Very overwhelmed newbie here!

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Thelma and Calistica

Thelma and Calistica

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Hi my name is Thelma and my little girl's name is Calistica. She just turned 18 in July! she was diagnosed with advanced IBD or small cell lymphoma in September 2008. We treated her with chemo (leukeran) and prednisolone. She was only on the chemo for 1 year but had to continue taking the pred which I suppose is the reason why we're on this board now.
The pred made her turn into a kitty balloon. We've had her on a diet but there the weight won't come off. We even give her less cals than the nutritionist recommended.
She also has liver, kidney and mild heart disease. The liver issue has been around for over 7 years but has never really been much of an issue. She has really bad arthritis, hip dysplasia too.
she gets acupuncture and her current meds are: prednisolone 5mg a day, 50mg gabapentin 3X a day for pain, buprenex 0.05ml (0.3mg/ml - 5mls) BID, denamarin, clamavox 62.5mg BID, Omega3 fish oil.

Since August her glucose levels have been on the elevated side. Then in September once time it was 200 then it dropped to 178 but we thought it was because she was at the vet.
Last weekend we tried a new med: amitriptyline to help her with her arthritis pain and it gave her a bad reaction. All of a sudden she started wanting to urinate constantly but not much was coming out. Then the med made her poop like twice within minutes. Calistica's history since 2008 has been two giant pees and poop a day. Last Sunday after the second dose of amitriptyline I found two drops of bright red blood on the carpet and then her urine was coming out dark. That stopped but the urination frequence didn't she was peeing a few drops at a time.
We took her to the vet this past Wed and the vet kept her there for the afternoon to do blood work and an x-ray to check for stones. Her urine was clean. No bacteria, no blood but I guess the glucose was high. The x-ray showed nothing. Calistica was kept overnight so she could get fluids to flush whatever out of her urinary tract. she also got antibiotics in case there is an infection (culture still pending). The ultrasound revealed an angry pancreas and some nodules in her liver which are believed to be benign. I thought Calistica had been in pain but I attributed it to the arthritis. Now I know it was pancreatitis pain
The arthritis in her hind legs is pretty bad but over the weekend we saw her pooping while lying down so I just thought that her legs could no longer support her. Now I think it is weakness from the diabetes.

Calistica hasn't drank water out of a bowl or fountain since 2008. she simply stopped drinking water back then when I stopped giving her the small amount of dry food I used to give her as snacks. So the classic signs of a cat drinking water, losing weight, peeing haven't been there. We always make her canned food soupy by adding water. This water seems to be all she needs.

My vet's office called me yesterday to tell me that the fructosamine test was positive and that we needed to start insulin ASAP. We have an appointment on Monday at 2PM to go over the treatment.
Calistica eats very well. She always perks up for her meals.
What can I do to prepare for the appointment on Monday? My biggest fear are the ear pricks. I don't mind the injections.

Calistica has been fed multiple small meals a day since 2008. I am wondering if this feeding schedule will be an issue now? She is practically fed tiny meals every 3-4 hours. she has an automatic feeder and she just knows when the thing is about to open.
Thanks!
Thelma & Calistica
 
Hi Thelma,
You will find lots of helpful people here. I am pretty new, so won't offer much in the way of advise, except on my experience with the ear poking. I didn't have issues with the injections, since I have MS and have been self-injecting for years. That part was easy. I dreaded the ear poking, too. What I have found that works for me is this:
I have the lancet device, meter, container of strips, cotton rounds and treats all in one container. (I use Halo Live-a-Littles.....both my cats go bonkers over them.) I warm up her rice sock, have the container on the rug where we test. I usually end up kneeling over her, with her between my knees. Warm up her ear.....have some of the treats munched up on a lid and give it to her to keep her occupied. Once it is warm, I tell her "ok it's time" and I put a cotton round on the back of her ear (I poke her in the front side...she let's me) lancet device firmly against the other side...and poke. Do the test.....she knows now when the meter beeps, she is done and get treats. So, I give her her treats, hold the cotton on her ear for a few seconds (however long she will tolerate it) and put on the neosporin. Give lots of love and praise.
Believe it or not, she now let's me know if I am late for testing! She comes whenever I use the microwave :lol: even if it isn't for her and she purrs through the whole 'ordeal'.
If you use the Halo Live-a-Littles, the cheapest place I have found them is online at Swansonsvitamins.com. They are about 1/2 the price than the pet stores. My vet calls it 'kitty crack' and they act like it is. Neither one of my two were interested in people food or many kitty treats, but they both LOVE this. I found I have to watch how much I give her, though, because she will start to gain. (my kitty is 'husky :sad: and I bought a scale and weigh her weekly)
Good luck with your kitty.....hope this helps.
You will find many people with different methods... I am sure one will work for you and Calistica.
 
Calistica has a lot of things going on, but a mom who is on top of things.

There are so many complications thatI would wonder if diabetes is the issue here, but a fructosamine test is, as far as I know, pretty conclusive, so let's assume that is what is happening.

The nice thing is that diabetes may be the easiest of the many issues you are dealing with. We have a very successful protocol that has helped thousands of cats to regulation and sometimes, remission.

As Maresydotes said, home testing is a big part of the picture. Here is a video that shows how it is done: Video for hometesting

We also urge you to feed wet lo carb food. The vet on this site explains why: www.catinfo.org We feed Fancy Feast, Friskies, Merritt, Wellness. We think prescription food does not have quality ingredients and is not worth the extra cost.

We like long lasting mild insulins like Lantus, Levemir and ProZinc. Humulin and N are short, harsh insulins and much harder to regulate with. We like to start at a low safe dose (.5 - 1 unit every 12 hours), increasing if necessary as we get blood glucose numbers. Our idea is that if you start at a low dose, you can always increase. If you start higher, it can be too much insulin and be dangerous. Our approach is called Start Low, Go Slow.

Good for you to start researching. This site is full of great info. If you have questions, ask. We would love to help you help Calistica.
 
Welcome to you both... you will find this is the best place to be.

Something that did help w/ us was to practice first.... I would sit in our special chair, our special towel and our special treats.... mommy had all the materials: lancet pen, lancets, meter, strips, neosporin, rice sock, treats, small napkin pieces...We would sit in our chair and practice w/ the lancet pen on Beans' ear and click it... without the lancets. Mommy was very scared and Bean knew it...I think she was too. WTH - what is that noise on my ear mommy?????
I would go thru the whole thing from top to bottom: treats, praise, meter beeping, napkin in the underside of the ear, neosporin and click click click w/ the pen on the outside. I know she was better when mommy actually put the lancet in.....much better than me! lol

It will get easier and easier I promise....She will get used to it and not hate you either.

Do you know what kind of insulin the vet is going to give you? I believe you can ask for specific kinds... I did not know this but my vet gave me PZI. It seemed to do just fine for Bean....She is in remission now...last shot on 5/24!

WE changed to low carb diet, did our home testing, adjusted insulin as needed (advice from this site), and she did great with dropping her numbers back into the normal range, no longer requiring insulin....She still eats low carb or raw food (mommy has a new grinder), low carb or no carb treats (petco Tuna Flakes or 100% freeze dried chicken).

I do test her every couple of weeks and so far so good.

If you would like to share where you live, perhaps someone is close enough to offer some help in the testing phase????

I know more will chime in and offer advice, so WELCOME TO YOU ~ furry hugs today :razz:
 
Hello Thelma, and welcome!!

You're definitely in the right place... you'll find this place to be a valuable resource of information and support, no matter what insulin your vet selects for your cat. Others have discussed hometesting... what food are you currently giving Calistica? If at all possible, you'll want to get her on a low-carb wet food with under 10% carbohydrates. Many folks here use auto-feeders... one thing you can do is to thin out the wet food with some water and freeze into "kitty cubes." drop those into the auto feeder and they melt in time for the later feedings. The only modification I would recommend is that I would not allow Calistica to have food after the 6 hour point in cycle (assuming you're given a long lasting insulin). Lantus, Levemir and Prozinc all hit their peak effectiveness around 6 hours after the shot is given. If you feed after that point, there is less insulin in the system to counteract the rise in blood glucose that will be caused by the food intake, so it can send numbers higher. Many people here feed at shot time, +1, +2 and +3 in mini meals. While this isn't an absolute necessity by any means, it is one of the many little things that will help your FD treatment be as successful as it can be.

A couple of things.... if your vet encourages hometesting but insists on a pet meter (particularly the Alphatrak), they are perfectly good meters, but they aren't necessary. They are extremely expensive, and should you run out of strips in the middle of a cycle where Calistica goes low and the vet isn't open, you're out of luck. If you still feel compelled to get the vet meter (no judgment here....I used it at first!), don't buy from the vet. You can get the Alphatrak meter and strips MUCH less expensively on amazon or ADW. The meter costs around $100, and you'll pay over $1 per strip. In contrast, many of us use the Relion Confirm or Micro meters from Walmart. In store, the meter costs $9 and the strips are about $0.40 each. You can also find the generic version of the meter, the Arkray Glucocard 01, on ADW for about the same price, and the strips are even less than Walmart's prices, particularly if you keep your eye out for coupon codes and if you link from a cashback site like Mr. Rebates. If you are using a U-100 human insulin, Walmart is also a great source of inexpensive syringes... around $12 for a 100 count box. Far less than the BDs the vets typically recommend. If you are using a human insulin, be sure to get syringes that have half-unit markings... with Lantus and Levemir, we recommend doing dose changes in 0.25u increments, which can be hard to measure on syringes with only whole unit markings.

Please continue to ask questions as you have them... you'll find that the folks here are very generous with their time and knowledge. And once again, welcome!
 
Thank you so much for such warm welcome. We live in Sudbury, MA and our vets are at Tufts University Veterinary Hospital
Mares, I used to use that Halo treat for my Angel Petuly when I gave her fluids. I went to a Whole Foods today and they didn’t have them. I need to find them before we start the treatment at home but thanks for letting me know where you get it. Great price!
Today I bought sterile cotton balls and I was told to get Vaseline but I see that some people use Neosporin so I’ll get that too. Sounds like it is OK to give kitty some treats before the insulin? I thought you had to test on an empty stomach for some reason.
Missy sounds adorable! I hope we have the same luck with Calistica.
Do you all use a lancet pen or just the little lancets?
Sue, I LOVE the “Start Low, Go Slow” approach! Thanks so much for saying that because you just calmed down BIG TIME!
Switching an IBD cat’s food is quite risky. It took us 3 months to slowly transition Calistica to Hill’s g/d. Any slight change of food can cause her to have diarrhea. If I have to switch her food we have to start with like 1/8 of an ounce a day for about a week and then if everything is OK we’d double the amount the following week. We have been adding extra water to her food for at least 7 years. It’s pretty soupy
10% carbs? OMG! Hill’s g/d is not even close! I need to setup an appointment with her nutritionist I think! Does anyonehere have an IBD cat too? What do you feed it?
I love the idea of practicing the lancet sound on kitty’s ear! Clever! Congrats to Ms Sugar Bean for her remission! Calistica needs to remain on pred. I suppose that means we’ll never be on remission right?
Christie, I think I’m going to hit Walmart tomorrow and buy the meter there. We have our appointment on Monday at 2PM. If I go with my meter the vet won’t have me buy the other one. You just totally lost me with this: “The only modification I would recommend is that I would not allow Calistica to have food after the 6 hour point in cycle (assuming you're given a long lasting insulin). Lantus, Levemir and Prozinc all hit their peak effectiveness around 6 hours after the shot is given. If you feed after that point, there is less insulin in the system to counteract the rise in blood glucose that will be caused by the food intake, so it can send numbers higher. Many people here feed at shot time, +1, +2 and +3 in mini meals.”
So Calistica’s meals go like this: 7:15AM, 10:15AM, 12:15PM, 3:15PM, 6PM, 10PM, 11:30PM, 1AM. The last two meals are 1 split into 2. I would think she’d get her first shot at around 7AM. So if I’m understanding what you’re saying she should not get a meal after 1PM? She won’t be happy! LOL
Then her second shot would be at about 6PM so she should not be able to eat after midnight right?

I will have to figure out all about the spreadsheets. I also need you to know that my hubby and I are very committed to our little girl who happens to be Daddy's little girl. He is the one who feeds her and weighs each one of her meals so she only gets the calories she should get. He also has learned to pill her. He is going to be the one who learns how to inject her in the AM because I leave for work at about 5:30AM
 
Hi there and welcome!

Boy, you guys sure are doing one crazy balancing act, I am so sorry that diabetes has now been added.

A couple of observations..

1. do NOT switch food. Maybe not ever, but certainly not yet. The pred is the likely cause of the diabetes and at 18 with all her current medical issues, its not hugely likely that she is a candidate for diabetic remission. You have to weigh the various medical conditions, and if her IBD is under control with gd then I seriously would not consider switching, at least not yet. Now, some cats here do well on a raw diet, but I have no idea whether that is ok for a cat who has been on chemo therapy. So yeah, I would have a consult with a nutritionist as this is past what most of us here can help with

2. amitriptyline for arthritis? I have never seen it used for this. my dog has arthritis and is on a very low dose of metacam but is on amitriptyline for emotional issues. Perhaps felines are differently but you may want to ask your vet why amitriptyline when there are other more commonly used arthritis meds for cats.

Good luck to you! I hope we can help you with your balancing act

Jen
 
Hi Jen, we do have a crazy balancing act. Up unitil now it’s mostly been IBD related. Calistica has a team of vets. This year we added a pain specialist because it was obvious that she was in pain. Amitriptalyne is an antidepressant which is used obviously as an antidepressant but also to treat cystitis and it has been discovered that it is a good treatment for pain. We had great hopes for this med but at least it made us discover that she was diabetic when we had to rush her to the vet last week. You can read about pain management here:
http://www.vetlearn.com/veterinary-tech ... ty-of-gain
I think that the diabetes has been developing for at least 5 months. She’s had hind leg weakness but we thought it was arthritis related only now I see that it was also diabetes related. So she’s getting a double whammy!
I’m so glad you don’t think we have to change her food just yet. I don’t like to make more than one change at-a-time.
We switched her to the g/d earlier in the year because her kidney values had started to go up. For a few years Calistica did incredibly well on EVO venison but when I tried to re-intro it again she had really soft poops!
 
I forgot to ask if we need to give Calistica cyanocobalamin tablets for her hind leg weakness or if it will resolve itself once we regulate things with insulin?
Are there different types of lancets?
 
Thelma and Calistica said:
Thank you so much for such warm welcome. We live in Sudbury, MA and our vets are at Tufts University Veterinary Hospital[
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Ahh, another local :smile: There are a few us in the area :smile:

I don't have any experience with Tufts but hear that it's a great place :thumbup I personally go to Angell since that's closer to where I live.

Mares, I used to use that Halo treat for my Angel Petuly when I gave her fluids. I went to a Whole Foods today and they didn’t have them. I need to find them before we start the treatment at home but thanks for letting me know where you get it. Great price!
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Especially For Pets in Sudbury carries Halo treats and other low carb treats and a great selection of the higher end low carb premium foods you can feed to your diabetic :thumbup http://www.especiallyforpets.com/sudbury.htm

]Sounds like it is OK to give kitty some treats before the insulin? I thought you had to test on an empty stomach for some reason.
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A few treats is fine to get your cat to hold still for the blood glucose test. You can test blood glucose level and give insulin while your cat is eating. That is fine :smile: If your vet prescribed Humulin N, which we do not recommend because it's too short acting for most cats, you would want to feed half the food, wait half an hour or so, then test and give insulin and then the rest of the food. HUmulin N can have a harsh effect so having some food in the tummy kind of softens the effect.

Do you all use a lancet pen or just the little lancets?
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It's preference. I always used the lancet devive (AccuChek SoftClix). Others prefer to freehand the lancet. If the lancet pen that comes with your meter doesn't work well even after trying all the depth settings (and some just don't work well on a cat), you can buy a new lancet device at the pharmacy (avoid the CVS generic one) or try freedhanding the lancet.


I will have to figure out all about the spreadsheets.
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A spreadsheet is valuable to track your cat's blood glucose levels. You can easily see trends, patterns, and other things. Most vets love having something that can look at to see the progress of a patient :smile:

Use the spreadsheet template here http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=50130 and follow the directions on how to upload it to Google Docs. Further down in that thread are instructions on how to share your spreadsheet with others.
 
Just wanted to welcome you Thelma. You certainly are handling a lot of issues and doing a wonderful job. Calistica is one lucky cat to have you and your DH.

I don't have any advice, rather new here myself, but I can help you in finding the treats. :-D I work in Wayland and have found the Especially for Pets Store (on Route 20) carries many types of freeze dried treats that are the same as Halo and better priced. I buy Pure Bites and Just One Ingredient there. I had trouble getting the Halo treats at Whole Foods too, seems they don't keep them in stock all the time.

The ear pokes get easier quickly. I was so afraid of hurting Ollie and was overwhelmed by the whole situation. Please post and ask questions...this is an amazing place full of people who truly love their cats.
 
Hi Patsy, glad to know you're in MA! I went to the WF in Medford yesterday and was thinking of going to the SP in Wayland. There is another one down Rt 27 toward Framingham. I wonder if they have it there? Thanks for the names of those other treats!
I'm really afraid to hurt Calistica. The other day I tried to give her an Adequan injection and I think it all went into her fur since the needle was so short. she has long fur! I'm thinking I may need the vet to shave her while I get used to this!
My DH is awesome. He adores this little girl and we would do anything for her. She is the center of our world and any little social life we have has to be worked around her schedule.
 
Ollie & Patsy said:
I don't have any advice, rather new here myself, but I can help you in finding the treats. :-D I work in Wayland and have found the Especially for Pets Store (on Route 20) carries many types of freeze dried treats that are the same as Halo and better priced. I buy Pure Bites and Just One Ingredient there. I had trouble getting the Halo treats at Whole Foods too, seems they don't keep them in stock all the time.
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I go to that Especially For Pets all the time :smile: The other one I go to is the one in Newton and they have a better selection of toys than the Wayland store. Pet World in Natick on Rt. 9 East (across from the Natick mall) is another good place for low carb treats and a huge selection of mid- to high quality food :thumbup

List of low carb heatlhy treats
 
I know there is another SP in Acton. I've never been in there but I've passed it. Good to know about Pet World. Is that the place before you exit to Speen St?
 
Hi Thelma,

I'm sorry that you have to be here, but there's no better place, not only to learn about the diabetes, but also other issues, though it seems you've done a marvelous job helping Calistica. Rest assured you can continue to give her that wonderful care, even with diabetes.

I am also dealing with intestinal lymphoma in Gandalf, who is also 18. He's been diabetic since he was 12.

We use one of the longer acting insulins, Levemir. Lantus is similar. Do you know when you're going to begin treatment with insulin?

Your biggest challenge with insulin is going to be because of the prednisolone. Please read this article for a little more info: http://petdiabetes.wikia.com/wiki/Steroids

I have only been treating Gandalf with prednisolone for a month and a half, but because of my experience with our insulin I saw right away that he was not getting the duration from a dose of insulin like he had previously. So you may see a good response from the insulin, but a dose just won't last through a 12 hour cycle. The solution for Gandalf was an unconventional dosing regimen, three times per day (TID)rather than twice (BID).

TID is an advanced technique to deal with lack of duration, but I can predictably maintain his blood glucose levels lower IF I can keep to insulin shots every 8 hours. Because of my job schedule it is very difficult to do that however, so it's not as successful as I know it could be. You can see Gandalf's BG spreadsheet by clicking the Current Spreadsheet in my signature below.

While I'm not saying that dose timing has to be done that way on steroids, I want to inform you of the possibility of having difficulty controlling her BG because of the steroid and that TID is a probable solution.

Also for the arthritis, have Adequan injections and/or acupuncture and B12 vitamin shots been discussed with you? Gandalf has been treated with all of those for 2 years and until the lymphoma his arthritis hadn't worsened. I also agree with Jen about the food change. You can work the insulin around the higher carbohydrate food.

I also wanted to briefly address Christie's statement:
Lantus, Levemir and Prozinc all hit their peak effectiveness around 6 hours after the shot is given. If you feed after that point, there is less insulin in the system to counteract the rise in blood glucose that will be caused by the food intake, so it can send numbers higher. Many people here feed at shot time, +1, +2 and +3 in mini meals. While this isn't an absolute necessity by any means, it is one of the many little things that will help your FD treatment be as successful as it can be.
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While it seems logical that there's less insulin in the system after peak, Lantus and Levemir work off a "shed" or overlap which builds up in the system over time. They maintain more level blood glucose because of that effect, rather than the marked peaks you will see on PZI or Prozinc. Unless the cat has food spikes (quickly elevating blood glucose from food intake), there should not be a need to change feeding times on Lantus or Levemir. However, since you are using a higher carb food, you may want to consider Christie's suggestion as it may be helpful in that case.

Also, it's ECID (Every Cat Is Different) regarding peak times and duration of chosen insulin, and so many other factors as well, such as eating habits and food choice. That's why home testing is the best way to learn how the insulin works in your cat so that you can best manage her blood glucose.

You're already on the right track. We can help you stay there.
 
Pet World is the one by Speen Street. It's a good one....it's where I adopted my Ollie from. :-D SPIN has some space in the store so watch out....your heart may get stolen by "someone" who needs a home!

If you need help with learning to test let me know. I would be happy to help.
 
hi Thelma and Calistica and Ray!
you have gotten good info...sorry my emails to you have been confusing...half the time i typed them from my phone so tried to do the short cut thingy!! ;-) and my explanations might not have been that great

people here on the board are very knowledgeable and super friendly.....you will be guided and it will allow you to make informed decisions in treating Calistica....you are a great bean to her (bean=mom)....and you and Ray will do just fine....

not gonna kid you...it is overwhelming and frightening at first....and yes with a multiple illness kitty it becomes a balancing act....so one thing at a time...take a deep breath :-D

and it helps if on your signature you can attach (link) Calistica's SS this way people here can view it when giving you advise.....

welcome to the board and sorry you have to be here....but I know you.....you will do just great to care for Calistica....she is your baby and I know it....Petuly would be proud of you!
 
Hi Vicky, sorry Gandalf has intestinal lymphoma now. Calistica has been on prednisolone since Oct 2008 so I know for sure that is the cause of her diabetes.
We don’t know what type of insulin we’ll use. We have our appointment tomorrow at 2PM. I thought DH was going to be able to come with us but he has meetings he can’t get out of so I’m freaking out.
I really think the TID dose would probably work better for Calistica. Does this mean you give it to him every 8 hours? I’m just not sure this will work for us. I usually get home from work between 3:30 and 4PM. She would get her first dose at about 7AM.
Calistica gets acupuncture too. The only thing she doesn’t get B12 shots because she hasn’t been cobalamin deficient and her vet won’t prescribe it unless the cat needs it. She did give her a shot last week when she had to spend the night which totally left me in shock!
I don’t understand the 12 hour cycle. I thought it was 6 hours from what Christie said? It would be awesome for Calistica if we didn’t have to disrupt her feeding schedule but I’m having a seriously hard time understanding how long a shot would last. If Calistica gets a shot at 7AM + breakfast she would have a meal at 10:15, 12:15 and 3:15PM. Then dinner at 6PM which would be shot #2
Whatever insulin we get we totally need the long lasting kind. This new lingo is killing me! I'm not sure I understand what a "shed" means.

Thelma and Calistica said:
While it seems logical that there's less insulin in the system after peak, Lantus and Levemir work off a "shed" or overlap which builds up in the system over time.
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Does it mean that it's efficacy decreases after a certain period of time?
So I won't know if her glucose spikes at meal time until we try it right? If it spikes when what do I do to bring it down? Does this also mean that I have to prick her ear again after I feed her?
I'm not clear on this statement from Christie: "Many people here feed at shot time, +1, +2 and +3 in mini meals." Does this mean I give her a single meal in three little portions to prevent a big spike?

Hi Claudia and Rocket! I'm totally lost! Thanks so much for pointing me to this wonderful group!

I got a Walmart meter today which is one a lot of people recommended: Relion Confirm. I also got some 33g lancets. Are they too fine?

Patsie, I know about Pet World and the cats they have for adoption. It broke my heart when I went there once. I wanted to take them all home!
 
I can't answer all your questions, but can answer a few.

TID is usually 8 hours and works easiest with ProZinc because there is no shed. Once the insulin is gone, it is gone. With ProZinc, you divide the amount you plan to give into 3rds and generally give every 8 hours during a 24 hour period. If you want to use Levemir like Vicky does, I think you will need specialized help with dosing because of the potential for overlap. Here is an explanation of the shed: viewtopic.php?f=9&t=150

If you dose twice daily, as most of us do, you give a dose in the am. The number (ideally) goes down gradually to the nadir (which for most cats is around 6 hours after the shot) and then gradually back up to the evening shot, 12 hours later.

Lots of the answers need to start with ECID (Every Cat is Different) Some do best with a meal in the am and pm, after the test. Some kitties do best grazing(normal amount divided up into several smaller meals), with food not available for the 2 hours before a test (so as not to skew the numbers) Many of us freeze the wet food and let it thaw as they eat. Some of us use automatic feeders.

Although ECID, usually unregulated cats eat and their blood glucose levels go up. When a cat is nearing remission and the pancreas is doing some of the work, they can eat and the number will go down.

Yes, 33 may be too fine a gauge at first. Until the ear "learns to bleed" usually 26 -27 gauge will make a bigger hole.
 
Sue, thanks for the link to the "shed" sticky!
The reason why we may have to do TID for Calistica is that she is on prednisolone to control her IBD.
The meter I bought came with some 30g lancets. I will have to go back to buy larger ones then.
Calistica has been eating smaller meals throughout the day for about 3 years now with the help of an automatic feeder. We may not have to change her schedule that much.
 
I have 5 unopened containers of Halo chicken. I didn't notice an expiration date, but I bought them when Donovan was first diagnosed (Spring 2009). Do you think they'd still be good? If so, I can send them to you.

MJ&Donovan
 
When do they expire MJ? I know of someone who gave expired Halo chicken treats to her cat and he got very sick.
I can't believe how expensive they are at our local Especially for Pets store! I paid $15 today but it was an emergency!
Mare told me she gets hers from Swansonsvitamins.com and that was half the price!!! I hope they're OK for my IBD Calistica!
 
The fewer changes with a complicated kitty, the better.

We have two kitties in The PZI forum who are doing TID. It is more complicated than BID. Kse has it pretty well figured out. bookworm is still experimenting with his kitty.

Here's the forum: viewforum.php?f=24
 
We really need to figure this out slowly! The closer the vet appointment time gets the more I freak out. I'm having panic attacks!
Can other meds be given at the time insulin is given?
 
Thelma and Calistica said:
I know there is another SP in Acton. I've never been in there but I've passed it. Good to know about Pet World. Is that the place before you exit to Speen St?
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Yes, as you're heading east on Rt 9, you would stay on the far right for the Speen St. exit. Pet World is right before the exit, past Christmas Tree Shop and what used to be Pizza Hut (now some restaurant called Moe's).

http://www.petworldnatick.com

PetWorld.jpg



Thelma and Calistica said:
We really need to figure this out slowly! The closer the vet appointment time gets the more I freak out. I'm having panic attacks!
Can other meds be given at the time insulin is given?
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Here are questions to ask the vet: http://gorbzilla.com/questions_for_your_vet_.htm

Most meds can be given around the same time as insulin but ask your vet to be sure. My diabetic had asthma and would get his puff of Flovent right before I tested bg and gave insulin.
 
Can you figure you will just take one step at a time?

The food you aren't going to change, so that is easy.

The things you need to figure out with the vet tomorrow are the insulin type and the dose. Dose is easy - we really encourage you to start low at .5 or one unit twice daily. And if I were you, I would start with twice daily and get that under my belt before I even thought about TID. Insulin - we suggest Lantus, Levemir or ProZinc. You might visit the 3 support groups for these insulins, read through some posts, get a feel for things. Support groups: viewforum.php?f=5

It will also depend on which insulin your vet has worked with. We would really discourage you from starting with Humulin or Canninsulin or N.

Everything else can wait.
 
squeem3, that is exactly the pet store I was thinking of!

MJ, maybe you can call the company that makes the Halo treats to find out how long they're good for. Maybe there is a lot number you can identify them by on the bottle?

Sue, thanks so much for the link to the questions to ask a vet!
My biggest concern is the frequency of the testing. I was going to take tomorrow off but will go to work and leave early so I can be at home on Tuesday morning so we can keep checking her BG.
 
And Thelma,
I know everybody says it, but it IS true that it gets easier. I had my panic moments, overwhelmed, am I doing the right thng for my kitty? moments, tired of all the worry moments.....but it really does get better.
I think one of the best pieces of advice you have gotten is to practice the ear pokes until you feel comfortable. I know my cat felt my apprehension and it made it worse.
Now that we both 'know the drill' testing and injecting her are easier than treating her acne. :lol: She purrs through the FD stuff and growls at the chin stuff.
I am going to have to try the other freeze dried chicken. Even at $7 Halo is still pricey, and you have to plan ahead. I have had to pay the pet store prices and they suck!
Good luck with your vet....take deep breaths.
Mares and Miss
 
Mares, thanks so much for your kind words! I do believe it gets easier but the ear pricks have me freaking out. I was practicing with the lancet pen on her ear yesterday and she didn't even flinch with the sound. I tried to gently pinch her ear with my fingernails as I did the pen and she seemed OK.
Now I have to learn to aim correctly!
Since the BG has to be tested pretty often on a given day do you alternate ears each time?
Remind me later to tell you how I've treated Calistica's acne please. I have to go leave for work now.
Thank you all and please know that I'm sending lots of prayers and healing energy to your babies every day
 
Thelma,
I think you are doing the smart thing by practicing! You both will be be more relaxed and it will be way less stressful. I was freaking out, too. I still don't LIKE doing it, but I figure, if she comes on her own, to the sound of the microwave, whatever little pain she feels is worth it fir the treats......SHE makes the choice to get up (even if she is upstairs sleeping) and come to the kitchen.....I never have to call her. I do alternate ears and sites. I do my own IM injections and it is just a good idea to alternate. It let's that area heal and keeps down scar tissue (don't know if they actually developed scar tissue from the lancets, but alternating sites applies to sub-cutaneous injections, as well) And their ears do start to bleed easier, so don't get discouraged. One mistake I made was leaving the vial of strips on the counter and I was on the floor, testing. Sometimes I didn't get a big enough sample or got an error msg for whatever reason. I hated to let go, even though the worst she did was scarf some treaties, to grab the strips, so I just have a tupperware container with the whole lot of stuff and it all goes down on the floor when we test....and back in the cabinet when we are done.
If you have tips on acne I would be SO grateful to hear them! It has been a struggle for months and months. It is looking better, but it has before and then flared up again. I feel so bad...when it flares, it sometimes even bleeds and you can tell it hurts. I never heard of feline acne before I had her (nor had an obese kitty) and I am amazed at the number of people here who also have had cats with it.
I hope your visit with the vet goes well and I hope Calistica does really well. I had moments, at first, where I wasn't sure I made the right decision, but even though she relapsed (she was OTJ for almost 5months) I KNOW it was the right decision to treat her.
Healing thoughts to you and Calistica from Missy and I
 
Hi Mares, it's almost time to leave the house for the vet's office. I want to throw up! Hopefully the real thing will go as well as the practice did!
Thanks for the tips! I'll make sure to remember because I have the feeling I'll be the one doing the first test + injection. Alternating sites is a must with subQ's so it must be the same here too.
The acne solution for us has been to keep the area clean. You have clean with a moist washcloth and pat dry after a meal.
I prefer to use a microfiber cloth. The vet prescribed an ointment called Muricin (mupirocin ointment 2%) we used it twice a day.
The key for us wasn't the ointment but a shampoo I found online
DermaBenSs Soapless Shampoo witth Benzoyl Peroxyde
http://www.amazon.com/Derma-Pet-Derma-B ... =pd_sim_k1

I take the microfiber cloth and I wet two corners. On one corner I put a little of shampoo and then rub the acne area with it not allowing kitty to ingest it. Then right away I take the other wet corner and rinse off the shampoo. Repeat the rinsing and then pat dry.
I did the shampoo and ointment once a day.

Your Missy is such a good girl! Calistica is obese too thanks to the pred she's been taking since 2008.
 
Is she pretty stable in her ability to eat and keep food down?

With Prozinc, it may be a bit easier to adjust based on the glucose levels as you see them, whereas both Lantus and Levemir are adjusted based mid cycle tests after stable dosing for 3-7 days at a time, barring obvious underdosing.
 
Thelma,
Thanks for the info on the acne treatment you used. I will have to get some of that shampoo. Something has to work, sooner or later!
How did your vet visit go? Hope it went well and you are armed with all kinds of good info....and feel better about home testing.
Let us know how it went
M&M
 
10/17 Calistica PMPS 331- Newbie-help

Calistica's glucose was really high at the vet today: 331. It was 200 last Thursday. Of course we had been there for over one hour waiting for the vet and she simply hates going. It also takes us 45 mins to get to Tufts. She also missed her 3PM meal.
The vet had practice syringes for me and we practices at aspirating fluid from a purified water vial. She gave Calistica a little water shot and she didn't even flinch! We didn't practice the ear prick on the patient because she was quite cranky by the time that happened and nearly shredded the vet's hand off!
So anyway we got Lantus. 1 unit twice a day.

I just came home (6PM) since we left at 1:15PM. Poor Calistica was starving. I had Ray prepare her dinner before we got home and she finished eating before I got a chance to get the syringe ready. I had no problem giving her the shot this time. She didn't even blink!
The vet had prescribed 29G syringes but CVS only had 30G so I thought that was fine.
I had no idea how expensive insulin was! WOW!
The vet doesn't want us to do a curve until Sunday. She wants the her body to adjust a little to the insulin. I will still practice the ear pricks.
My dead aunt prayed all day for Calistica and I and when I got home from work I wanted to puke but once we got to the veterinary hospital I was calm and I knew God was with me. I said to myself: I can do this!
So I'm cool with the injections. Wish us luck with the ear pricks!
What do a I do next? Join the Lantus forum?
 
I am glad things went so well! Except for poor Calistica's hunger. Lantus is a good insulin and you started at a good dose.

I would start by reading the starred threads on the Lantus forum. They give you information on how to dose, how to store - everything you always wanted to know about Lantus. viewforum.php?f=9 Then when you post and everyone asks if you have read them, you can answer with a confident YES!

They would like a spreadsheet so you and they will have a quick picture of what does you are giving and how Calistica has responded. Here are the directions: http://felinediabetes.com/FDMB/viewtopi ... =6&t=50130 If you have trouble, just ask for help.

Then, get some numbers so you can start filling it that color coded chart!

Sounds like parents and kitty both deserve a treat tonight.
 
Thelma,
So happy to hear it went so well today!!
I don't want to add too much to the mix, since I know in the beginning there is so much information overload. :-D But, when life calms down, ask about the Lantus SoloStar pens on the board. It is a way to decrease the costs of the insulin for you, if you started off with the vial.
Mares and Miss
 
Thanks Sue and Mares! I still have to conquer the ear pricks so I'll try it in a little while.
I downloaded a copy of the spreadsheet and will start reading the Lantus posts. I feeling like I'm about to crash. It's been a very emotional day!
On Sunday we will do a curve every 2 hours from 5AM-5PM and I'll fax it to the vet on Monday.
Thank you all so much!
Sending all your babies lots of prayers and healing energy
 
You had a tough day but it sounds like you handled it all well. I hope you get to put your feet up and relax tonight...you deserve it!

Send me a PM if you want some help testing. I get the feeling you'll be a pro before too long!
 
Thanks Patsy. I feel so good about having made it though today! I just hope the little girl responds well to the insulin!
Thanks for the offer to help! I already wrote it down so I know who you are! :lol:
I am going to practice the ear pricks with the 33G lancets. Just so I get comfortable doing it.
 
10/17 Calistica PMPS 331- Newbie-help

I pricked her! She didn't even react! I tried the 33G ones and nothing happened. I think I could see a little hole but no blood. Then I had some 30G and I got the tiniest drop of blood. I need to work on aiming right because this was too close to the edge. What do I do if I don't get enough blood? Prick her again?
 
Yes, you can double poke - a quick second poke in the same spot.

Did you sure get her ear nice and warm? That was the secret with Oliver. You can put hot water in a pill bottle, warm the ear and use the surface to poke against. You're getting close!
 
Re: 10/17 Calistica PMPS 331- Newbie-help

Thelma and Calistica said:
I had no idea how expensive insulin was! WOW!
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Lantus is pretty expensive but there are ways to cut costs. Did the vet prescribe the 10 ml bottle? In the future, ask the vet to write the prescription for the Lantus SoloStar pens. The pens are 3 ml each and comes in a box of five pens. The initial cost is higher (last I saw it was $150 or so for the box) but just break the price down per pen. Each pen lasts about a month so the box is basically a 5 month supply. A 10 ml bottle might last a month and then you're shelling out another $100+ for another bottle that only gets a teeny but used before it poops out again.

Some people buy their Lantus pens from online Canadian pharmacies for way less.

You can also use a free prescription drug card to save some money at the Human pharmacy. Here's a pet one: http://www.felinediabetes.com/FDMB/viewtopic.php?f=28&t=53397


The vet doesn't want us to do a curve until Sunday. She wants the her body to adjust a little to the insulin.
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Smart vet :smile: Lantus needs at least a few days to "settle" in your cat's body before you see any noticeable effect on bgs. Any time you change the dose, you need to give it a couple days to "settle" before doing a curve.
 
Sue, I'm not sure it was warm enough. I put a warm washcloth inside a ziplock bag by maybe I'll use rice to see which is better.
Love the idea of the pill bottle! God knows that between my meds and Calisticas we have plenty of those!
Do you double pock with the same lacet?

Squeem3, thanks for that pet med card info! Do I enter my name or Calistica's?
I did get a 10ml bottle! I definitely need to get those pens! Prices around here are pretty competitive.
Good to know that not doing a curve out of the gate is the right thing to do! I have to keep practicing my pricking technique
 
Thank God I can poke with the same lancet! Once I get the technique I'll have to train DH! He watched us today.
I think I'm going to need 5X magnification glasses to do this though! :smile:
 
And Thelma....go to the Lantus web site, they have a coupon for $25 off the pens. Every little bit helps.
Happy to hear Calistica is doing so well with the poking. :mrgreen: I bet that is a relief. Getting Missy's ear so it is warmish to the touch makes a huge difference in results with her.
I bet you are ready for a nice big glass of wine(if you drink)! :thumb up
Mares and Miss

Oh, I forgot to tell you....I keep a pair of drugstore glasses in with all Missy's testing gear...I can't see any other way. ;-)
 
10/18 Calistica AMPS 296 - Newbie-help

I was able to get my first reading! YAAAY! Calistica was such a good girl too. I warmed up her ear well using a wet paper towel inside a ziplock bag and I used level 4 on the pen. I got nothing the first few pokes but I am not sure what the pen was set to. With level 4 I got a beautiful drop of blood and a reading!
Mares, it sure has been a HUGE relief that my little girl is doing so well. I didn't sleep well at all thinking that I had to get up at 4:30 to do this. I always get up before that but this is different. Normally DH feeds her breakfast and pills her. Now I have to feed her breakfast at 5AM, do the poking and injection. Once I get better at this it will be OK. It took me about 1/2 hour to get this done. I'm sure it's probably more of a 5-10 minute task right?
I will try uploading the spreadsheet later on today but her PMPS last night was 331 and her AMPS today was 296 which makes me think that the reading at the vet's yesterday was stress related. I can't believe that just last week her BG was 200!!
Thank you all so much for your support and wonderful advice!
Sending lots of healing energy to your fur babies!
 
I knew you would be a pro in no time! You are doing so well. :-D I use the same ear and the same side of the ear each time....Ollie's other ear is pretty messed up from "his life before me" so I don't trouble it.

Hope you have a great day :-D
 
Thelma and Calistica said:
Squeem3, thanks for that pet med card info! Do I enter my name or Calistica's?
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Either. I used a different precription card and put it under my cat's name. It worked :smile:

I did get a 10ml bottle! I definitely need to get those pens! Prices around here are pretty competitive.
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You can check for approximate prices here: http://www.easydrugcard.com/drugpricing.html The price that shows up for the pens is for each individual pen, not for the entire box. Just mulitply the picie by 5 to get the box price.

When you do get the pens, you don't need to buy the pen needles. Human diabetics use them but for a cat and the teeny doses they need, you can just stick the insulin syringe needle right into the rubber stopper of the pen just like you would with the bottle. There are pictures of how to do that here: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151 Don't inject air or extra insulin into the pen. The pen is designed to work with negative pressure.

Good to know that not doing a curve out of the gate is the right thing to do! I have to keep practicing my pricking technique
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You'll get the hang of it soon :smile: A "rice sock" works great for most cats. It's like a floppy catnip square toy for cats but with uncooked rice or dried beans inside instead of catnip. You can use an old cotton sock instead of making an actual square of fabric. Fill with 1/4 cup or so of rice or beans, knot close, and heat in microwave until really really warm but not hot. Wrap sock around the edge of the ear for 10-15 seconds or so, then poke while holding the sock under the ear for support.

Thelma and Calistica said:
. I didn't sleep well at all thinking that I had to get up at 4:30 to do this. I always get up before that but this is different. Normally DH feeds her breakfast and pills her. Now I have to feed her breakfast at 5AM, do the poking and injection. Once I get better at this it will be OK. It took me about 1/2 hour to get this done. I'm sure it's probably more of a 5-10 minute task right?
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5-10 minutes? It might take that long in the beginning but soon you'll be able to poke/test/shoot in under a minute :-D
 
Thanks Patsie and Squeem3!
Poor Ollie and his ear! He's so lucky to have found you!
Squeem3, I figured it would be easy one I get the hang of it but not that quick! I added the feeding, pilling, poking and injecting time. The part that took me forever was to warm up the ear. I tried a pill bottle with hot water but that didn't work. Then I did the wet napkin which is what the vet did. I'm going o have to make a rice sock and give it a try too! Thanks for that link to the Lantus info! Great video too!
 
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