I replaced Buddy’s Dexcom sensor Saturday afternoon. He had been using it for 12 days, and it was coming loose on the sides. I had reglued it a few times with Skinister, but the dressing was becoming a bit hard from the multiple applications of Skinister. The sensor was still giving good readings though, and using an Anubis transmitter I am able to restart a sensor and so use it longer than 10 days.
Since I had placed the first CGM sensor on Buddy late February, I had always cut away some of the dressing around the sensor to create a smaller footprint on the cat. I had underestimated how crucial that step was.
Saturday’s sensor change turned out to be challenging. The first sensor seemed to have been inserted into a muscle and blood vessel, and Buddy was pretty upset and he ran away from me. These hurt, I know the feeling. 🙁 Poor Baby.
He came back 5 minutes later without the sensor, and with a large drop of blood on his back. Poor Kitty. After some treats and cuddles and cleanup, we tried again. New sensor, a layer of Skinister medical adhesive … However, just like with the first sensor, I did not reduce the size of the dressing. The insertion went well, I attached the transmitter and started the sensor session. Buddy was relaxed, he finished eating his freeze-dried chicken liver treats, then he walked away calmly, and casually turned around and grabbed the sensor with his teeth and pulled it off. Just so. I believe that the adhesive was not cured also – it was just too casual …
Oh, no. This was turning into an expensive afternoon!
After the second lost sensor and seeing how easily he had just pulled it off his back, I was a bit insecure about the Skinister adhesive and decided to use VetBond for the sensor. But importantly – I cut the sensor to size again.
The third sensor was no problem, and in that way was just like almost every other sensor I had placed on Buddy in the last 6 weeks. After the sensor and transmitter were in place, he went to groom the area, but with the much shorter dressing he could not grab the sensor or the dressing with his teeth and couldn’t easily pull it off! See below a picture of how much I usually cut away from the sensor dressing:
Lessons learned:
- Buddy will absolutely pull off the sensor if he can do so easily. However, if there is not enough room for his teeth to grab hold of the sensor’s dressing, he won’t bother with it.
- Double-check that the Skinister adhesive is applied in a sufficient amount and is tacky before attaching the sensor to the cat. Wait for the adhesive to cure before inserting the sensor wire.
Remission support with another pod
He’s wearing an Omnipod again – he’s been off external insulin between Wednesday morning 6 AM and Saturday around midnight. He was keeping his blood sugar in range (between 70 and 180 mg/dl sensor value), but I noticed him drifting higher. He was spending more time in the > 140 mg/dl area and creeping up on higher blood sugars.
I decided to giving him another pod Saturday night. Last week, rather than using an Omnipod (which is filled with ultra-fast-acting 10% diluted insulin), he’d been getting occasional 1 Unit shots of undiluted long-acting insulin glargine. Yesterday I opted for a pod to support his extremely low insulin requirement. It’s simply easier to give him a tiny amount of fast-acting insulin (the smallest amount possible with the 10% diluted insulin is 0.005 units!!), and back off if he trends too low. An injection of glargine, which cannot be diluted, is both a commitment (once in the cat, it stays for many hours), and at the small amount he needs, the U-100 Glargine is very much suboptimal. It’s challenging to draw up precisely 1 unit of U-100 insulin. It’s a messy proposition to precisely draw up 0.8 Units …