Pearl is also an Asthma Kitty

Pearl's diabetes was kicked off by prednisone being given for asthma. She was most likely predisposed to diabetes because the pred pretty much kicked in the BGs immediately. But it took me about 3 months to figure out that it was the pred. Many cats that have steroid induced diabetes may not become full diabetics. So we got her off of pred and I ordered an aerokat. It's based on the idea of a child's mask and chamber to deliver inhaled meds. A great great resource, and the first place you should visit if you find out your cat has asthma is Fritz the Brave's site. Dr. Padrid is the noted vet that helped pioneer using inhaled meds. His protocol is located on the site and you can print it out for your vet. That's what I did. They were happy to try something new. There is also a great message board for Feline Inhaled meds that you can find there and subscribe to (it's a Yahoo group). I took a period of time getting Pearl used to the mask.

While I was waiting for it to be delivered, I took an empty toilet paper roll and would place it over her nose and mouth and remove it right away and give a treat. I would increase the time I held it and always treat. She looked at me like I was nuts, but the treat was A-OK so she cooperated. When the Aerokat came, I first put the mask in a bag of catnip hoping to get rid of some of the plastic smell. I would lay it on the floor by her food dish each meal so she got used to seeing it in connection with FOOD. Then I smeared food on it and let her lick it off. Then just as with the toilet paper roll, I would put the mask over her nose and mouth, briefly, and then treat. This was a bit scarier than the empty toilet paper roll, but we extended the time over a couple of days and she became fairly relaxed with it. Hey, she got a treat so, whatever, she thought.

Then I tried the flovent. For the first few days, I would shake the cannister (always shake before you puff) and hold my hand over the open end of the mask, puff it into my hand and then move the mask onto her face. Probably didn't get full doses doing that but it made the transition more smooth. She got used to the smell of the flovent and didn't have that puff sound quite so close. After probably 4 days, I just started putting the mask ON her to puff. We now puff once a day. Pearl is a moderate asthmatic, so she does well on one puff of 110mcg Flovent a day. I keep albuterol on hand in case she does have a cough, but we have not had to use it often. She did get wheezy on me in the cat box the other day, so I used it, but normally the flovent keeps her well controlled. Miss a day and not so much.

Here is a little video of Pearl getting her flovent puff. I wish I had a better video camera, but I think you get the idea.



If you take the time too desensitize your cat, you will do fine, and your cat will have MUCH better controlled asthma without nearly as much danger of systemic steroid troubles. Personally, I believe even mild asthma should be treated. I got Pearl when she was 6 years old and she had a habit of coughing with no hairballs EVER, and sometimes heaving up a clear mucous after a coughing fit, after she ate, but with no food coming back up. This happened a couple, three times a month. I just didn't know. 2 years later we went to get xrays because it became more frequent. The lungs looked ok, but we got distracted by finding arthritis in her knee. I didn't pursue the coughing. Fast forward to two years ago. One Sunday, Pearl had 5 coughing fits between 8 am and 3 pm and by then I could hear a wheeze. I took her to ER where, because she was having attacks THAT DAY the xrays showed pretty classic signs. She started on pred and the coughing wheezing stopped pretty much immediately. I took the xrays to my vet the next day and she agreed it could be, but she also saw something with the heart she didn't like. The ultrasound guy was coming that afternoon for a cat with a thrombosis (who sadly didn't make it). He found Pearl did have a mild mitral insufficiency in her heart chamber. Her heart was FINE in the first xrays I got when she was 8 and she had been coughing since before I got her, so we do not believe the asthma cough is anything but asthma. However, we did put her on 1 enecard pill and 1/4 lasix a day. Who knows if it helps, but it doesn't hurt.

Pearl got the really short stick on the genetics draw. But we are coping pretty well.

Is it easy to test a cat?

Well, not always at first, although, ECID (each cat is different). However, most cats adapt well, and are extremely cooperative. I made these two videos on July 4 to show you how Pearl comes to her testing station and gets a blood test.






In the beginning, the key is to warm the ear first with either a sock that has rice in the toe and is heated a few seconds in the microwave, or with Pearl, I used a damp washcloth in a baggie, heated just 13 or so seconds. I always tested it on MY ear to make sure it was not too hot. I had to hold it on the ear a good 20 to 30 seconds. That did the trick. Believe it or not, after a while you do not need this. The ear learns to bleed.

Another good pointer is to provide a firm surface under the ear. I use my finger. I have rarely poked through. When I tried to use the surface of a rice sock, it gave too much. I like using the device but some people prefer to free hand with a lancet. They hold it at a 45 degree angle; somewhat like sewing. For me, I cannot poke fast enough. But whatever works for you. Try both ways.

Like anything, this takes practice, but once you get a routine down, it's about as much trouble as brushing your teeth and takes considerably less time!

Why keep a log?

As you can see, Pearl's weapon of choice for logging is one of my Harry Potter fountain pens.




Whether you keep an online account, excel sheet or, like Pearl, the non-techno version of pen and paper, logging is very helpful. We do both. Pearl's way, and then I put it online, so we can keep the vet up to date by emailing, or now, by the blog.

Logging your BG results can help you manage diabetes by seeing trends in the numbers. The way you do a diabetic log and how it is written for best at a glance comprehension is to label your preshots am and pm: thus amps or pmps to establish what your number was. Notate the amount of insulin given after that. Right now I am still figuring out Pearl's optimum dosage, so I do more tests in between. To notate when a reading is taken, you use a +number number=hours after shot.

Thus

Today so far looks like this

amps 396 2.4u
+4 140 (niiiiiice)

Later, I will add more numbers. probably a +6 and a +8. I know that Pearl is going to peak somewhere in there, so I am not going to test nearer to the shot times as I am doing today.

Today's curve will be

amps
+4
+6
+8
pmps


What, you say? That is 5 pokes in one day! It's OK. If I showed you Pearl's ears, you would not even know which ear I test on. But even so, I don't like to subject her to tons of pokes. So, normally, I would do preshots only throughout the week and do curves or partial curves on weekends. It's less expensive (strips are the costly part of diabetes) and less annoying to Pearl. She mostly just doesn't care for her ear being held. Rather like Captain Sisko being seized by the ear everytime he comes across a vedik.)

If you do a curve, that means you track the BG levels throughout the day, either every two hours, or I prefer every three hours or sometimes just 4 hour spot test with a two hour middle. This will help you determine when the insulin "Peaks" or your lowest BG levels. You want your curve to be gentle, and insulins like Lantus, PZI and some even use Levemir are longer lasting and provide, in general, long, slow, calm curves. Other insulins like Humulin N, Vetsulin or Caninsulin usually peak early and may have very short, sharp curves. If this happens, you may want to investigate slower insulins. Short curves leave the cat too high much of the day.


Of course, with diabetes, your ideal isn't always acheivable and you take what you get, but a log of your tests can help you approach management with good data that you and your vet can use for good decisions.

And, besides, it's fun to use a fountain pen.

Pearl's "Sister"

My other cat is Sugar (yes, how ironic my non-sugar cat is named Sugar).
Pearl's favorite toy. Pearl doesn't see wonderfully and she is not a huge "player". She likes to run around very fast and howl like Tarzan when she is feeling good. She will chase a laser dot and she likes watching a feather disappear under a rug, but if she could talk, I think she would say her favorite game is "Chasing Sugar". It has taken 4 years, but they have finally gotten the rules down. Pearl chases. Sugar runs. As long as they are both in the mood and there is "no touchy touchy" it's fun. Well, to give you an idea of their relationship, just check this video out. It makes me laugh every time I watch it. I wanted to show that contrary to the pics posted so far, Pearl doesn't just lay around in queenly splendor.

Sugar will be getting her own blog one of these days.

The Journey of Patience part

Well, lately this is where the "journey of patience" comes in. We are doing the sugar dance. 2.1, 2.2, 2.4. It's enough to make you crazy. If you look at Pearl's numbers this week, you can see she went quite low and it looked like 2.1 or 2.2 units would be good, but she is slowly going up again. Then she threw in an odd low preshot of 239. When you have a preshot number you are uncomfortable with, one option you have is to feed and wait a few minutes and test again to see if the level is going up. Then you can feel out whether or not to shoot at that time. Key words: a few minutes. 30, 40 minutes is usually sufficient. Yeah, you don't go back to bed for nearly 2 hours. Yeah, did that today. Argh. So, I missed the little window to maybe keep her on an even keel today. smaller dose, gentler curve. Yup. Blew it.

Tonight I have gone back up a tad in dosage to get her down a bit. With Pearl, apparently .1 or .2u reallly can make a difference. The way I am able to shoot such tiny changes is that PZI is a u40 insulin and I have u100 syringes. You can't go the other way, but this way you are able to make tiny changes. Which is rather nice on a cat like Pearl. This is the conversion chart I use. It's important to realize if you have a u100 insulin you can only use u100 syringes.



So, we trudge on. Just on the edge of figuring something out, but just not sure what.

Hi! I'm Pearl the Diabetic Cat

This is where I test Pearl. It's a handy spot in the kitchen, with the counter of the halfwall between the kitchen and the rest of the apartment handy with Kleenex for staunching a poke and to hold the meter and lancet device. It's a good set up as I can just reach right over Pearl. As you can see, she likes to just lounge there too sometimes.

This is Pearl. She is a black domestic short hair cat. She was diagnosed with diabetes after being on prednisone for what appears to be asthma for a short time. Once diagnosed, we got her off pred and onto flovent, which works wonderfully. Though many cats go into remission, it isn't looking like this will happen for Pearl. We recently (April 30) switched from Lantus to PZI as Lantus had stopped working well for Pearl. So now we are in our second month of PZI and numbers are looking much better again. I decided it might be a good time to start blogging for Pearl.

You can see our numbers since we got on PZI at a glance here. As we go on, I will try to post numbers here too.