Trouble for Pet Sitter

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HisMomaCat

HisMomaCat

Member Since 2012
My cat "Church" has been diabetic for about 18 months. He received 2 units of ProZinc every 12 hours, and he is feed Purina DM can food. We are located East of Atlanta, GA, USA.

My problem is that Church is not a social cat and can be spooked very easily. He can be difficult some days even for me. I have a pet sitter (and good friend) who has been feeding and medicating him while I travel for work. Church usually tolerates her very well. However, this week, he has chosen to run from her, hiss, and threaten biting when she attempts to give him his shot. She doesn't want to get hurt. She has even resorted to brides of chicken (which is his all-time favorite treat) with no success. He escalated to full flight or fight mode last night. At her wits end, she skipped his pm dose last night. Luckily, she was able to give his am shot this morning with minimal damage.

I hate for him to skip any dose of insulin.

Does anyone have any ideas for my pet sitter? How much damage is it causing for him to miss a dose?

All suggestions are appreciated.
 
We always had the best luck shooting insulin while Oliver's head was deep in his bowl of breakfast or dinner. We tested him, at first, using the kitty burrito; you wrap them in a towel without only their head showing. I don't know if that would be easier or harder.

Do you test at home? The reason I ask is that sometimes if the dose is too high and makes the cat feel lousy, they fight getting the shot.
 
I do not currently home test. However, I have purchased the test kit and plan to start as soon as I return home from this trip. I do watch his behavior, and I do see changes toward a more aggressive kitty when he is getting too low. I just had his blood tested for his average this past week at the vet. His average was 149. The vet did not want to change his dose until we see the curve.

Normally, I do give his shot while his head is deep in his food bowl. He currently is not eating until the pet sitter leaves.
 
I would be a little nervous about a 149 at the vet. Sometimes cats can read up to 100 points higher there because they are generally stressed by the strange noises, smells and other animals. And stress raises glucose levels. What sometimes happens is a dose based on those stressed numbers can be too high once they get home and relax. 2 units into a 149 could be deadly; I assume the 149 was not at shot time.

Would you be comfortable lowering the dose to one unit until you get home and can test? If he gets agressive when he goes low, maybe this could be why he is fighting the shot?

We suggest starting low (.5 to one unit twice daily) and going slow with the insulin, raising the dose in small amounts based on numbers gotten at home.

What medicine is he getting? Could he be feeling crummy with it?

When will you be home?
 
Oh sorry, let me clarify. The 149 was the results of his fructosamine test. I would never rely on a snapshot blood test AT THE VET for the bases of his insulin dosage. He becomes very stressed with a vet visit. The ONLY way the vet tech can handle him is with me holding him. If they take him away from me, he becomes a demon cat and is impossible to handle. Sedation would be required.

You ask about his insulin. We are using ProZinc.

My pet sitter has been able to get the shots administrated with the exception of that one evening dose. I will be home this evening. I will be able to see if he is feeling/acting odd or if he is just being a brat about his shots with the pet sitter because I am traveling.

I will begin home testing tomorrow. I am very curious to see how his curve looks. I would love to get him OTJ.

Thank you for all your comments, Sue and Oliver.
 
I tested Church this morning prior to food at his normal insulin time. His number was 118. So I did not give him any insulin. I did give him his normal food.

I attempted to test again three hours later, but after five tries I still had not been able to get enough blood from his ear to test. I guess it was beginner luck this morning. I decided I had stressed Church enough for a while.

I will attempted to test again prior to his feeding time this evening.

"Deep Breath, Relax, and Keep Trying" is my motto for the next week.

Thank you all for the support.
 
That's a great motto. :mrgreen: The 118 is a nice number and yes, it was wise to skip. When was the last time he had insulin and what was the dose?

I am so glad you got a test this am before the shot. Two units into 118 could have caused a hypo.
 
When I tested this morning and got the 118, it had been over 10 hours since his last insulin shot of 1 unit (U40) of ProZinc and food.

This evening did not go well. He remembered the ear pricks from earlier today and would not allow anything near his ears. I got bite once even using the towel burrito. I gave him lots of loving and treats. I will try again on Sunday.

Thank you for the encouragement and the advise. I will keep trying.
 
The next time you might use the clothespin trick. It mimics when the mother cat grabs the kitten by the scruff of their neck. You put a couple clothespins on the scruff of his neck; it sort of immobilizes him.
 
The behavior toward your pet sitter suggests to me that Church may be associating how he feels with the insulin shots. If he is possibly having near hypoglycemic episodes, he would be feeling odd, but may not exhibit symptoms of hypo. He may simply have felt this way in the past when the sitter gave him the shot and not yourself, to explain why he's not acting this way with you. Cats are amazing creatures and we should never underestimate their ability to reason, they just think differently than we do.

Cats can go in to diabetic remission. The BG results you got suggest he is in normal range and his pancreas may have healed enough that it is starting to work again. Dosing 2U of Prozinc at this crucial point could be dangerous. Hometesting is the only way you're going to know how the insulin is working.

Fructosamine does not determine a specific BG value but rather the ranges indicate how well controlled the BG is. Here is a chart.

Cats
Fructosamine values (mmol/L)

Normal non-diabetic cats
190−365

Newly diagnosed diabetic cats
350−730

Treated diabetic cats:
excellent control
350-400

good control
400-450

fair control
450-500

poor control
>500

prolonged hypoglycemia
<300

As you can see, the 149 is not even on the chart. If the vet told you his BG average is 149, there is no way he could know that unless he actually did a curve and a curve is used to determine the lowest or peak point of the blood glucose during a 12 or 24 hour period.

Something does not sound right here with what you were told. Could be a matter of miscommunication because the 149 sounds like it may have been a peak/nadir value rather than a fructosamine value, as Sue assumed. 149 is in the upper range of normal BG. See here: http://petdiabetes.wikia.com/wiki/Blood_glucose_level

Home testing will give you some much needed answers.
 
Thank you for all the advice.


Since the one reading I have got was at 118, I have stopped his insulin until I can get more readings. I am scared that he will get too low while I am blinding dosing him. I love this cat, and I want to keep him around for a long time.

However if his blood sugar IS still high and I have stopped his insulin, what should I look out for? Can I be making him sick by not giving his insulin? How many days before I see the signs?

Thank you.
 
It is important that you test for ketones.

http://petdiabetes.wikia.com/wiki/Ketoacidosis

The best way to tell whether he is high or low is to test. Keep trying - maybe start from scratch with just ear rubbing then treats and release until he puts up with that. Then add the heating with the rice sack or pill bottle, treats and release. The hope is by the time you add the lancet and meter, he has decided the treats make this process worthwhile.
 
Ok, I have the strips to test for ketones. I hope once a day or so is adequate. Not sure I will not be able to catch his urine any more often than that. I haven't tested yet.

He didn't eat as much this evening as normal, but I did have company today. So life was not a normal today. Also this evening, he seems a little bit agitated, but again, it may have been from the company today.

I will keep an eye on him.

Another question, since I am working up to blood testing, if he continues to not eat as normal and be agitated, should I go ahead with a small insulin dose at some point? Or is it better to just wait?

I am so blind here without the blood test. I hate this guessing in the dark. I hope he allows blood testing soon. I need numbers.

Thank you all again for your advice and support.
 
I have a headstrong cat who didn't want to test at first.

What worked for me was I would get her favorite treat ready, shrimp, and put it out of reach, and I took her from wherever
she was.... and I wrapped her up in a blanket burrito style and she would squirm and get an arm out but I would just keep putting it back.
I had an ineffective lancet ( 31 gauge instead of 28) and unfortunately, I had to try several times, sometimes 8, before hitting
a spot that would bleed enough. I did find that putting the neosporin ointment on before the poke helped the blood to bead
up better. We struggled, and I would say I'm sorry, I have to. And I would reward her for putting up with me. And I told
her we'd buy a better lancet.
After about a week of this, she figured out that she would rather cooperate than be held down so I pick her up and put her on her short cat tower right beside me on the couch, turn on my reading lamp so I can see, I walk to the other side of it so I can stand beside her so she's knows it's time and she still growls occasionally but she knows I'll come get her if she runs.
She also knows she gets that treat as soon as we are done so now she is almost assuming the position.
We started doing this 20 days ago. I am now getting blood almost every time. Her ears did learn to bleed as they all said they would.
And even though it was all difficult to do, I kept reminding myself that this was far better than taking her to the vet and leaving her where she would stress out and be miserable so that they could do it instead with inflated numbers.
So I tell you this hoping it will help you find your resolve and persist.
Even tho' it feels hard while you are starting, persistence will pay off and you will soon be successful with monitoring
and then you will be able to help your baby get better.
As or the ketone strips, I was having luck with putting a big plastic bag over my litter box where she could feel the litter under her feet but she wasn't really touching the litter and she would use it. Nice easy to dip the stick in.
I now have one of boxes that has a reservoir where I can test it once a day.

You definitely want him to eat . No food in the system is not good when he starts getting insulin again.
If he has new cans, he might get finnicky. If you are willing, if he rejects the food of the day, you can cover it and try offering it again later. And try a different flavor. Or you can sprinkle a little parmesan on it, or tuna juice, something to
get his attention.
 
Good News!!!

I was able to get a blood sample this evening prior to feeding. He was at 257. He had not had any insulin in 24 hours and no food in the last 10 hours or so.

With this number, I gave him 1/2 unit (U40) of ProZinc with his food.

I am hopeful to get more numbers.

Thank you for all the support.

Kelly & Church
 
I think I have found the trick to checking Church's blood.

No rice sock, no towel to wrap him, no flashlight.....nothing new or out of the ordinary. He was sitting in my lap. I rubbed his ear for a while and then went to collect testing kit and chicken. With him on my lap, I manually prick his ear and test him. After medicine and applying pressure to the spot, I give chicken as treat. He did GREAT! No hiss, no growl, no bite, he didn't even get out of my lap. YAY!

Ok, he didn't eat well this morning and he has been acting like he didn't feel well. (I gave 0.5 unit (U40) this am blind.)

Around 3:45, I gave him a can of FF and he finished it by around 4:00. I tested at 5:00. His number was 214. I gave 0.5 unit and plan to feed him some more this evening around 8:00. I was just worried that he had not eaten much today or last night. I feel much better to have some food in his system.

My plan (now that I think we have the blood testing technique established) is to test on an empty tummy in the morning and start the curve then......paws crossed.
 
Not bad for a .5 dose. As soon as you can get some midcycle numbers (+5-+7) we can see how low the insulin is taking him. Good job getting the test!
 
His mid-cycle number today (+6) was 224.

I think this means that I should increase his insulin to maybe 0.75 or 1 unit. Do you guys agree?
 
That's pretty flat. Unfortunately it can a sign of too much or too little insulin....I would give it one more day and if he is still flat, increase.
 
PMPS = 257
I gave 0.5 unit (U40) of ProZinc.

I have started his SS, but it only has today's info on it.

Thanks again for your help.
 
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