Conference misery::feline

    I've seen article about diabetic cats in the various cat magazines.  If
    I can find any I'll send you a Xerox.  Basically they were very
    positive about life expectancy with the proper treatment.
    

    Hi Karen,
    
         Thanks, I'd really appreciate that.  I feel so bad for Loki,
    "sticking" him every morning.  The last two mornings he's mewed when
    I've "shot" him; I think he's starting to develop sore spots even
    though I try to rotate where I inject him :-(
    
    					- Andrea

    When i get a shot of novacaine at the dentists, the assistant usually
    rubs the gum a bit afterwards.  Just an idea.  Or you might recheck
    with the vet to see if you're giving the shots correctly.
    

    Yup, I agree with Karen, however rub the spot before too.
    This is what my doctor and dentist does. They rub quite
    hard before and it sort of stimulates the area and gets
    the blood going to accept the needle better.
    
    I admire you for the effort you are putting forth to keep
    your kitty alive.  
    
    Barbara

    Our oldest cat Peppi (aka Fatcat and Horse) has been on insulin since
    last March - 5 units a day.  Before he was diagnosed, he weighed 18 -
    19 lbs (hence the nicknames) but he's a big cat at about 38 inches from
    nose to tail-tip.  He dropped down to 12 lbs, but has recovered to 16 -
    17, which sometimes makes finding enough loose skin for the injection a
    bit of a chore.  Being mostly Siamese, he's a real screamer, but rarely
    ever cries about the shot except for a greeting.
    
    We always show him the needle before shooting him so there's no
    surprise and he's gotten so cooperative recently that he shows up from
    wherever he's been sleeping every day at shot time.  On rare occasions,
    he's made a pass at biting my wife while she's giving him the injection
    (hasn't happened to me), but no serious damage has been done.
    
    Peppi's about 14 years old and our vet is quite positive that he'll be
    around for quite some time.  He did have two seizure-like episodes not
    long after we began the insulin treatments, but the vet felt these were
    related to an infection and initial stress from the shots and not a
    diabetic reaction.  I have a close friend who's been a diabetic since
    childhood, who's never had a reaction like Peppi's (though I'm not sure
    that would be a valid comparison).  Our vet did warn us about exposure
    to other cats and stressfull situations, since diabetic cats are
    (apparently) more susceptible to infection.  Pep's been an indoor cat
    for years, so the vet thought he may have picked something up at the
    clinic while they were establishing the dosage (vet treated him at no
    charge on that occasion!).
    
    Frankly, I wasn't overly enthusiatic about this at the start, but it
    quickly became part of our daily routine.  By way of compensation, I
    guess - aside from still having the purring monster around - are the
    priceless reactions we get from first-time guests with the question,
    'Honey, are you going to shoot the cat tonight, or should I do
    it...'!!!

    Re. .3 & .4:
    
         I tried rubbing the spot before I shot him this morning, and he
    didn't make a sound.  Hopefully that numbed it a bit for him ... I'll
    keep doing it and see how it goes.  Thanks for the suggestion!
    
    Re. .5:
    
         So far, no reactions from the insulin or diet.  My vet has us
    giving the injection first thing in the morning after a urine test
    (Loki's being really good about urinating first thing now), then an
    hour-long feeding, then another hour-long feeding 12 hours later with
    no shot.  Sounds like your schedule is to give the shot at night.  (I
    like the comment "who's going to shoot the cat" 8-) 8-) 8-) !)
    
         I'm going to ask the vet why the hour-long feedings are better
    than snacking all day.  I would think, like a human being, the goal
    would be to have a constant level of sugar rather than "spiking" it
    twice a day, but perhaps felines react differently than us ...  
                                                        

    re: .6  You're right, we give him the shot about 6:30PM.  One of the
    reasons for this was to make it convenient for the vet in case we had
    to board Peppi (as well as the fact that handling sharp objects first
    thing in the morning has never been a goal of mine!).  One of the few
    problems we've had with this is the need to maintain the medication
    when we're out of town - there are no boarding facilities except for
    the animal clinic that will give the shots.  Our vet has said that
    missing one or two days is less damaging than the stress of being
    boarded (Pep starts moaning as soon as he's put in the car), but more
    than that is dangerous.
    
    In regard to feeding: we also started out on the every-12-hour
    schedule, but that didn't last for long and as mentioned in the my
    prior note, Pep's gone right back up to his 'normal' weight and
    activity level.  Before we gave up on the schedule, he was screaming at
    us constantly and trying to get to our other cat's food which we'd
    placed up high (the old boy really can't jump much anymore).
    
    One thing that perhaps ought to be mentioned for folks who might be
    facing the same situation is that the medication is quite low in
    expense.  Our costs are about $30 for about 4 months worth of insulin,
    needles and testing papers - that's less than half the cost of cable
    for the same period and the cats are much more fun to watch!

    Let's see if I can remember my nursing school training here.  
    
    Diabetes is the inablity of the body to get sugar from the blood
    into the cells for use as energy.  Insulin acts as a sort of key,
    unlocking a door to the cell and allowing the sugar through the cell
    membrane.  
    
    Insulin is produced in he pancreas and in "juvenile onset" diabetes
    in humans, the pancreas fails to produce insulin at all. 
    
    Sugar builds up in the blood stream, unable to be used by the
    cells.  Meanwhile, the cells still need to keep functioning and
    the body starts burning up its stores of fat.  That's why weight
    loss is one of te prime symptoms of diabetes.  Since carbohydrates
    (sugar) are necessary for the correct metabolism of fats and since
    the cells can't get any due to the lack of insulin, the fat is
    improperly metabolized resulting in the production of "keytones".
    These can be detected in the urine and in a human in severe cases
    by a fruity smell to the breath.  
    
    Diabetic coma is the result of very high blood sugar
    levels.  (HYPERGLYCEMIA)
    Insulin shock is the result of very LOW blood sugar levels as the
    result of too much insulin or not enough food or an improper schedule
    of food and insulin.  (HYPOGLYCEMIA)  One symptom of low blood sugar 
    that many of us have experienced is "the shakes" - you feel weak, 
    light-headed and shakey.
    
    Diabetes effects the circulatory system in a negative manner.  If 
    uncontrolled it can result in the loss of sight, in kidney impairment
    and other significant problems.  It adversely effects healing and
    diabetic patients must be very very careful if they get cut or injured
    in any way.  I assume this goes for cats too.  Diabetics just don't
    heal as well as non-diabetics.  
    
    Conditions that can effect the insulin/food balance are stress,
    illness, and exercise.  
    
    I remember that I was just amazed when learned how extensive diabetes
    is.  I hope this helps anyone who has to deal with a diabetic cat
    (or person :^)
    
    

    Re. .8 
    
         Great stuff, Nancy!  Thanks for the medical info!
    
         Loki went into the hospital today.  His blood sugar has been going
    up and up, and even though we've increased his insulin his blood sugar
    hasn't been cooperating.  He's been eating more and more (my guess as
    to why the level goes up), but that's not really normal as he isn't
    losing any weight at all.
    
         He's in for regulation until Monday, then on Monday his vet comes
    back and she'll do an x-ray to make sure that there isn't something
    (tumor, cancer, etc.) wrong with the pancreas itself.
    
         It's only been 4 hours and I miss him already!
    
    					- Andrea

         Oh, one other thing.  Eli Lilly is discontinuing the PZI insulin
    that Loki's on now.  The vet is also going to convert him to another
    kind of insulin, as long as he's there.

    The Kal Kan breeders program includes a newsletter called the Breeders
    Forum.  This issue of the Breeders Forum has an article about
    Diabetes Mellitis in cats, and controlling it with insulin.  
    
    Jo

    Hi Jo,
    
         Could you please send me a copy of it?  I'd really appreciate it!
    
         Thanks!
    
    					- Andrea

               <<< MUTTON::USER2:[NOTES$LIBRARY]FELINE.NOTE;1 >>>
           -< Meower Power - Where Differing Opinions are Respected >-
================================================================================
Note 14.82                   Introducing the FELINES                    82 of 82
HOTWTR::JOHNSONLO "Lori Johnson"                     64 lines  24-JUN-1992 17:24
                         -< Meet Bacardi, a survivor >-
--------------------------------------------------------------------------------
Bacardi, turning 15 in human years in September, has been
my constant companion since I picked her up at the Humane
Society during my junior year of college.  She was 6 weeks
old, and part of a litter of 6 that had been dropped off
the day before.  

She's a Siamese-Tabby mix - mostly white, also brown, black
and tan, with a black ringed tail.  Sporting pale blue
Siamese eyes, her meow becomes more Siamesey as she gets
older.

Joining me at a mobile time of my life, she loves riding in
a car - even purrs.  When she was smaller, she'd ride on
my shoulder, to the delight of any kids passing by in other
cars.  As she got bigger, she still insisted on perching
there - I still haven't a clue how her back legs were 
hanging.  She was a bit miffed when I went to high-backed
seats.  Being older and wiser now (both of us), she is secured in a
carrier strapped in with a safety belt at all times.

Four years ago she became extremely ill and was diagnosed
with diabetes.  The stand-in for my vet that day explained
in a ruthless manner that the odds of her survival were practically
nil as it was difficult to stabilize insulin levels for cats
because of their metabolism and size.  I could barely drive home, 
clutching the skin and bones of my sick kitty.  

The symptoms hit rapidly - increased water consumption, indiscriminant
urination and increasing lassitude.  I was suspecting a behavioral
problem, not a physical one, because of recent changes in her 
environment.  I know more now.

She was hospitalized for 10 days, then came home with instructions for
two insulin shots daily at 12-hour intervals after being feed.  She
curled up inside my armpit that night, with a rattling purr shaking
her 7 lb frame (down from 11 lbs).

I kept a diary of her eating habits - setting the food out until she stopped
eating, then giving her a shot.  Oh yes, and the twice daily urine 
tests for sugar level were also logged.  Over a four-month period, her
insulin need declined, but my life had changed drastically to meet
the schedule for feeding and monitoring her.  With close vet supervision,
the injections dwindled to one-per-day, then one-per-week, to none at all.
The explanation offered by the vet was that a prescription diet was
helping control the problem, but somehow or another her pancreas
began producing insulin again - something unheard of in humans or dogs.

Bacardi still eats prescription food - which I leave out for her at all
times.  I watch her weight carefully and her water consumption.

Basically, I've lost her once (curse that insensitive fill-in vet for
some of that anguish), and feel I've been blessed by the additional
years we've had together.  As she grows older, I appreciate the time
even more.  Even the annoying paw in my nostril at 5 am when she 
feels it's time for breakfast.

Didn't mean to rattle on about her illness, I thought that was out
of my system.  Moderators:  Perhaps this should be cross-posted or
moved to the Diabetes topic?

Lori
Who-just-discovered-this-topic-last-week

    Hi Lori,
    
         Bacardi sure is a survivor, just like Loki.  Apparently this
    "diabetic reversal" is not an unusual occurence - Loki went through one
    already.  He was diabetic, then "cured" himself, and is
    insulin-dependent again.
    
         Other than congratulations for taking such good care of Bacardi, I
    suggest that you monitor her urine sugar two to four times a month. 
    This is how we caught Loki's recurrence, and we were able to catch it
    and put him back on insulin (he's permanently on prescription food)
    before he went through drastic water/weight symptoms again.
    
    					- Andrea

Thanks Andrea,

I meant to post this sooner.  I'm following your advice,
especially since I switched perscription foods two weeks
ago from Science Diet R/D to M/D.  I know she's in
remission, not *cured*.   I just can't imagine my life
without her, although I also know I have to face her
*felinetality*.  I also will not watch her suffer, and
know eventually, I will be involved in making that call.

Bacardi's last check up (a month ago) was great, but she's
clocking in at 9.8 lbs, down another pound from last year.
This mitigated the switch in food.

I have another demon to deal with here too...she needs to
have her teeth cleaned - plaque under the gums - deep.   He
scraped as best he could, but she's rather wild about
someone poking around in her mouth.  Her vet is advising 
me not to do it because of the risk of anesthesia at her 
age with the diabetic complication.   

Maybe I should get a second opinion.  I was considering
waiting another month - to see what, if any, complications
may arise from the food switch, then taking her to another
vet for a blood work-up and consultation on the tooth-cleaning
situation.  I'm saving the $$ for this now.

She'll be 15 in 11 days and I know the diabetes has impacted
her overall health and aging process.  Another tough call.
Sigh.

Lori

PS.  Urine tests are consistent and *normal* - so is Bacardi.

    I think brushing doesn't help when plaque is already established,
    but as a preventitive measure.  My Sweetie now lets me brush his teeth.
    Little Bit lets me if he feels like it, and Holly says "No way."
    
    Sweetie really likes the GelKam flavor (bubblegum),I really think that
    makes a difference.  He thought the Grape was Evil.  However, these may
    contain sugar, so I'd ask your vet about whether they do or not.  (I
    got it from the vet.)
    

         In Loki's case, at least so far, having diabetes hasn't really
    impacted his life.  He plays with the other cats, eats, drinks,
    eliminates, sleeps, just like a normal cat.  In fact, if you didn't
    know he was diabetic, you'd never know he had a problem.
    
         He's only 11, but I fully expect him to have another 9 years at
    least 8-) !
    
         Feline diabetes is no longer the "terrible" thing it was even 
    5-10 years ago.  Certainly it is something to watch, but I think a
    feline diabetic can have just as normal a life as a human diabetic. 
    Maybe more - since I control his diet, he can't "snack" ;^) !
    
    					- Andrea

    Fluffy, our senior (14 years) cat, has some puzzling symptoms that have
    us thinking about diabetes.  She seems to eat well, but she's also
    losing weight.  (Not sure how much, since we've never weighed her.) 
    She begs for food all the time, which is new behavior for her.  (She
    does have to compete for food with a younger male who's pretty
    aggressive at meal time.  However, that's been the situation for four
    years, and Fluffy gets her share.)  They mostly eat Nine Lives, but
    Fluffy gets additional dry food when Pilou's not around.  (It's Hill's
    W-D, I believe - Pilou just throws it up, which is why we don't feed it
    to both of them.)
    
    In the last couple of weeks, she's also taken to drinking water from
    odd places.  She's always been a faucet drinker but now she licks the
    side of the basin, hops into the tub after I shower - any odd water she
    can get at.  (She always has a bowl of fresh water available - she
    doesn't seem more interested in that than usual - it's just the more
    interesting sources she's after.)
    
    She seems to be completely healthy - energetic, affectionate, curious. 
    With her weight loss, she's able to (and does) jump onto the kitchen
    counter for the first time in years.  No lethargy here!  But she
    demands attention and food more insistently than a few months ago.
    
    I know cats hide physical problems very well.  Do we just have an
    eccentric old lady here, or is it vet time?  
    
    Thanks for your opinons,
    Andy

    
    Andy I suggest it's vet time!!!  the symptoms she is displaying is
    very similiar to the symptoms we saw in my sister's cat who is
    also 14 years old.  (constant hunger, energetic, losing weight).
    
    My sisters cat was diagnosed as Hyper Thyroid which is a very treatable
    disease but could be very dangerous if it is not taking care of.  
    Normal range is somewhere between 3.5....but Mitzi was 10.5!! 
    
    It also sounds like it could be diabetes as well...so I think it's
    vet time!!!
    
    Sandy

    Hi Andy,
    
        Sounds like diabetes, especially since she seems to be feeling
    energetic otherwise.  But I echo Sandy ... best is the vet!
    
    					- Andrea

    Thanks for the quick replies.  Sounds as if some early intervention
    might prevent a lot of heartache later on - I'll take her in.
    
    Andy

     From the diabetes notesfile ...

================================================================================
Note 94.0        Humilin Insulin soon to be only type available          1 reply
--------------------------------------------------------------------------------
    Just got back from my doctor today and heard that after September 
    pharmacies will no longer be selling any insulin other then 
    Humilin type.  Any diabetic old timers out there who are taking 
    beef or pork insulin should probably see there doctor and get 
    switched over to humilin insulin before they go to refill there 
    prescriptions and are unable to.  
    
    I haven't made the switch yet but do have a new RX and am told that 
    the dosage will be slightly less then the pure pork I am currently 
    taking.  
    
    Just thought it might be of interested to someone else.
    
    
================================================================================
Note 94.1        Humilin Insulin soon to be only type available           1 of 1
DKAS::FEASE "Andrea Midtmoen Fease"                  20 lines   6-JUL-1993 07:28
                          -< Bad news for pet owners >-
--------------------------------------------------------------------------------
         Oh, no!  I'm going to have to ask our pharmacist if there is a way
    to get NPH Iletin, perhaps from the manufacturer or through our vet.
    
         Loki (our diabetic cat) is perfectly regulated on the Iletin, but 
    when he was tried on Humulin it was like injecting him with water - he 
    couldn't metabolize it at all!  This could be a serious problem for
    him.
    
         Gosh, I wish companies would stop screwing around with insulin! 
    First he was on the other insulin that they stopped producing (I can't
    remember the name, but it was around about two years ago).  That's when
    they tried him on Humulin and it didn't do anything for him.  The NPH
    has been working great, but now ...
    
         Does anybody know of someone I could write to?  I don't know what
    human diabetics reactions to Humulin are, but I do know what pet
    reactions are and maybe we pet owners could make someone listen
    (doubtful, but it's worth a shot!).
    
    					- Andrea

    
    
    	I thought it was only Lily who was no longer making beef and
    	pork insulin. Therefore beef and pork insulin are still avail-
    	able from Squibb.
    	The first time I read the notice at the pharmacy I missed
    	the manufacturer's name and was pretty upset too.
    
    
    					-Pat

    
    How is insulin "made?"
    
    

Animal insulin is extracted from the pancreas' of slaughtered animals
(cattle, hogs). No one particularly eats that organ (could be wrong)
and so it also helps to avoid waste (not much but some).

Humalin is made through DNA splicing. The human DNA for insulin production
was spliced into some bacteria (Probably E. Coli perhaps something easier 
to breed). These are then raised in vats. The liquid is then removed
and the insulin is extracted from that. The insulin is, in essence, an
unintentional waste product of the cells.

Thanks,
Keith

My cat has recently been diagnosed with diabetes.  Aside
from being very worried, I'm trying to get control of the
situation.  He was in the hospital for four days - coming
home with orders for 4 units of insulin twice a day (he's
a big cat.)  The vet, however, was not sure that we had
zeroed in on the proper dosage, so I'm trying to help
figure it out.

Does anyone have advice on testing urine.  How and when
do you collect it?  What happens if you work all day?
Also, our other cat is in at night and shares the
litter box at night.  I would like to log the blood
sugar level's as soon as possible, but am finding it
hard to "catch" Caper in the act.

Nancy

         Gee, Nancy, that's kind of a tough one.
    
         Loki usually goes about the same time every night and every
    morning, and since I only have to "catch" him once a week I sometimes
    let him pee without rushing up with the testing strip ;^) .  That way
    he can relax a little and not think he's under "surveilance" all the
    time - that makes him want to "sneak" his pee's.
    
         I think there are special litters that will test glucose?  If so,
    you could put him in one room with the special box until he goes (I
    know it sounds cruel, I wouldn't want to do it with Loki either, but
    sometimes Moms have to be tough ;^) ) and then check the glucose that
    way?
    
    					- Andrea
    
    P.S.  With Loki I just hold the strip under his urine stream.  I don't
    know if most cats would allow that much intrusion on a private act,
    though ...

    Since this note hasn't been used in a while I thought I would see if
    any of you had some advice for a guy in my group who's 15 yr old flame
    point was just diagnosed with Diabetes.  He is extremly upset as he had
    this kitty since it was a kitten and before he got married.  The vet
    said that the kitty should pull through and be fine, but he will have
    to give it insulin shots twice a day.  He is not worried about giving
    the cat the shots.  His main problem is that he also has one other cat
    and a dog and he is not sure how the sick cat will take to the
    environment since becoming ill.
    
    Any help or suggestions will be helpful and I will relay them to him.
    
    
    Thanks,
    
    Liz

    Has the kitty been with the other dog and cat before the illness?
    If so, I would think there would be no problems just because
    he's come down with diabetes.  I would suspect that a sudden
    change, such as introducing a new cat or dog, would be more
    upsetting than the dog and cat he's used to.  I've never heard
    of other cats or dogs reacting negatively to an ill animal, other
    than some hissing when they've returned from a stay at the vets
    (they smell different).
    
    Tell your friend the best of luck.  I give him credit for being
    willing to go through the shots - some non-animal people wouldn't 
    think twice about putting a diabetic cat down.  
    
    Pam

    My 15 year old Jimmycat was diagnosed with diabeties right before
    christmas. He gets two shots a day (6 units) and he is back to his old
    self again, and is remains in his same place in the cat hierarchy, and
    had no problems when we adopted Zoe (they hang out togeather). In fact,
    I'd say he has more spring in his paws now than he did a year ago. The
    only problem your friend might have is if the cats were used to being
    free-fed; Kitty must get measured amounts of food, and only immediatly
    after recieving the shot. ABSOLUTELY NO BETWEEN MEAL SNACKS!
    
    Also, it is important to regularly monitor your cat's glucose level on
    a schedule that your vet suggests (Jimmy's blood is tested the first of
    every month, and I randomly test his urine with those little strips you
    can buy in the drug store.)
    
    good luck, and if your friend has any questions, please ask.
    Deb 

    one other thing; Jimmy realizes that he can't eat until he gets his
    shot. I can even put his food out infront of him and he will hold off
    until I inject him. He has this cute little look on his face as if to
    say to me "hurry up; I'm hungry!"
    
    Deb

         I can second what Deb said.  Loki has had diabetes for 2 years
    now, with no ill effects, and he gets two shots a day (4 units in the
    morning, 3-1/2 at night).  He has had no problems with our other pets
    (some of whom aren't feline!), and the other pets have no problems with
    him.
    
         Please tell your friend not to worry, everything will work out
    just fine.
    
    					- Andrea

    Yesterday, I had an afternoon doctor appointment, so I got home about
    an hour and a half earlier than usual. Thank goodness I did. There was
    no Jimmy to greet me, but I did find a large pile of cat vomit on the
    dining room rug (it looked like a combination of his w/d and the whiskers
    that the younger cats eat). I found him in the sun room, very lethargic,
    and dehydrated. Need less to say, we raced to the vet. His blood sugar
    was only 50. They pumped 250 of lactated dextrose ringers into him, and
    he seemed to become alert, and he started eating. The vet said that it
    was good that I found him when I did.

    Anyhow, to make a long story shot,the vet said that if this happens
    again, force 1 to 2 teaspoons of Karo syrup into him (he is 13 lbs; it
    may be less for a smaller cat). It would have been OK for me to to give
    him lactated ringers *WITH DEXTROSE* (and is probably what I should have
    done first, but since it had sugar I was not certain). Anyhow, he seemed
    OK this morning, but is going in for his monthly glucose checkup
    tomorrow.

    I guess my point in posting this is that with the weather so warm right
    now, a vomiting cat can dehydrate quickly, and you have to be especially
    careful if the cat is diabetic.

    Deb

    Having a Diabetic son, I was wondering if it might be easier for you to
    give your cat some Cake frosting (gel variety) which comes in small
    tubes.  It would be easier to get into the cats mouth I would think.
    This is what they recommend for humans.  It is also recommended to
    always treat for a LOW blood sugar as this comes on much faster and is
    quicker to put the diabetic into a coma.
    
    Check with your vet though!
    
    Linda

    Thanks; I'll ask the vet. Basicly, I was going to put the syrup into an
    oral syringe, but the tube frosting sounds like a good idea (and you
    avoid wasting the time of finding the syringe and loading it should you
    need it fast. I'll ask my vet what he thinks. Thanks.
    
    I brought Jimmy in on Saturday morning for his monthly glucose check
    and he was his normal perfect 79. Unfortunatly, we also found a lump on
    his neck and he had to have it removed on Monday. Putting a diabetic
    under for surgery is a bit risky. We were fortunate that the lump was
    right under the skin; they just tranquilized him, made a small insision
    and the lump just popped out. He was home within hours! It was pretty
    small, smaller than the nail on my little finger, but had none on those
    awful legs like you see on a cancer tumor. The biopsy will be back next
    week so I will just keep my fingers crossed.
    
    Deb

         Poor Jimmy; his diabetic "cousin" Loki asked me to send best wishes
    for a speedy recovery.
    
         We've been fortunate that Loki hasn't had any low-sugar spells;
    thanks for the warning about hot weather.  We do have air-conditioning,
    but when I'm not home who knows if the power has gone out, or the A/C
    gone kablooey.  I'll make an extra effort to be home early on these hot
    days, just in case.
    
         My vet had said to just rub the Karo syrup on his lips if he had
    an episode.  Tube frosting ... hmmm ... sounds a lot simpler ...  I'll
    have to ask too.
    
    					- Andrea

    Thanks. Just out of curiosity, how often does Loki have his glucose
    tested? And what is his normal reading? How old is he now? 
    
    I re-read a couple of notes and noticed that Loki's insulin has been
    adjusted a few times. How did you know that you could cut it down? Jim
    currently takes 12 units per day (6 and 6).
    
    Deb

         Loki's glucose gets tested about every 3 months.  He was on 4
    units in the morning, 3-1/2 at night but his last test was around 83. 
    The vet considered that to be too low, plus he was a little less
    energetic than usual.  So we reduced his dosage to 3-1/2 morning and
    evening.  Loki just turned 13.
    
         Seems like there are at least two different kinds of tests; when
    we were at Tufts, a normal reading was around 200.  Now with this kind
    of test, the normal reading is around 100.  I guess we'd have to ask
    some human diabetics (like the person who answered a couple of notes
    back, sorry I don't remember your name) about different scales.  Then I
    read that your vet said that 73(?) was normal for Jim - sounds like yet
    another scale (sigh).
         
         Loki seems better on this reduced dosage, so we'll just see how
    things go.  We do try to run a glucose/ketone strip under his urine
    stream 2-4 times a month to check for excess sugar; so far, there
    hasn't been any.
    
    					- Andrea

    actually, 73 is a bit low; 79-80 is what he normally goes at which the
    vet says is good. Also, Jim usually eats at 6:30 and 6:30, but when he
    gets tested, since the vet opens at 9 (10 on weekends) the fast is a
    bit longer, which accounts for a slightly lower blood sugar.
    
    Jimmy is on W/D, althouh he likes Friskies Senior and Purina Mature a
    lot better. What is Loki eating?
    
    Deb

         Loki is on a similar schedule, eating at 6:00 and 6:00 and getting
    his test at noontime.  He's also on W/D, with no treats (well, on his
    birthday he gets a little people tuna, but that's special...).
    
    					- Andrea

    great news! I just got voice mail from the vet and the biopsy results
    are in; what they removed was a BENIGN cyst!

    Deb

    Whew!  I'm so glad everything is okay!
    
    :^)
    

    Great news Deb......Sandy
    

    I asked the vet about tube frosting. He suggested that I use the Kyro
    syrup instead because kyro is a simpler type of sugar and would
    instantly help the cat. The tube frosting sugar is a bit more of a
    complex sugar and would take a little bit of time for the cats system to
    break down; not a lot, but since time is of the essence when youve got
    to do this, his feelingis why give the cat something that might take
    even a fraction of a second longer to break down? 
    
    Deb

    re: .38 ("scales" of what a normal reading is)
    
    I asked the vet about this. They explained that there is a normal
    range, and as long as the cat is consistantly at a rate within the
    range (without losing weight or becomming obese), that is a the correct
    reading for the cat; sort of analogous to a temp of 98.6F is not
    "normal" for some people.
    
    Deb

          Loki had a setback on Saturday; after 2-3 years of controlled
    diabetes, he crashed at 9:00PM Saturday night.  It was so scary, he
    started twitching and when we took him off the couch and put him on the
    floor (he was near the fireplace, we thought he might have been too
    hot), he had no motor control.  We quickly rubbed Karo syrup on his
    lips, and took him to Tufts since they were the only ones open, and we
    weren't sure if it was a diabetic shock or a stroke.
    
          When we got him there he was able to move, so we thought about
    just taking him home and working on him there, but we decided to admit
    him to Tufts just in case.  As it turned out this was a bad move (Tufts
    mismanaged his case and we couldn't get any information except "we
    don't know" about him, which was probably due to the holiday/weekend,
    but still, I'm sorry to see that we had another bad experience with
    them when we had good experiences a few years ago).  We could have just
    continued the Karo, taken him off the insulin 'til Monday when our
    regular vet opened, and kept an eye on him.  But at least we got him out 
    yesterday morning.
    
         He went straight to our regular vet, who did some testing and sent
    him home with us last night (she felt he was better in our hands than
    alone in a cage), and he's back in today for some more testing.  He's
    lost 3 pounds, so we've been unknowingly "overdosing" him with insulin,
    and that's why the crash.  He needs to be re-regulated, but we also
    need to know what happened after being steady for so long.  Tufts found
    blood in the urine, so he's on amoxy until the urine culture comes
    back; this will also help with the runs that he got (probably from
    stress) and a cold that he picked up (typical hospital - people
    hospitals do it too!).
    
         I think he'll be okay once things settle down, but the unknown of
    why this started is a little scary.  Hopefully it will be nothing ...
    
    					- Andrea

    Andrea,
    That must have really been a bad scare!!  I'm glad that you at least
    have him stabilized and at home again.  
    
    I would write a letter to Tufts if I were you.  I know they are good
    there and have up to date medical stuff, but they cannot overlook the
    fact that they need to be responsible to the pet owners too.  Perhaps
    they need a wake up call for them to realize they need improvement in
    this department.  That's too bad.
    Have a wonderful Christmas!
    Karen and all the "moonstas"

    Hugs to Loki...and you because I'm sure you were very scared.
    Let's hope you can get the insulin back under control and Loki
    can again live a wonderful normal life!!!
    
    Sandy
    
    ps..if I remember correctly the last time Loki had a set back was
    the same timeframe that Van Gogh was being operated on at Tufts
    which will be three years in January!!
    

    Andrea,
    
    A couple of things. First, when a cat has a fevor, they can be insulin
    resistant (they won't respond to the insulin so their sugar level goes up).
    
    Second, I am friendly with the animal officer in Waltham. They have a
    14 year old female (Oedipuss) as the pound mascot (who incidently looks
    just like my Jimmy; I wouldn't be surprized if she was Jimmy's offspring).
    Anyhow, she was diabetic, was getting 2 units twice a day for a
    couple of years. All of a sudden she started needing less; now she
    doesn't need any at all. It is almost like her pancrease kicked in and
    started working again.
    
    Finally, last Aug I had to change insulin brands; Lilly was phasing out
    pork/beef so we had to goto Novolin (beef only). The literature said to
    going from pork/beef to beef should require no change in dosage. Jim
    didn't do real well. He started needing more. I was pretty sick at the
    time, and Jim got pretty lethargic. The Sept. day I got admitted to the
    hospital, I fought with my doctor and got a 1 hour reprieve to bring
    Jim to be boarded at the vet (I've never taught my friends that catsit
    how to do the injections.). Something told me to tell the vet to check
    his glucose first. It is a good thing I did; His blood sugar was around
    50.  Another shot and he'd have gone into a coma. They shot some Kayro 
    syrup into his mouth (via oral syringe) and he got some lactated ringers
    (saline and dextrose). Anyhow, the vet spent the week restabilizing Jimmy,
    and he now only takes 2 units. (I might add, Jimmy was the "star boarder" 
    when he was there. He had the run of the clinic, and was sleeping on
    the vet's desk. :-) )
    
    My vet is real good with diabetes (he is a dibetic himself). Apparently,
    it is real common with a diabetic cat that needs insulin shots to someday
    not need them at all, or at least only needing a drasticlly reduced
    dosage. Anyhow, that is one of the reasons that he likes to check
    glucose at least once a month, so that if a change is brewing, the cat
    can be stabilized earlier). I've heard a lot of vets usually think that
    it suffices to check it quarterly. 
    
    set flame/on
    I can't get over that tufts didn't have any info to give you. It only
    takes a couple of minutes to run a blood or urine test for glucose!
    set flame/off
    
    
    I hope everything is OK for Loki,
    
    Deb & THE FIRM
      

         Loki had no fever; do UTIs come without fevers?  We're still
    waiting on the bloodwork/urine culture to figure out what happened.
    
         Sandy, I think Loki was diagnosed with diabetes at the same time
    you had Van Gogh in.  Van Gogh has really been doing great (give him a
    hug for me ... maybe he'll like Capone better when the time comes ;^)
    ).  Tufts did great for Bigfoot 5 years ago, but I would never send him
    back there now, and that's disappointing to me.
    
         Thanks for the info, Deb!  Loki has been off insulin once, about
    six months after he developed diabetes.  He stayed off for almost six
    months, then went back on it and stayed for the past two years.  I
    think he needs to be re-regulated since he has lost so much weight -
    3-1/2 units twice a day was good for him at 15 pounds, but at 12 pounds
    it's just too much.
    
         Loki came home last night and ate like a piglet ;^) .  He's home
    today to get back to routine (no insulin), and then goes in tomorrow
    morning for a blood test after a "normal" day of eating.  I think he's
    still got the diabetes, though, as he drank a ton of water this morning
    and cried from midnight on for food (diabetes makes you feel like
    you're starving).  I don't mind - I've been doing injections for so
    long, it's routine (in fact it feels weird to feed him with no shot
    ahead of time).  I just want him stable again, poor little orange
    tabby.
    
    					- Andrea

    Andrea, 
    
    I made a slight mistake; I meant to say infection rather than fever.
    Usually infections cause a fever (eventually).
    
    One other thing; When Jimmy got re-regulated, I wound up bringing him
    in for glucose tests 2x week, then once aweek for about 1.5 months, then
    back to his regular monthly check. Bascily, the vet wanted to make sure
    that the dosage was correct while he was re-gaining his weight. (Jim
    went from 13 lbs down to about 10.5) Also, since we estimate he is
    about 16, we wanted to be especially careful.
    
    Out of curiosity, what does your vet charge for a glucose test? We pay
    $10 and no office visit fee.
    
   > long, it's routine (in fact it feels weird to feed him with no shot
   > ahead of time).   
    
    I know what you mean; I can put food in front of Jimmy and he won't eat
    until he gets his shot; considering that a diabetic cat is usually
    ravinous at mealtime, coupled with how long Jimmy was feral and never
    knew where his next meal was coming from, I think that this is an
    amazing behavior on his part. It is kind of like he is reminding me that
    he needs his shot. 
    
    
    Good Luck!
    Deb & THE FIRM

    Hi Deb,
    
         Same with us, $10 for the glucose test and no office visit
    (although she tends to really undercharge - if we do so many tests she
    drops them to $5 each!).
    
         Since Loki was stable for so long we were doing glucose tests
    every 3 months, and then went to every 6.  That was probably a mistake;
    I think now we should go no longer than 3 months, and probably monthly
    once he's stable until he gains his weight back (which I know he will,
    he *likes* 15 pounds ;^) ).
    
         Blood test this morning (hubby is taking him in), and then we'll
    see from there!
    
         Thanks for the support, everybody!
    
    					- Andrea

    Andrea, how is Loki doing?
    
    Deb

    Hi Deb,
    
         Holding his own right now.  All of his urine tests are negative
    for glucose.  However he does seem to have less of an appetite, so he
    might be going low-sugar instead of high.  He's got an appointment for
    next week for another glucose test, and we'll go from there (we were
    going to do it tomorrow, but it looks like nasty weather tomorrow
    morning ...).
    
         Thanks for asking - I'll let you know when I get some results!
    
    					- Andrea

    good luck, and let me know what happens. Jim's appitite changed a bit
    for a couple of days when it got cold; what surprized me was that he
    was leaving food instead of inhaling it. I found that feeding him
    boiled chicken breast (@$2.99/lb) seemed to bring his appitite around.
    
    Deb

         Well, both Loki and Bigfoot went to the vet for their checkups and
    they both came out with flying colors.  Loki's sugar is 159.
    
         Maybe I'm just not used to a chowhound who isn't chowing ;^) . 
    Anyway, his weight is 11-1/2 pounds; we'd like to put a pound or so on,
    but not up to the 15 pounds he used to be.  Maybe if we keep his weight
    down, his diabetes won't flare up again ;^) .
    
    					- Andrea

    Glad to hear that the checkups went well. 159 seems a bit high but it
    is in the normal range (Jimmy tends to run 80-100). I knw that when
    Jimmy's glucose count was high, he didn't feel like eating; may he
    needs the insulin adjusted a tad more?
    
    Deb

         Right now Loki is on *no* insulin ... I guess we'll just wait and
    see ...
    
    					- Andrea

    How is Loki doing now?  Sweetie is in his second (or third?) long
    remission and hasn't had to take insulin for some time.  He gets a
    blood test every six months now (after much more frequent ones
    while he was stabilizing), unless I notice his water drinking
    going up.  All my kitties are on dry CD or WD to keep their weight
    down.  Changing to the dry food also made a huge difference in
    how often they need their teeth cleaned, which used to worry me
    no end, esp. with Sweetie's respir. condition.  He is doing really
    well all around.
    

         Well, Loki's still off insulin, in fact he now has *low* blood
    sugar and needs to eat continuously (which he likes 8-) ).  He's had a
    complete blood panel, including thyroid, but everything is negative.
    
         He is at 11 pounds and holding, which we still feel is too low. 
    We want him to gain *1* pound, but so far he doesn't seem able to.  At
    15 pounds he was a bit too hefty, but at 11 he looks just too lean.
    
         Don't know how long he'll be this way, or if he'll swing back to
    having high blood sugar.  Don't know what caused his pancreas to
    re-activate; what caused his pancreas to shut down in the first place
    is a mystery.
    
         But he's doing fine, and I'm glad to see Sweetie is too!
    
    					- Andrea

    Is Loki eating CD?  That's well known for porking up kitties :-)
    

         Nope, he's on a mixture of half dry food (Blue Seal Kat Kare - low
    ash) and half wet food (1/4 W/D, 1/4 9-Lives, 1/2 Friskies Senior).  He
    eats like a pig but no weight gain.
    
         Is C/D okay for young cats (Midnight is almost 5)?  How 'bout old
    cats (Bigfoot is almost 17)?
    
    					- Andrea

    The vet put my cats on CD several years ago to ward off urinary tract
    infections.  It has done that, except for Little Bit, who once every
    year or two years gets the unusual kind where crystals form but
    they aren't sure why.  Before the change to CD, Sweetie and
    Holly had a couple of bouts apiece with UTIs, if I remember correctly.
    CD is high calorie.  Sweetie was having to have MEtamucil sprinkled
    on his food, to deal with side effects of his pelvic problem.  To make
    a long story short, all three get dry CD or WD (like high fiber CD)
    or RD (like low cal WD) depending on what's happening with their
    weight.  With part of
    the diet WD or RD, I no longer have to give Sweetie Metamucil.  I
    think all three are good for preventing URIs, although I never
    doublechecked that with the vet.  They do pork out on 100% CD.  As
    far as I know CD is okay for "healthy adult" cats, but a senior
    cat might have special needs.  CD should not be used if the cat
    is already taking a urine acidifier, as that's overkill.
    
          

         Thanks for the info!  I'll have to ask the vet next week when we
    go for a checkup with Bigfoot.  She recommended the Friskies Senior,
    but it comes in small cans and it's expensive when you have 3 cats to
    feed.  Probably comparable to C/D though, I bet.
    
    					- Andrea

    Friskies Senior comes dry as well. Jimmy eats it on occasion, but
    prefers Purina Mature. He is still on 2 units twice a day, and is
    maintaining his weight. He seems to be beautifully stabilized. 

    Jimmy may soon be taking part in an experiment. Our vet is diabetic,
    and his doctor asked him if he knew of any diabetic animals that might
    be willing to take part. The vet has a diabetic dog and treats about a
    dozen dogs and cats for diabetes. Anyhow, they have developed a
    synthetic DNA that they shoot into the cat or dog's abdomen, and it
    finds it's way to the pancreas. The pancreas get a "kickstart" and
    starts producing insulin on it's own. Current experiments are working
    for 1 month, this one is to see if it will work for 3 months.
    Ultimately, this treatment will be available for humans. 
    
    Deb

    Sad news, hoping someone can help me feel better...
    Two weeks ago my sweet grey tiger cat Brutus started acting lethargic.
    It was extremely hot, so I gave him a couple of days to perk up in
    the A/C.  Nothing.  I took him in, he had a temperature to 103.7!
    He was immediately put on antibiotics while awaiting blood test
    results.  The vet was expecting FIV, but two days later called and said
    he had diabetes and to bring him right in.  He tried to stabilize him,
    but his liver failed and he died.  WIthin 10 days of looking kind of
    mopey, he was gone : (
    Sarah

    
    Sarah,  so sorry for your loss. My deepest sympathies. 
    
    Shaw

   Sarah,

   I'm so sorry about Brutus - I've added his name to the Silver Lining
   Memorial list.

   Debbi

    I'm so sorry about Brutus. It is so hard to loose a good friend.
    
    Deb

         Sarah, I'm so sorry to hear of your loss.  Sometimes these things
    happen so quickly, it's hard to believe.
    
         My sympathies ...
    
    					- Andrea

You have my sincerest condolances.  I wish I could do something.

    Thanks for all the notes, here and in mail.  It just seems so unfair,
    since diabetes is considered 'treatable'.  But I guess Brutus had
    business elsewhere...
    Thanks again for all the warm thoughts.  It helps : )
    Sarah

    I want to share my story about Casey with fellow cat lovers. 
    
    Casey is a short haired, tan, 8 year old male (hopefully he'll make 9). 
    Casey came to me as a birthday present 8 years ago this month.  He has
    been relatively healthy, except for an occasional cystitis, maybe 3 in
    the last 5 years. 
    
    Around Christmas time, we noticed he started losing weight.  Because he
    was 17 pounds we really didn't think anything of it, ok, he can stand
    to lose a few pounds (can't we all :)).
    
    We had a friend come over a few weeks ago and wanted to know what was
    wrong with Casey.  We then started to notice that something must be
    wrong.  We took him to the vets this past Saturday and they kept him. 
    His blood sugar, with a normal range of 80-120, was 400.   He was
    started on IV fluids and insulin.  By Monday AM the count was 234.  By
    2:00, it was down to 98.  However, something happened and by 5:00 it
    was up to 400 again.  I called at 9:30 this morning and found out that
    count. 
    
    What causes this number to change so much.  They said the only thing
    different was that he was eating.  I'm waiting for the doctor to call
    me with all the details and possible cause.  
    
    This isn't going to be a fun time, I can already tell. 
    
    Lisa Cozzens
                    

    
    
    
    Stabilizing a diabetic cat can take some time, and a lot of patience.
    
    it took a long time to stablize Jimmy (who was 16 at the time). He was
    in the hospital for two weeks, and they just couldn't stop the glucose
    count from bouncing, or get it under the mid 200s. They let me take him
    home for Christmas (a Saturday) but I had to bring him back the
    following Monday. His levels were perfect; He went back every day for a
    test for a week, and his levels were still perfect. Stress can make the
    glucose rise, and the vet felt that being away from home was a major
    stressor for him. His monthly checkup seems to be between 70 and 80
    these days :-).
    
    Are you going in to visit the cat while he is in the  hospital? It
    could make the cat feel a little less stressed. 
    
    Good luck and keep us posted,
    Deb 

    Hi Lisa,
    
         Blood sugar is a funny thing, it's influenced not only by insulin,
    but by food intake, activity and even stress.  In some cats it's
    relatively easy to regulate (like Loki was**), in others it is harder. 
    
         Once your vet has an idea of what insulin is "likely" to be a good
    dosage, you'll get to take him home and get into a routine.  Weekly (or
    even twice-a-week, depends on Casey's regulation) checks will soon
    determine what dosage is really right for Casey.  Try to get Casey into
    a fairly strict routine - in Loki's case it was shots every 12 hours on
    the dot and food for half an hour after the shot and *no* snacks. 
    You're trying to keep Casey's blood sugar steady, which means steady
    food intake, steady environment, steady insulin dosage.  Gosh I wish my
    life were as steady and even as Loki's was when he was diabetic 8-) !
    
         Diabetes can be manageable, just takes a little time until the
    regulation is done.  Please keep us informed as to how he's doing, and
    feel free to call if you need some advice/support/etc. 8-) .
     
    					- Andrea
    					  Bigfoot, Loki & Midnight
    
    ** I say "was" because Loki has been non-insulin dependent for over a
    year now.  He's also lost a ton of weight (was around 13 pounds, is
    down to 9-1/2) and can't seem to gain.  This is probably good, the
    diabetes was probably a side-effect of his heftiness.  But now we are
    in the very early stages of kidney disease.  To me, the diabetes was
    easier - we both had a set routine.  Now it's free-feed, eat what you
    want, do what you want, but I don't have as good an idea of his health
    as I did when he was diabetic.  Poor guy used to be able to have once-
    per-quarter checkups, now he has to go every month :-( .
                                                                  

    When my Sweetie first developed diabetes, the vet kept him in 
    the office for just one day to do several blood sugar readings
    during the day to get an idea of how his sugar level varied
    during the day.  From that he deduced that Sweetie needed one
    insulin shot in the morning as opposed to two shots a day.  He
    sent Sweetie home on an initial (very conservative) insulin dosage,
    then checked him about three days later (I think I brought him in in
    the morning for a test and possibly at 5 pm also -- he wasn't in there
    all day, which would have stressed him out), and adjusted the dosage,
    and we cycled like this for 2-3 weeks, with longer time intervals
    between the office visits as we reached the correct dosage.  Then
    for quite some time Sweetie was coming in once a month for one
    test in the morning, etc.
    
    After awhile, Sweetie went into a state where he didn't need insulin at
    all.  He's varied between insulin and no insulin now 2 or 3 times.
    
    My understanding is that a cat can tolerate a high reading, like 400,
    for enough time for the stabilization process to work.  (Double-check
    wih your vet, though)  I would be concerned that a cat kept in at the
    vet's for several days would be so stressed that his blood sugar levels
    would not stabilize. Sweetie's initial reading was off the scale at
    400+.
    
    Also, did your vet explain about keeping Karo syrup around in case your
    kitty ever goes into shock from an insulin overdose (this has happened
    once with Sweetie over the course of several years, when the vet was
    out of town and a vet tech did the test)?  You give the cat a small
    amount of Karo and it should revive in a few minutes.  Of course, you
    call the vet, and also if the cat hasn't revived, speedily go to an
    emergency clinic and/or increase the Karo, but the Karo should work.
    My vet also said that if this happened when I couldn't reach him, like
    on a weekend, (he was certain the Karo would work) when it came time to
    give insulin the next day, to reduce the dosage by half until Monday.
    
    Hang in there - I know this is scary.  But with proper care, diabetes
    is generally very easy to manage.  Even giving the daily shot or two
    is amazingly easy - much easier than giving a pill;  the vet will show
    you how.  The needle is tiny and goes in at the insensitive area at the
    back of the neck. You do it when the cat is eating, and s/he basically
    doesn't even notice it. For me in the morning, it takes 1-2 minutes
    to prepare the syringe, and for Sweetie it takes about two seconds
    for the injection.  He generally looks around, then continues eating.
    
    Please let us know what is happening with your kitty.
     
    

    I should have added, diabetes does require food management.  Sweetie
    and my other cats get only dry CD, and I leave it out for about
    an hour in the morning when he gets his shot and an hour or two in the
    evening.  Once a month I give them a tuna treat though.
    

    In the last three months I have gone through the same problem
    you are experiencing with my kitty Van Gogh.  Hopefully we
    now have it under control!!!  We started at 2 units once a day...
    then up to 5 units once a day...and I think we finally stabalized
    at 3 units once per day.
    
    I do want to note that part of our problem was BAD insulin..and 
    after we realized that and got a new bottle, we still had a 
    problem where I was not getting all the bubbles out of the needle; 
    therefore Van Gogh was not getting the insulin he needed.
    
    I do hope and pray we now have it under control!!!  
    
    Sandy 

    I'd like to emphasize the food mgt too. I couldbe dying, but Jimmy eats
    at exactly 6:30 AM and PM. And he requires a midnight snack which I was
    getting up at 12:30 to give him, but now he gets it at 10 PM.
    
    It was scary giving the shot at first, but Jimmy is a little trooper; I
    can put his food in front of him and he wont touch it until he gets his
    shot (sort of says "hurry up! I'm hungry!).
    
    re: bad insulin
    
    Sandy,
    
    did the bottle go from refrigerated to unrefrigerated? Or was it bad
    from the start? Jimmy's glucose went up co-inciding with a new bottle.
    The vet suggested getting another bottle from a different drug store
    and that "fixed" the problem. I brought the insulin back, explained the
    problem and they gave me my money back.
    
    Deb

    As the mother of a diabetic human child, I can offer a couple of
    suggestions on insulin...
    
    1.  It should ALWAYS be refrigerated - shelf life in the fridge is
    about 2 months - much less if unrefrigerated.
    
    2.  Easy way to get air bubbles out (this is easier demonstrated but
    I'll try):
    		Place the syringe on the correct dose and inject the air
    into the bottle.  Draw up an amount of insulin EXCEEDING the amount
    required. KEEP THE NEEDLE IN THE BOTTLE and push the insulin back into
    the bottle (along with the air bubbles).  Keep doing this until all the
    air bubbles are gone.  Then even off the insulin in the syringe to the
    correct amount.
    
    	My friend who has had diabetes for almost 20 years gave us this
    suggestion when my son was diagnosed and it works great - really saves
    on insulin AND on the frustration of having to start all over again
    because you allowed too much insulin to go out along with the air (if
    attempting out of the bottle.)
    
    Linda

    About the air bubbles, my vet said to turn the bottle enough
    to mix it, but not to shake the bottle.  Then hold the bottle upside
    down, which will tend to make the air bubbles rise away from its
    now upside down top, insert the syringe, and draw the required
    amount.  I tend to draw a bit more cause my hand is a little shaky,
    and have to munge the plunger around a bit to get the correct amount.
    Then I remove the syringe from the bottle.  I don't remove the syringe
    from the bottle until I'm at the correct amount, or I'm sure I would
    often get a too small amount and have to start over
    
    Also before removing the syringe from the bottle, I eagle-eye the
    syringe to be sure I don't have air bubbles in it;  it helps to
    hold it against a contrasting background to see this.  If there is an
    air bubble, I depress the plunger fully and start again.
    
    I have never done the thing from .81 about first inserting air into
    the bottle.
    

    The insulin is always refrigerated.
    
    Regarding Bad insulin:   Van Gogh had been on this insulin for
    close to a month and each time we went to have his blood drawn
    his reading was still pretty high. (300-450)  We had started him
    on two units,,,then three...then four...and was up to five, but
    the reading was still pretty high.  The vet suggested that Van
    Gogh spend the night and they would give them the insulin in
    the morning.  Well they gave him his normal 5 units...and his 
    sugar level plunged down to about 45; which clearly showed that 
    the 5 units was too much.   At that point the vet recommended 
    that I go buy new inusulin....and that seemed to do the trick!!   
    
    regarding air bubbles:  I followed the same technique as most...
    Roll bottle, hold it upside down, draw over the amount needed,
    tap bottle to remove bubbles, keep needle in bottle until
    you reach the desired number of units.   What I assumed...was
    this technique always worked on the first try!!! WRONG...and
    that is why sometimes I still had air bubbles.   I now follow a
    very similar routine..but now when I remove the syringe from
    the bottle I have one unit over the recommended dose...and
    right before giving the shot I push one unit out in the sink!!
    I know this wastes one unit per day...BUT I now I don't have
    air bubbles!!!  No matter what works the key is you just need
    to ensure there are not bubbles!!!
    
    Sandy 
    

    RE: inserting air into the bottle prior to drawing up the insulin.  The
    Diabetes educators who trained us on how to care for our son really
    stressed inserting air into the bottle in equal amounts of the insulin
    to be drawn.  I think it has something to do with displacement (but
    science is not my strong area!).
    
    Anyway, sounds like you're already doing pretty much what I described. 
    I hold the bottle, with syringe, up to either a light or a window. 
    That really helps me to see if there are any bubbles left.  Putting
    more insulin in the needle and then ejecting some after you take the
    syringe out of the bottle ONLY works if you've flicked any remaining
    bubbles to the top of the syringe (near the needle end).  Sometimes
    this action only causes more bubbles to get in so, if you continue that
    practice, still make sure you check for bubbles prior to injection.
    
    I've been doing this for over three years now...believe it or not, it
    gets easier with practice!
    
    Linda

    Lisa, how is Casey doing?
    
    Karen
    

    Casey came home last night.  We spent an hour at the vets learning all
    about diabetes and how to care for him.  The vet showed us how to give
    the injection then we practiced on him with Saline.  It seems like he
    doesn't feel a thing.  I gave him my first injection at 7:00 this
    morning and I'm still standing.  It wasn't as hard as I thought it was
    going to be.  We'll see how he does.  
    
    He goes back next Wednesday evening for a check to see how things are
    going then the following Wednesday for an all day visit to recheck the
    curve.  
    
    The AM checks have been running around 400 so they increased the
    insulin to 3 unites 2x per day.  
    
    We'll wait and see how he does. 
    
    Thanks for all the concerns.  It is nice to know that there is a
    sympathetic ear out there.  
    
    Lisa 

    Hi Lisa,
    
         That's great news!  Casey's sugar will probably come down a tad
    since he's *home* and not at the v*t (a.k.a Stress City).  And soon the
    injections will become a piece of cake and just part of the routine 8-)
    .
    
         Please let us know how Casey (and you) do ... we're pulling for
    you!
    
    					- Andrea
    					  Bigfoot, Loki & Midnight

    Lisa,
    
    I agree with Andrea. In no time at all you will be a real pro with the 
    shots. 
    
    On another note, I'd like to talk about reuse of syringes. My vet had
    told me use each needle only once. However, I read on Prodigy (in the
    diabetics BB) where the American Diabetes Association (and many of the
    participants doctors) have told them it is ok to keep using the
    syringes until they become uncomfortably dull. There was one guy that
    got 52 uses out of one needle. The interesting thing is that you must
    NOT try to sterilize the needle between uses, as the needle has
    something on it to make it go in smoother and alcohol acts as a
    solvent. I find that I can do 4 injections with one needle before it 
    seems to be difficult to get thru Jimmy's hide.
    
    Deb
    

    About alcohol, my vet had said to wipe the top of the insulin bottle
    with rubbing alcohol before inserting the syringe.  My human doctor
    just happened to mention in a random discussion that they've recently
    found that the time-honored practice of swabbing injection sites with
    alcohol is useless since it doesn't allow enough time to kill anything. 
    I'm wondering if the alcohol on the bottle top removes whatever is on
    the needle to make the injection smoother...
    

    maybe I said that wrong. Alcohol acts as a solvent of what the needle
    is coated with and makes the injection less smooth.
    
    Intersting about the swabbing not being of any use. I've always thot
    that myself, although I was thnking more along the lines of cat and dog
    fur rather than human skin.
    
    Deb

         I personally used each syringe once.  Yes, it was a tad expensive,
    since Loki needed two shots a day = 2 syringes a day, but I always knew 
    that diabetics were more prone to infection, so I figured rather than 
    take a chance, use a new needle.  That's my personal opinion, which may 
    be wrong, but what felt right to me.
    
         I never used alcohol on the needle (since each was new and
    sterile), just used the alcohol swab on the bottle before insertion,
    and didn't use the alcohol on the injection site (which disappointed
    Loki since he gets "drunk" on the smell of rubbing alcohol 8-) ).
    
         How's Casey this morning?
    
    					- Andrea
    					  Bigfoot, Loki & Midnight

Because it's always been done. Have to look up in our trusy library, but I think
the alcohol needs to be there for like 10 minutes to be effective. Lots of
disinfectants are like that. It's handy for wiping away surface dirt from the
infection site and putting some on an animal's leg mats down the fur, making the
vein stand out better if you're going IV.

						Trace

    The latest update on Casey looks like this.  We took him back on
    Wednesday, February 28 for a 12 hour glucose count.  We had given him
    his 3 units at 7:00 and at 9:00 his count was 516 and rising.  The
    lowest it went was 450 and started back up again.  This is using the
    scale that 80-120 is good.  We changed his insulin to 4 units 2x a day. 
    I called the vets today, he isn't doing wonderfully better, he has a
    little sparkle in his eyes but he is drinking, eating, and peeing like
    there is no tomorrow.  She gave us the ok over the phone to put him up
    to 5 units 2x per day.  We'll see how he does on this.  
    
    The vet said that if we were looking at 10 units 2x per day, she would 
    change brands.  Anyone else run into a situation like this?  What
    makes them different?  Will we have to start the trial and error all
    over again if this brand doesn't work?
    
    Thanks,
    Lisa Cozzens

    Lisa,
    
         When Loki was first diabetic, we had him on one type of insulin
    (beef, I think).  He did okay on this.  Then that insulin was
    discontinued, so we tried him on Humulin.  The Humulin acted like
    nothing, I might as well have been injecting him with water, for all
    the good it was doing.  Then we switched to NPH Iletin I (beef/pork). 
    That worked remarkably well.  He was stable on this insulin for several
    years.
    
         I've heard talk on the diabetic line that beef/pork insulin is now
    discontinued (I don't know if that's the case, as Loki's been off the
    insulin for two years now).  But it might be worth a shot (no pun
    intended ;^) ) to try that if it isn't.
    
         Otherwise I *think* there are several types of insulin out there;
    it's worth a try to switch it if the one Casey is on isn't working.
    
         Sorry to hear you and Casey are having such trouble; hopefully
    things will work out soon and he'll stabilize.  Hang in there!
    
    					- Andrea
    					  Bigfoot, Loki & Midnight

    I think it's early days to be concerned.  3 units once a day is a
    low dosage.  Sweetie has been up to eleven once a day before his
    response kicked in.  Since Casey's still being stabilized, I personally
    would have a once a day glucose count taken a few days after the
    dosage level is changed, at least that's what my vet does, so he
    really knows what's happening.  He also said that up to 150 glucose
    level was normal, and higher readings (up to a point) are okay if they
    are during a time when the cat isn't processing food.  He worries more
    about too low readings than too high readings during stabilization.
    
    He just went to a vet's conference a week or so ago and said
    there was new news about diabetes, that cats can tolerate much
    higher readings for longer than they had thought without damage
    occuring.  He said one vet had reported a cat whose owners had
    decided not to treat its diabetes (grrr) having readings over
    500 to 600 and he (the vet) just about fell over when six or eight
    months later the people called to make the annual vaccination
    appointment for the cat, since the cat was doing well.
    

    Ditto what Andrea has said about the types of insulin. Jimmy didn't
    respond at all to the humulin. My vet has had shouting matches with
    some of the "experts" that tell him insulin is insulin, it shouldn't
    matter (yet their package insert warns against changing insulin types
    or even brands). Jim was not showing any improvement when the vet decided
    to stabilize him on animal insulin (beef/pork). Jimmy began responding
    immediately. (Jim was the first and last animal that my vet tried the
    humilin on). 

    Andrea was correct, Lily and Novalin begin to discontinue the animal
    insulins, but they got such a tremendous reaction from the veterinary
    community (as so many animals live to be much older, vets are seeing a
    lot of diabetic animals) that I know Lily is producing it again. The
    problem is because all the endocrinologists are pushing Humulin, for
    new patients, you often have to order the animal stuff. For example,
    Walgreen's can get it over night, but CVS usually has it in stock. Osco
    doesn't carry it.

    Hang in there for Casey; it can be a roller coaster until they find the
    right insulin and dosage.
    
    Deb

    one other thing; the number of units that the cat can take in a day has
    to do with the cat's size. I think that the rule is no more than 1
    unit/day per pound. If your cat is 10 lbs, then 5 2x day is about the
    max.
    
    Deb

    Re. -1:
    
         I think my vet said kitty can have up to 2 units/day per pound. 
    So a cat which is 10 lbs can have up to 10 units twice a day.  You
    might want to ask your vet (and let us know 8-) !).
    
    					- Andrea
    
    P.S.  Thanks, Deb, for the info about animal insulins - since we always
    go to CVS, it's nice to know that they'll have the stuff if Loki ever
    goes back diabetic.

    Thanks for the comments.  It is nice knowing I can share this
    experience with others who understand it.  
    
    At Christmas time casey was 17 pounds, when we took him to the vets
    early in Feb, he was down to 10.5 pounds.  When he went last Wednesday,
    he is up to 11.5 pounds.  He still feels skinny as a rail to me though. 
    I have to call the vets on Thursday to tell them how the 5 units is
    doing, which seems to be pretty good.  He is a bit brighter, but still
    eating and drinking like there is no tomorrow.  I don't know if this is
    because he is simply hungry from losing so much weight or that his
    insulin is still off.  
    
    Someday we'll get this figured out. 
    
    Lisa
    

    The "units" on the insulin needle are 1/2 cc or 1/2 unit each; I think that
    that is what your vet is referring to.
    
    My vet is referring to 1 cc as a unit (which is two units on the
    insulin needle), but a unit and a cc are interchangable terms, I guess.
    I was pretty confused about it myself.
    
    Deb

    RE: .99
    >doing, which seems to be pretty good.  He is a bit brighter, but still
    >eating and drinking like there is no tomorrow.  I don't know if this is
    >because he is simply hungry from losing so much weight or that his insulin is still off.
    
    His insulin mught need some adjusting, but in general the eating is a 
    good sign. someone else can probably explain this better, but the
    insulin helps metaboloize the glucose, which will lower the level of the
    glucose and the cat will feel hungry.
    
    Have I got this right?
    
    Deb
    

    RE:  Last
    
    Yup, you've got it right.  Hunger is your body calling for more energy
    which is sugar.  This means your blood sugar is on the low side which
    means the insulin is working.
    
    Excessive thirst and urination is a sign of HIGH blood sugar - your
    body is just flushing everything through and not getting what it needs
    to survive.  That was my sons first sign of diabetes.
    
    Linda

    What does it mean if the cat looks lethargic?  I have a call in to the
    vet but wanted to get the feeling of others.  His insulin has been set
    at 5 units twice a day.  He is still eating, peeing, and drinking a
    lot.  The vet said it was OK to put him to 6 units 2x a day.  He
    doesn't look as perky but he isn't eating and peeing as much either. 
    Will he level off at 6?
    
    Lisa

    Sounds like it may be somewhat of an overdose.  If you don't hear from
    the vet pretty promptly, I would consider giving the cat some
    Karo syrup (half a small spoonful) if you think he might be about to
    become unconscious.  Don't want to scare you...  If this is what it is,
    he should become quite alert within ten minutes.  Then you do need to
    consult your vet to see about the dosage.
    

    I agree with Karen that he could have got an overdose and low
    sugar is worse then high sugar.  I would definetly call the vet
    again.
    
    Once when Van Gogh was down the vets for his blood curve...his level
    went from 400 to 41 and he was acting very sluggish which put the
    vets in a total panic until they could regulate the sugar.  They had
    to use ALOT of Karo Syrup....
    
    Sandy 

    agreed. Give the the cat some kayro immediatly, and if possible, get a
    glucose test asap.
    
    you mention that the cat is urinating a lot. You can get these strips
    that can detect sugar in the urine at the drug store. I use them to
    check Jimmy between glucose tests.
    
    Deb

    
    For whatever reason, Casey now seems to be doing well on 6 units 2x per
    day.  I did speak with the vets and she said what has been said but
    because it was a one-time incident, she said to keep him on 6 and see
    what happens for a couple more days.  Last night he was playing and
    running all around the house. 
    
    Anyone have the problem that the cat pees where he wants to?  Casey
    will eat and drink then pee in the closest spot.  I'm going to move his
    food to the basement closer to the litter box and see if that helps. 
    The vet thought that it would.  Any others experience this unpleasant
    side effect of getting regulated?
    
    My husband is at his witts-end and is ready to have Casey put down.  (I
    know, not a good thing to say here)
    
    Lisa

    
    
    I'm glad to hear that Casey is feeling better.
    
    As for the indiscriminate urination, I'd take that to be that the cat
    still isn't feeling up to par, or if his diet has been changed, he
    doesn't care for it. I had a little problem like that with Jimmy even
    after he got regulated. He had lost a good amount of weight and muscle.
    Jimmy had the physic of a football player, and while he was getting
    regulated, he looked frail. Once he got regulated, gained some weight
    and rebuilt his muscle the indiscriminate urination stopped.
    
    On the other hand, if he isn't going in the box, take advantage of the
    situation and run some glucose urine tests in the puddle he is leaving.
    It will tell you if the cat is really regulated, and in an inexpensive
    and relativly stress-free manner.
    
    hang in there,
    Deb

    I would promptly talk to the vet about Casey's peeing in the wrong
    places.  He may have a urinary tract infection, which should get
    prompt attention because esp. in males it can be dangerous if they
    become completely blocked.  Peeing in the wrong place is a classic
    sign of it.  I'm not aware of any connection with diabetes, however
    it is sometimes associated with stress, and he's probably stressed
    by the vet trips, etc.  Get some Nature's Miracle at the pet store
    to remove the smell from the peed on areas. If they don't have
    it, look for an "enzyme-based" product that does that.  The vet may
    carry those products also.  If the smell isn't removed, it will
    reattract Casey to it as an "okay" place to use.
    

    I was told that when the sugar is "way off" kitties tend to
    get Urinary Tract Infections alot.    As a matter of fact when
    Van Gogh's sugar was so high...they put him on antibiotics just
    to play it safe.
    
    My guess is...he now has a Urinary Tract Infection and a little
    bit of antibiotics will clear it up quickly.
    
    Sandy

    > was told that when the sugar is "way off" kitties tend to
    >get Urinary Tract Infections alot.
    
    If you think about it, that makes a lot of sence. Bacteria will grow in
    sugary liquids left out, and and when the cat's sugar is high, it
    spills into the urinary tract.
    
    Deb

    Casey has been on an antibiotic since it was discovered he was a
    diabetic.  So we can rule out the UTI. 
    
    Something the vet did tell me is that if the food and box are not near,
    and he feels he has to go, he'll use the closest spot, the floor, which
    is what he is doing.  I moved his food back downstairs last night, in
    the same room as his food and I didn't find any puddles this morning. 
    Maybe I'm on to something. 
    
    Lisa

    >Casey has been on an antibiotic since it was discovered he was a
    >diabetic.  So we can rule out the UTI.
    
    Well, not necessarily. Some infections seem resistant to amoxcillian but
    respond to a different antibiotic (like clavomox). 
    
    Deb

    Actually I have heard the opposite...that some cats have problems
    when there food is too close to the litterbox.  But hey...if it 
    worked for your kitty...keep it up.  
    
    Not that I don't want to agree with your vet...but I even disagree
    with mine sometimes...BUT cats are VERY clean animals and 99% of
    the time they have litterbox problem it is mostly because of
    a medical problem or a slight percent is behavior problems.
    
    Sandy

    Hello all.
    
    Well, my boy Teddy was diagnosed yesterday w/ diabetes. He's at the
    vet's today being tested for insulin dosage.  This afternoon I get to
    learn how to give shots to him.
    
    I've begun reading through these notes and have learned quite a bit
    already.
    
    My wife will be happy to read these also, we really know very little
    about diabetes (much less feline diabetes).
    
    If you have any additional advice, please email me ([email protected])
    
    Or if you would like to give Teddy some emotional support, you can
    email him as well ([email protected]). Yes all of our cats have personal
    email addresses.
    
    Thanks in advance
    
    Paul Kitwin
    

    Finally read through all of the notes in 87 here.
    
    I feel a bit better knowing I'm not alone.
    
    Teddy has been prescibed Humilin. It appears (after only a few days) to
    be helping. He is getting 4 units a day, once a day.
    
    To the person (I have yet to get a grasp on names yet, just getting in
    here) who had a question about "units" vs. "CCs" VERY DIFFERENT!
    
    A CC is a cubic centimeter (picture a sugar cube)
    a unit is a milli cc (1000 cc's).
    
    Thanks for all of your experience and info.
    
    If any of you get to Seattle, call me (Check ELF for Paul Kitwin).
    
    You can meet Teddy (and his 4 buddies).
    
    _Paul
    

    Casey is now up to 9 units 2x per day.  Seems to be doing wonderfully. 
    
    Lisa

    The roller coaster ride is beginning again.  Casey does well for a few
    days then symptoms recur.  The vet has changed the insulin to something
    called U100 Lente Iletin1.  Anyone familiar with this one?
    
    Lisa Cozzens

    Yes, this is a natural insulin made by Lilly, probably beef/pork, and I
    presume it is NPH. Jim was on this but was changed to Novolin (which is
    the same product by a different company). We only changed him because
    Lilly at the time was saying they were going to discontinue animal
    insulins (they subsequently changed their mind).
    
    Was Casey on Humilin? My vet has found Humilin fairly ineffective on
    cats and puts has all his diabetic patients on animal based insulin.
    
    Deb 

    Has anyone perused the DIABETES conference? I was going to check it out
    and then I saw that it was members only, and I don't know how the
    members of that conference would feel about asking cat-diabetes related
    questions?
    
    Deb

    Sometimes it does take awhile to stabilize.   For some reason
    Sweeetie has been going thru this for the past few months.  The vet
    hasn't been too worried because the range has been high but
    tolerable.  Fortunately lately he seems to be approaching
    stability, but he's been in at the vet's for a day visit about once
    a week for some weeks for testing.  Hang in there...  (Deb, you might
    ask the DIABETES moderator about access to the conference.)
    
    Karen
    

    I'm a member of the DIABETES file.  I don't see any reason why you
    wouldn't be welcomed.  I'm pretty sure there's already a note in there
    on Felines.
    
    It's a quiet file these days - I can check out the MODS for you if you
    can't find the names.
    
    Linda

    
    Casey was on the Humelin NPH insulin by Lilly.  He is now on something
    by Lilly called Lente.  Something different.  He is up to 7 units 2x
    per day on this one.  The thing that is the concern for the doctor is
    constant diahrea.  They said that there is too much fluid in his body
    and this is how he is getting rid of it, as well as urinating large
    amounts.  I'll inquire about a different brand if this doesn't seem
    to work. 
    
    Lisa
    

    What is the vet doing for the diarrhea?  Does he think it should
    be stopped or that it needs to happen because of the "too much
    fluid"?  Is Casey drinking huge amounts of water?  (Just questions
    to get me oriented, I didn't see diarrhea with Sweetie...)
    

    Also, what is Casey eating?  Could that be a problem?
    

    Hill's makes an special diet for real bad cases of diarreah; Hill's
    Prescription Diet EN. (ENteritis formula).
    
    It is a moist food, comes in foil packets, and it usually only takes a
    couple of feedings to fix the problem. I seem to recall a box of this
    food was $7(?) for 8 packages. It is only availiable from 
    
    An supermarket variety that would help bind the cat would be Tender
    Vittles.
    
    Hope this helps,
    Deb

         Loki never had diarrhea (though he sometimes has it now, because
    of the kidney disease).  He was always on Lilly NPH Iletin 1 (beef/
    pork).  I hope that this newer insulin will help Casey out.
    
         I was a member of the diabetes conference for a while because of
    Loki (the note about feline diabetes is from me ;^) ).  I haven't
    accessed it for a while, but the people there are very nice and
    informative and I think they found it interesting to talk about animal
    diabetes, and figuring out what is going on with a being who can't talk
    and say "I feel dizzy" or "I feel thirsty" 8-) .
    
         Hang in there!
    
    					- Andrea
    					  Bigfoot, Loki & Midnight

    OK, finally, after almost 10 weeks we have Casey stabilized.  The
    diahrrea has stopped.  This was caused by too much fluid in his system,
    yes he was eating and drinking to beat the band, non-stop it seemed. 
    This has also stopped.  Casey is on 8 units 2x per day of the brand U100 
    Lente Iletin.  He is also on Hills Science Diet Light Maintenance
    formula, dry food.  All my other cats are on this too, I go through 
    about 20 pounds in 1 month.  
    
    Casey is a muncher and doesn't care for wet can food so we have the 
    beauty of leaving crunchies out all day and all night long.  The vet 
    said this is fine, she actually told us to do it.  His original weight 
    before the diabetes was 17 pounds, he dropped to 10.5 pounds and is 
    now up to 13.5 pounds.  
    
    It seemed like getting him level would never end, but it finally did. 
    I've also found a wonderful cat sitter who will come into my house
    twice a day while we travel, (we are campers and I didn't want to give
    this up and I didn't want to take Casey with me.)
    
    If anyone else feels exasperated saying they will never get the cat
    regulated, relax, there is light at the end of the tunnel.  The vet
    let us determine how much insulin he needed.  She told us to start at
    say 6 units and increase it by 1/2 unit every 5 days if he didn't seem
    better.  When we  hit 13 units of the other brand she decided to change
    to this particular kind.  We started this at 6 units and finally had
    him on 8 units for a whole week.  She then asked us to come in for a
    glucose curve and found that he was doing wonderfully.  
    
    We gave Casey his insulin at 7:15, like usual, they did the first
    glucose count at 8:35 which was 406.  She used the range of
    54-150 as a good range for him.  They took his blood every hour and
    after 4 hours it was down to 62, it then started climbing up, which is
    what she wanted to see.  
    
    Finally, a success story for me.  Thanks for all the support people
    have offered. 
    
    Lisa Cozzens                    

    Great news, yeah Casey!
    

    Great news about Casey.  But I do have one warning..don't
    let this great news stop you from keeping a VERY watchful
    eye on Casey.
    
    My Van Gogh who I felt was regulated the past few months once
    again had to have his units adjusted because his level went
    down to 45!!  (it was up to 475 at one point)  He is now only
    on 2 units once per day.   
    
      Just keep a close eye on any changes in eating, drinking or
    behaviour!!!
    
    Sandy 

         Fantastic news about Casey.  I agree with Sandy, though; make sure
    you keep an eye on him via urine strip tests if nothing else.  We took
    Loki's stability for granted (after 4 years, he should be stable,
    right?), and wound up with him crashing.
    
         Just something to watch, but enjoy your happy kitty!
    
    					- Andrea
    					  Bigfoot, Loki & Midnight
    

    There is a wonderful web site about Feline Diabetes at
    http://home.sprynet.com/interserv/raprice/diabetes.htm
    with just tons of information and personal stories
    about kitties with diabetes.  I sure didn't know points
    three thru five below about how to give injections:
    
       For example, he has been unhappy with his shots over
       the last month, whereas he used to come seek them. I
       stopped, reevaluated the whole process and saw that I
       was making five large errors: 1) not getting on the
       same level with Austin. Of course he is terrified when
       I straddle him and loom over him. 2) Not preparing him
       with some loving: being on my lap or the bed and
       getting brushed or petted, etc. 3) Pinching up too
       much skin between my fingers so that the numbing this
       provides wasn't reaching the area I was injecting in.
       4) Not keeping the bevel of the needle up. Having the
       bevel down means the point of the needle doesn't go in
       first & there isn't smooth sharp entry into the skin
       and it hurts!  5) Not inserting the point quickly
       enough. Most of the nerve endings are in the skin
       surface and the faster you pop the needle through the
       very first layer of skin, the less it hurts. Austin
       has been doing well with the shots for the last week
       as I have made the changes in my technique. He hasn't
       gone back to appearing spontaneously when it is time
       for shots but I am working on a lure/routine!
    
    

    Re: .137
    
    Well, I just re-read this note and realized that I had
    misinterpreted direction 4 (keep the bevel of the needle up).
    I've been aligning the bevel down for the past few days.  Probably
    because just visualizing it, that seems more logical, so my
    subconscious "edited" what I remembered of the directions :-)
    Whatever... following the directions to pinch less skin, being
    relatively quick, and with the bevel down things have seemed
    to be much more comfy for Sweetie.  The only way I can see the
    bevel is to carefully align the needle against a dark background
    and rotate and angle it so that it catches the light and reflects.
    There seems to be total randomness from one syringe to the next
    as to where the bevel is in relation to the markings on the syringe.
    
    I'll try the bevel up and see how that does, on my dear little
    guinea pig Sweetie :-)