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Friday, July 21st, 2006 05:23 pm
Preliminary update from the blood lab: glucose high. I don't have a number on that nor do I have an "upshot" (insulin required or not). The rest of the report will arrive Monday, including stuff like thyroid numbers.

I've already told my vet that if she's diabetic I'll want to switch to a veterinarian closer to where I live. He suggested I ask the emergency clinics for a recommendation. "They usually know," he said. "As these animals come in they know whether a vet's any good." I bet that's excellent advice.
Saturday, July 22nd, 2006 03:07 am (UTC)
I'm so sorry to hear about Duchess going diabetic. It can be hard to maintain, but the insulin shots (if you need to go there) are very very easy (you scruff the cat, so they just think they're getting scritched and often purr, too... especially if you do it when they're eating!). If you want to talk about it at all, my Athena was diabetic for the last few years before we lost her, so I've seen the ups and downs of it. *wry smile* Low blood sugar is terrifying, but there are definitely things you can have on hand in order to handle emergencies. Diet control can also work, and requires monitoring (and some trial and error to find the right foods). We ended up doing diet control, which we knew wasn't perfect, because insulin wasn't working for us.
Saturday, July 22nd, 2006 03:21 am (UTC)
I'm glad you say the shots are easy. I hope I will get over my wooziness around needles. (I'm firmly of the opinion that if ya hafta, ya hafta. That wooziness is a frailty I may no longer have the luxury of keeping.)

Answering questions from firsthand experience would be great if you're willing. I'll probably "talk" your ear off. :-)

- Did you give shots during meals?
- Did you give the shots in the scruff, like sub-cu fluids, or elsewhere? (A website I have seen recommends elsewhere.) Did you vary the placement?
- What did you use to deal with low blood sugar?
- What do you mean when you say insulin wasn't working?
- Did you have to fight a bit with the vet to try only diet control after having tried giving insulin?

My major worries now are low blood sugar / insulin shock episodes and having to be there every twelve hours without fail. My lifestyle is definitely going to change.
Saturday, July 22nd, 2006 03:47 am (UTC)
Many veterinary assistants also pet-sit and know how to give injections. Would be good to interview some whom you might be able to call on when you're not going to be available.
Saturday, July 22nd, 2006 04:22 am (UTC)
Mmm, good idea. Last night I thought of the pet sitters I usually use and thought "I'll call them and ask whether they've ever cared for a diabetic cat." Then I didn't. Asking at the vet's office is a good thought. Thanks.
Saturday, July 22nd, 2006 01:34 pm (UTC)
Our vet has a pet sitter they recommend who does shots and meds and handles diabetic cats. Definitely check with your vet.
Sunday, July 23rd, 2006 04:03 am (UTC)
I'll do that, once I switch vets to one in my area. (SOME things at least are going to get easier. No more 25-minute-one-way trips to the vet's!)
Saturday, July 22nd, 2006 01:32 pm (UTC)
You're right about lifestyle changes. One thing we learned, however, was that bringing Athena to the vet upped her stress level and her sugars, and also she was demon kitty and they couldn't give her shots. After a while they recommended that three days for the weekend alone in our house, as long as someone fed her at least once a day, would be alright.

We fed her twice a day, not always exactly twelve hours apart, but as close as we could get it (like 7am over breakfast and 7pm over dinner).

We gave her the shots while she was eating, once we'd experienced her first low blood sugar from her turning up her nose at her food. So we always made sure she was eating well before giving her the shot after that.

Speaking of food, we started out with special food from the vet, but since Athena wouldn't eat it, that didn't work, so we switched to nine lives. We have a WONDERFUL vet and she agreed, if we're doing insulin, and the cat's not eating, the food's not working. So she didn't try to argue us back into the special kitty food.

Yes, we always did the scruf. Real easy, just tent it up, slip the needle in, cat doesn't even notice. I was real wiggy about it at first (because I was diabetic and insulin controlled during my first pregnancy and I HATED it) but it got easier and I always remembered to end with putting the cap back on the needle (so I didn't prick ME) and scritching her for a little while to keep her motor going while she ate. Because grey & white kitties (at least all the ones I've known) seem to need their motors started in order to eat properly. *grins*

We never varied placement -- I know you do on a human, but we weren't given any other places because cats are so, well, small compared to us and hard to see much under the fur!

Low blood sugar. *shudders* I have to admit, low blood sugar is the worst part of it. Depending on your cat's diabetes, it can manifest in different ways. For my mom's cat Gila, she would start pacing around, looking a little loopy, a half hour after the insulin. For Athena, if we missed that, she would go quickly into crash state... limp and very scary. We kept a medicine syringe (of the sort one uses to squeeze meds into an infant's mouth) for Athena, labeled with her name. We would load it with clear corn syrup and squeeze it into her mouth to give her a sugar rush. If needed (for Athena, usually, for Gila, rarely) we would then get her to the ER for fluids and more food and stuff. Oh! Also keep baby food meats around. Cats will tend to eat those when they're eating nothing else.

Let me add that Athena was a pretty brittle diabetic. Most cats aren't as brittle as her, however, it is possible that cats can spontaneously NOT be diabetic. Yes, literally. Gila stopped completely.

When I say insulin wasn't working, it's because Athena was so brittle. She was having an OMG FREAKING LOW blood sugar episode about every six months. We realized we couldn't handle it. I couldn't handle rushing to the ER anymore. *wry smile* So we monitored her fluid intake as a way of monitoring whether her blood sugar was high or not, and went for high protein, low carbohydrate foods (at the time, certain nine lives foods were best).

We had the world's best vet ever. So wonderful that honestly, were we to have another cat, we might go back despite the fact that they are 30-40 minutes from us. I mean, they were wonderful. The sorts who when you say "this isn't working" they say "okay, we'll change the plan". We had a rough time with all three of our cats, for varying reasons, and these people were with us all the way through every high and low. Their focus was on the cat, and on making sure everything was right for her. If what they said wasn't right, they changed it. *happy smile* Wonderful people.

One last thought. Make sure you do insulin early in your wakeup so that you're there for an hour or so after she takes it. So you can be sure she's in good shape. And most of the time she will be. Diabetes is a tough disease, but for most cats it works out. I hope it works out well for Duchess!
Sunday, July 23rd, 2006 04:02 am (UTC)
I like the "shot while eating" idea. That's a good way to make sure she at least HAS enough food to go with the insulin.

Duchess is gray and white too. That part made me smile. I will have to make sure her motor is running properly. :-) :-)

The website I looked at also recommended Karo syrup for sudden low blood sugar incidents. Two votes is enough for me. I'll have to get myself some of that right away. If she's going to get a mis-estimated dose it's likely to be early, when I'm still a total goober. Thanks also for the tip about baby food! That could be very handy.

Gila stopped being diabetic completely? That's amazing! How did you know to stop giving her insulin? Sugars consistently under control with lower and lower doses? Did she stay not diabetic for a long time?

That hour or so in the morning is going to be tough. Right now I'm usually out the door ten to twenty minutes after rolling out of bed. Shifting the sleep schedule won't work unless I ditch Rob (*wry smile*), so I guess I'll just be showing up at work later. I will probably cancel the YMCA membership because there's no way I'm going to swim in the mornings now.

Thanks for all the information! This is very helpful. I had no idea you could vary things as much as you did with Athena. That's reassuring in a big way.
Sunday, July 23rd, 2006 04:20 am (UTC)
Teenie was a tuxedo cat, and I had her at the same time as my folks had Baby (another tuxedo cat). They were scarily similar in some parts of their personalities!

It's not just the mis-estimated dosage... sometimes their sugars just vary (just like humans) so they need more food to counteract. Except they don't understand what's going on like we do. *wry smile*

Oh, and I thought of something else as a suggestion other than the Karo. When I was diabetic myself, the doctor told us to buy tubes of the frosting gel (which is basically colored corn syrup) because then if I went into insulin shock, it was pre-prepared in a tube and Kev would be able to just stick it in my mouth. I don't know how that would be for cats, with additives, tho.

And yeah, Gila stopped being diabetic pretty much completely. My mom caught that she was going low blood sugar more and more, and when they retested her at the vet she was steady, so she just went to diet. One thing that is frustrating is that at least when we did it with Athena, there was no blood sugar testing at home. Which means it's all guesswork. And watching. I kept wanting to use my own test kit on her, but figured I'd likely get a hand torn off if I tried it!

You'll find a way to get the schedule worked around. It took me some time, and I was extra extra careful at the beginning. You'll need to learn her patterns. One hard thing with multiple cats is making sure that the right one eats the right food! But once you and she both get used to it, you'll get something of your schedule back.
Sunday, July 23rd, 2006 10:03 pm (UTC)
Yeah, the variation in their sugars is what I was thinking of when I said a mis-estimated dose. I'm likely to be less aware of signs and signals early on, plus she'll probably be varying more.

I like the frosting gel idea! I suspect an additive in the gel would be a lot less of a problem than slipping into a coma due to no sugars, and I'd hope to avoid using it often. I'll ask my vet whether that's an okay infrequent substitute.

I get the impression that some vets are supportive about home testing of a cat's sugars -- and that it's done with a human kit. One web site recommends getting the blood droplet from the ear. Poor kitty!

If I'm "monitoring" her for an hour, can I, say, hop in the shower for ten minutes during that? How critical is it? How about if she's in the bathroom with me and I can stick my head out the curtain? The ability to shower and dress *while* watching her would really help.
Monday, July 24th, 2006 12:24 am (UTC)
Yep, human pharmacy. But without human insurance. *wry smile*

For the monitoring, yes, you can definitely take a shower and go about your normal stuff and just keep peeking at her periodically.

I could see the blood testing working with a normal test kit. Kitty levels are different than human levels. Well, actually they aren't, but it's harder to get a kitty into the optimum place without rising low blood sugar, so at least for us, we were told to expect her to run a bit high regularly.