitty isn't getting full nutrition from his food because of his diabetes so he'll likely need more food now than later when he's becoming better regulated on insulin. Your goal right now is to get him to gain back some weight. Later on you can do more monitoring and adjust feeding based on Cliff's weight. A digital baby scale works well for this.

MiCo said:
The other cat weighs 12lbs, she needs same amount of food, right? 5-6oz. I think she's gonna be dramatic about this change and act like she's starving in between feedings without the dry food to graze on.
Click to expand...

Cats can vary in their calorie needs just like people so I can't answer this. If possible, it might be easier for you if you can train them to eat in separate rooms at scheduled feeding times. That way you can feed the type of food in the amount needed to each.

MiCo said:
Does it have to be two feedings daily only? Can he eat 2 hours prior to pm insulin? Previously we fed at 6am, 3 or 4pm (when hubby gets home) and then again at 9pm. Gonna try to switch to 6am/6pm feeding schedule.
Click to expand...

Vets often recommend twice a day feeding associated with shot times for FD cats. However, some kitties don't do well with this schedule so people take the total daily ration and split it into several meals with the largest portions before shots and the rest divided into smaller snacks for other (convenient to you) times. The important thing is to have no food on board at least 2 hours before a shot so you have a fix on whether the dose you're planning is too high for the BG number.

MiCo said:
Other cat (Stella) is on denamarin for liver issues and needs to take her pill in am one hour before eating. This shouldn't be a problem to maintain with Cliff's new feeding schedule. She sometimes gets an upset stomach though if she goes too long without eating (thus, the smaller meals more frequently.)
Click to expand...

Sounds like you can fit Stella into Cliff's schedule.

MiCo said:
Vet said to do all day 12hr monitoring 7-10 days from start. Hubby has off Monday 11/7-would it be okay to do this on Day 6? He would have had 5 full days of insulin by then.
Click to expand...

I doubt that one day less will make much of a difference so I'd go for it. It's far better for Cliff to be at home for monitoring than at the vet's where stress can have quite an impact on BG levels. Be prepared for some wonky numbers, though, because many cats take a while to adjust to exogenous insulin. I suggest very strongly that you post a message on the main health forum (and in the ProZinc forum if you wish) giving the ProZinc dose that the vet has prescribed for Cliff. Many people have had vets prescribe far too high a dose to start. Generally a starting dose should be 1 unit every 12 hours. Some kitties even need that adjusted downward once their owner starts testing BG at home. That's why we strongly encourage the use of our spreadsheet. There's a massive level of experience here in dealing with FD - far more than most vets have.

Whew! That was long! I hope it helped. :)
 
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Kris & Teasel said:
I doubt that one day less will make much of a difference so I'd go for it. It's far better for Cliff to be at home for monitoring than at the vet's where stress can have quite an impact on BG levels. Be prepared for some wonky numbers, though, because many cats take a while to adjust to exogenous insulin. I suggest very strongly that you post a message on the main health forum (and in the ProZinc forum if you wish) giving the ProZinc dose that the vet has prescribed for Cliff. Many people have had vets prescribe far too high a dose to start. Generally a starting dose should be 1 unit every 12 hours. Some kitties even need that adjusted downward once their owner starts testing BG at home. That's why we strongly encourage the use of our spreadsheet. There's a massive level of experience here in dealing with FD - far more than most vets have.

Whew! That was long! I hope it helped. :)
Click to expand...

THANK YOU, THANK YOU, THANK YOU for the thorough and thoughtful reply to my morning brain dump. You alleviated most of my worrying with your answers. I will definitely follow your suggestions in terms of creating a spreadsheet (tonight, hopefully) and posting to the ProZinc board (or here) with prescribed dosing and more information, once I have it and start testing/dosing. We are starting with 1 unit of Prozinc every 12 hours.

I also hope to pay it forward on this board, once I have more experience! :)

Have a great day!!
 
Welcome, yes you are anxious and overwhelmed now. It will go away as you learn.

And you know what, we are human we all make mistakes. It happens, usually it isn't anything you can't fix.

Two tips to mention:

If you ever think one of the insulin shots you give doesn't go in. Don't ever give a second one. Chalk it up to being a fur shot and wait til next time. You never know if any got in or not.

One treat to use is Nature Variety Instinct Raw Boost Minis. They are low carb, semi crunchy. Buy the dog ones. Bigger package and cheaper that the cats if you can find any for cats. They are exactly the same.
 
Woodsywife said:
Welcome, yes you are anxious and overwhelmed now. It will go away as you learn.

And you know what, we are human we all make mistakes. It happens, usually it isn't anything you can't fix.

Two tips to mention:

If you ever think one of the insulin shots you give doesn't go in. Don't ever give a second one. Chalk it up to being a fur shot and wait til next time. You never know if any got in or not.

One treat to use is Nature Variety Instinct Raw Boost Minis. They are low carb, semi crunchy. Buy the dog ones. Bigger package and cheaper that the cats if you can find any for cats. They are exactly the same.
Click to expand...

Thank you for the encouraging words! And the two tips are awesome!
I know I am new here, but I am so thankful to have stumbled upon this message board. I'm using Evernote to collect all my notes/tips/instructions on Cliff's new diagnosis and care.
 
MiCo said:
Today is Day 1, or maybe 0. :)

The husband and I go to the vet tonight to pick up Cliff's insulin and have an injection demo.

I am so nervous, and despite multiple informative emails from my vet and spending time reading this board, I am so nervous.

I am a very analytical/detail-oriented person who likes to follow instructions, so I feel overwhelmed and have lots of questions. And I don't want to "mess up." That is always my biggest fear, making a mistake.

Here's what I know:
  • Cliff is 9yo
  • 12.5 lbs (at last visit 10/27/16... Down from 16lbs at last visit in June 2016)
  • Will start Prozinc twice daily 1-unit today, this evening
  • We bought AlphaTRAK2-will arrive today
  • Vet recommends: Purina DM, but also gave me a list of OTC foods. Have PurinaPro and FancyFeasts options right now.
I don't know his baseline #s yet, but hopeful can get those at the vet tonight.

*I'm nervous about all the numbers. Reading this board and nothing makes sense right now in terms of numbers.

I'm also nervous about switching his diet. Switching their diet, because she is sensitive to change too. We have two cats, and he's historically been the picky eater who has gone through phases of eating less. In the past year, we've tried to ween them off dry food, but up until this morning they were still getting a scoop of dry food each day. Also, we were feeding wet food 3x a day (smaller meals worked better for them) and switching to 2x 12 hours apart makes me nervous. Hope the cats adjust easily. I picked up all the dry food this morning.. Here's to a fresh start!

Also, him being a picky eater, we used to "jump start" his eating at each meal with some treats. He likes crunchy. I'm worried bc the vet said no dry food. Can I give freeze dried treats to start, if needed?

Other food concerns/questions:
  • Does it have to be the *same* wet food each day for consistency, or can I have a rotation of 2-3 kinds for variety? Not sure how strict I have to be to start?
  • Can I use freeze dried treats (I've seen a recommended list posted here somewhere) to jump start his eating, if needed? Or should I avoid that to start?
  • How much should he eat before I give him insulin? Is 1.5 oz ok? This morning he ate a whole 3oz can by himself, but there are times when he eats less.
  • How much *should* he be eating each day total? 5-6oz for his current weight? He's 12.5, but that's down from 16lbs in June. :( I realize he was overweight then, but I'm not sure what he needs to eat to maintain, and if the vet wants him to maintain or gain?
  • The other cat weighs 12lbs, she needs same amount of food, right? 5-6oz. I think she's gonna be dramatic about this change and act like she's starving in between feedings without the dry food to graze on.
  • Does it have to be two feedings daily only? Can he eat 2 hours prior to pm insulin? Previously we fed at 6am, 3 or 4pm (when hubby gets home) and then again at 9pm. Gonna try to switch to 6am/6pm feeding schedule.
  • Other cat (Stella) is on denamarin for liver issues and needs to take her pill in am one hour before eating. This shouldn't be a problem to maintain with Cliff's new feeding schedule. She sometimes gets an upset stomach though if she goes too long without eating (thus, the smaller meals more frequently.)
  • Vet said to do all day 12hr monitoring 7-10 days from start. Hubby has off Monday 11/7-would it be okay to do this on Day 6? He would have had 5 full days of insulin by then. We could also probably do on the weekend, Nov 12. Otherwise, I'll have to do overnight, since I can't take off work right now (short staffed.) Trying to avoid the stress of dropping him off at the vet for this 12-HR monitoring.
I think that's all for now. Thanks for reading, if you did. :)

Have a great day!
Click to expand...

Welcome. Be sure to post any questions on the health and ProZinc forums. If you wake up at 1:00 in the morning to find his blood glucose is low, post. Someone will come, help you out and stay with you. We have members all over the world who can help you at a scary time. I know, I woke up early in the morning to find my Callie had very low numbers. Several members stayed with me until Callie was back into safe numbers. I will always be grateful to those members. Things like low numbers seem so scary at 1: AM.

This is a wonderful board.
 
donnalea said:
Welcome. Be sure to post any questions on the health and ProZinc forums. If you wake up at 1:00 in the morning to find his blood glucose is low, post. Someone will come, help you out and stay with you. We have members all over the world who can help you at a scary time. I know, I woke up early in the morning to find my Callie had very low numbers. Several members stayed with me until Callie was back into safe numbers. I will always be grateful to those members. Things like low numbers seem so scary at 1: AM.

This is a wonderful board.
Click to expand...

What wonderful and encouraging news about the type of support offered on this community. I'm glad you got the help/support you needed online during your stressful time. Thank you for the tip about posting when I need help.
Thank you!
 
If Cliff has been eating dry food all this time, and you're switching to wet food and starting insulin at the same time, please be sure to test him before giving insulin. Sometimes the switch to low carb wet food can lower their BG's significantly.
 
Sharon14 said:
If Cliff has been eating dry food all this time, and you're switching to wet food and starting insulin at the same time, please be sure to test him before giving insulin. Sometimes the switch to low carb wet food can lower their BG's significantly.
Click to expand...

Thank you for the tip!
 
My cat is super carb sensitive. If he sneaks a few kibbles that the other cats spill, his BG goes up 100points!
 
Sharon14 said:
My cat is super carb sensitive. If he sneaks a few kibbles that the other cats spill, his BG goes up 100points!
Click to expand...
Yeah, I hear ya! I appreciate this comment. I picked up all the dry food this morning, and swept up around the areas. I gave the husband strict instructions about NOT giving the cats anymore dry food from this point forward. I will probably freeze what little dry food we have left in case of emergency. I will also keep a few of the high-carb cans around, just in case--but otherwise, I will probably be donating the canned food I had already stock-piled.

I also let the husband know Cliff might become a real beggar, or try to get human food--that we have to be extra careful now. :) Next step is getting the Hubs to join this board! He is reading all the emails from the vet and will be going tonight to learn the insulin/testing process.

Thanks!
 
MiCo said:
Yeah, I hear ya! I appreciate this comment. I picked up all the dry food this morning, and swept up around the areas. I gave the husband strict instructions about NOT giving the cats anymore dry food from this point forward. I will probably freeze what little dry food we have left in case of emergency. I will also keep a few of the high-carb cans around, just in case--but otherwise, I will probably be donating the canned food I had already stock-piled.

I also let the husband know Cliff might become a real beggar, or try to get human food--that we have to be extra careful now. :) Next step is getting the Hubs to join this board! He is reading all the emails from the vet and will be going tonight to learn the insulin/testing process.

Thanks!
Click to expand...

Great getting the hubby involved. It's so helpful when one needs to go out the other can take over. Get him familiar with this board also in case he needs info and your not available.
 
Checking items off my to-do list!
  • Download/create Cliff's FDMB spreadsheet for tracking-Done!
  • Add to my signature line here-Done!
  • Read: Understanding the Spreadsheet Grid-Done!
Once again, you guys are wonderful! I already feel more confident going into my appt with the vet tech tonight.
 
Sharon14 said:
If Cliff has been eating dry food all this time, and you're switching to wet food and starting insulin at the same time, please be sure to test him before giving insulin. Sometimes the switch to low carb wet food can lower their BG's significantly.
Click to expand...
I was going to say the same thing exactly; I second Sharon's advice, this is very important for keeping your kitty safe!
 
Vet tech, okay. Here some things to watch out for.

Make sure you are given the proper syringes for the type of insulin you will be using.

Also, make sure you can read the syringes correctly (so many are not sure how to read or shown how and overdoses have been given)

If you are injecting for the 1st time ever and on your cat, it should not be insulin. Use normal saline, lactate ringers or plain water. Nothing with sugar in it.

Do not let the tech give a second shot if 1st shot is questionable and insulin was used. No matter what. Have seen this happen also.

Most importantly, try to stay calm and relaxed. Have your questions answered before you leave. You should get copies of all test results. Now and any future ones done. It's a good idea to get into the habit of asking for copies.

Good luck. Can't wait to hear all about it.
 
Woodsywife said:
Make sure you are given the proper syringes for the type of insulin you will be using.

Also, make sure you can read the syringes correctly (so many are not sure how to read or shown how and overdoses have been given)
Click to expand...

The Vet Tech & hospital cat were great!

The instructions about what syringes to use for our insulin were very clear. And the tech was great at showing us how to fill the syringe to 1 unit.

The demo was with the hospital cat (who was a sweetie) and using saline. We each practiced filling the syringe, holding the syringe, grabbing the skin to shoot, and I practiced once with injecting saline. We also went over the glucose testing process, and the tech demo'd on kitty's ear, but I didn't make her actually prick her.

We were also given a handout on FD customized to include info about Cliff. There was one conflicting piece of info in the handout--it said to inject in the flank or armpit, but the tech demo'd on the cat's scruff. Where do most of you inject? What area(s)?

The handout also says shots every 12 hrs, but says the diet can be served in "several small meals a day if possible." That kind of contradicts what I've seen in other literature we've been given, but I would rather do smaller meals. Just not two hours before injecting.

I forgot to ask for my results, but I do need to get in the habit of that. They are actually out of the insulin we are going use, so I have to go back tomorrow and pick that up. It gives me another day to read up, prepare, and practice without insulin. And my AlphaTRAK arrived, so maybe I can do a test later or tomorrow AM. Thanks!
 
MiCo said:
We were also given a handout on FD customized to include info about Cliff. There was one conflicting piece of info in the handout--it said to inject in the flank or armpit, but the tech demo'd on the cat's scruff. Where do most of you inject? What area(s)?
Click to expand...
They often teach injection in the scruff because the loose skin there is easy to grab and less sensitive - good when you're learning. The absorption is arguably poorer in the scruff but many people use that area all the time with success. You could inject there for the first while until you feel more confident and learn how Cliff reacts. As your skill builds over time you could try out other areas. Some kitties are picky about which spots they like and some are oblivious, especially if they're injected while they're eating. That works if you have a cat that loves his grub and you're certain it'll all be eaten. Cliff will let you know what he'll tolerate. You'll be surprised at how quickly your skills in testing and injecting will develop. :)

As for several small meals, go that route if it works best for you and Cliff.
 
You should go ahead and get a few tests in tonight if you can. It sometimes takes some practice to get it right. Give it a try and if you have problems there will be some time to ask questions and figure it out.
Here's a pic of injection sites. I started with the scruff and, like Kris said, I moved to other sites as my confidence grew.
injsitesforcats1.jpg

injsitesforcats2.jpg
 
I found that I could inject anywhere as long as he was eating. I would shoot anywhere along his back approximately 1 inch from the spine. If he wasn't eating, he was much more sensitive to the injections.
 
Welcome to the best place that you never thought you would need. We've all been where you are right now and we all remember all the uncertainties of those "early days". I was so scared and worried that I'd do something to make things worse. This board and all the wonderfully supportive and experienced people here have saved my sanity many many many times in the past year and a half. I have just a few tips to add to the ones you've already gotten... 1) Take a deep breath and know that you are not alone with all this diabetes stuff. We will do whatever we can to help you, so post your questions and concerns as much as you'd like. 2) As you begin the process of trying to get a drop of blood to test, know that it doesn't really hurt the cat because there are very few pain receptors on the edge of the ear. 3)Remember that your cat needs to associate all the new stuff you are doing to him with yummy snacks (lo carb of course) and lots of love and affection from you. 4) Take another deep breath and enjoy your extra sweet kitty. :cat:
 
Sharon14 said:
You should go ahead and get a few tests in tonight if you can. It sometimes takes some practice to get it right. Give it a try and if you have problems there will be some time to ask questions and figure it out.
Here's a pic of injection sites. I started with the scruff and, like Kris said, I moved to other sites as my confidence grew.
injsitesforcats1.jpg

injsitesforcats2.jpg
Click to expand...

Great reference chart. Once your comfortable giving the shots. It's important to change locations if you can. Some spots absorb better than others.

Sounds like your ready to embark on this journey.
 
donnalea said:
How did your first night turn out?
Click to expand...

So, as it turns out... last night was not the start! :) The vet was out of our insulin, so we only got the demo and the syringes last night.

However, this was a blessing in disguise. It gave me one more evening to familiarize myself with the whole entire process. And we received our AlphaTRAK2 yesterday, so we set that up, calibrated it, and took our first reading last night before bed. :)

I got the call over lunch that the insulin is ready/available for pick-up, so TONIGHT will be the night! :)

Thanks for thinking of us and checking in!
 
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