kitty just diagnosed but seems fine

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Marquene Klimchok, Feb 15, 2015.

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  1. Marquene Klimchok

    Marquene Klimchok New Member

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    Feb 11, 2015
    Hi all ... Hoping for some guidance and please don't take my question the wrong way. Trixie was diagnosed last week with diabetes after the usual symptoms of thirst and increased urination. She shows no other symptoms or concerns. I am so scared of starting insulin (which the doc did recommend after some bloodwork and regulation at the vet office). The main reason I am so concerned is because she IS doing so good. And I'm so scared of her crashing with insulin, and it causing more problems than she has. Could someone please put this in perspective for me? I am sorry for again probably sounding foolish, just want to make sure I am doing the right thing. Thanks...
     
  2. BJM

    BJM Well-Known Member

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    Welcome to FDMB.
    One of the most important things you can do for your cat's safety is to learn to home test the blood glucose. You'll need an inexpensive human glucometer, matching test strips, and lancets for alternate site testing (26-28 gauge). The WalMart ReliOn Confirm or Confirm Micro, or the Target Up and Up are inexpensive. Avoid meters with Tru or Free in the name as they tend not to work as well for cats. There are feline reference numbers in my signature link Glucometer Notes.
    Some Neosporin ointment (not cream) with pain relief and some low carb treats such as PureBites freeze dried chicken also make the process smoother.
    And wouldn't it be lovely if you could possibly avoid insulin? Depending on the initial glucose readings, vet stress can raise the glucose 100 - 180 mg/dL, so home tests will often show lower numbers.
    A change to a low carb canned or raw diet may drop the glucose 100-200 mg/dL, too. See Cat Info for more info. One low cost canned food in the US is Friskies pates.
     
  3. Marquene Klimchok

    Marquene Klimchok New Member

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    Thanks for the response. Yes I am doing a ton of research today and am trying to see what options there are. Diet seeks to be the first immediate change before going to too many extremes. And yes home testing to see what is going on here at home. I will take a look at your info and numbers etc. thank you so much
     
  4. Marquene Klimchok

    Marquene Klimchok New Member

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    One question and I'm sure I would find on this board eventually, what time of day do you check BG if not on insulin yet?
     
  5. phlika29

    phlika29 Well-Known Member

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    Hi

    I check remi's blood glucose before his morning meal or before his evening meal. In effect you can check it whenever you want as long as it is at least two hours after food.

    With regards the insulin whilst I know what you mean about the worry of going low the quicker you get the blood glucose under control the less long term damage will occur and thus possibly improve the chance of remission. If you have the opportunity I would switch to a low carb wet food as linked in BJM post before you start the insulin and get used to hometesting at the same time but realistically you need to start the insulin sooner rather than later if the levels still prove high.
     
  6. Marquene Klimchok

    Marquene Klimchok New Member

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    Ok thank you...I will definitely be doing some shopping and some discussion with my vet.
     
  7. BJM

    BJM Well-Known Member

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    Be aware that your vet may not be up to date on feline diabetes. They have to treat numerous species for numerous conditions and diabetes isn't as common as some other things they see.

    See this post for some info to share with your vet, just in case you need it.
     
  8. Elizabeth and Bertie

    Elizabeth and Bertie Well-Known Member

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    Hello Marquene and extra sweet Trixie, and welcome to FDMB :bighug:

    You don't 'sound foolish' at all: The only silly question here is the one that goes unasked. ;) So please do ask anything you want to.

    As BJ said above, a cat's blood glucose level can drop quite a bit when switched from a higher carb to a low carb diet. And for some very lucky kitties this is all that is needed. Most cats do need insulin though. And the idea of that can be scary at first. But all of us here have been through what you're going through right now, and will do everything we can to help you.
    There's a lot to take in at first, but you will very soon get used to the routine. And the good news is that, with care, a diabetic cat may live as long and as happily as a non-diabetic. :)

    A few questions for you:
    Did the vet tell you what Trixie's blood glucose level was?
    Did the vet do a fructosamine test?
    Has Trixie had any steroid treatment recently?
    How old is Trixie?
    What is she eating at the moment?

    I would suggest that you monitor Trixie's pee for ketones. You should be able to get Ketodiastix (or similar) test strips from most pharmacies. Since Trixie seems well it is unlikely she has ketones. But some kitties are prone to ketones so it is as well to check, especially since she is a newly diagnosed diabetic.

    Welcome aboard!

    Eliz
     
  9. Marquene Klimchok

    Marquene Klimchok New Member

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    Hi Eliz, just spoke to the vet today about the blood results. Trixie's BG was 425, liver enzymes up a bit, but doc is blaming that only on the diabetes...says all other bloodwork looks good. Not sure about the fructosamine? No steroid treatment recently. Trixie is almost 9 years old. She is eating Iams dry and I just purchased some of the low carb canned foods that I see on here.

    Doc is recommending PZI, again, he would like to keep her for 3-5 days to regulate her. He said that he does keep in mind that fact that her BG will go up due to the stress of being at the vets, and will adjust the insulin accordingly. Still tells me not to change her diet, but I think I may change it for 2 weeks and schedule her 2 weeks from today for the insulin start.

    Please tell me any thoughts you all may have. I know that home testing sounds important too...and that I will definitely consider... can anyone tell me if they support my plans so far?

    Thanks so much!
     
  10. phlika29

    phlika29 Well-Known Member

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    Hi

    I would definitely switch to a low carb wet food if your cat will tolerate it. I would do this slowly just changing 25% per day. You want to avoid giving her an upset tummy and so don't do it too suddenly. Having said that when I emailed dr Pierson about changing food before trying insulin she said not to leave a cat without insulin for too long and so I would not wait for two weeks before taking her in. Whilst she might seem okay now it only take a day or so for things to begin to turn. Personally I would change the food over the next few days and get all that you need to begin home testing. Then I would book her in with the vet. Not sure why the vet would need to keep her for quite that long, if you are testing at home he may agree to just have her in for a day or two.
     
  11. Marquene Klimchok

    Marquene Klimchok New Member

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    Since i am so nervous about the risk of hypo, is this something that happens to all cats? Or just a risk? Dr. was very nice today.... he may agree to bringing her home quicker if I home test, but I feel unprepared since I have no clue what I am doing :( I'm trying real hard to read and comprehend, but having a hard time since it's so close to my heart.... :(
     
  12. manxcat419

    manxcat419 Well-Known Member

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    Personally, I'd go with home-testing rather than making Trixie stay at the vet for 3-5 days. Regulation isn't a one-off event, it's an ongoing thing just like with a human diabetic. And there's no real way of knowing exactly how an individual cat's BG will be affected by the stress of being at the vet - I'm just not sure you'll get the best regulation that way IF regulation is the only reason he wants her to stay there. I know for sure it wouldn't have worked for my Rosa as she has dreadful vet-stress, but for whatever reason that didn't seem to push her BG much higher between the initial vet test and the first ones I did at home. Obviously if he has other concerns or he thinks there's another condition going on at the same time that requires her to be hospitalized, then that's a different situation entirely.

    Switching to low carb wet food really can make a huge difference and is definitely worth doing, but maybe 1 week not 2 - you don't want her BG levels to be too high for too long.
     
  13. manxcat419

    manxcat419 Well-Known Member

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    Hypo is a risk as with any diabetic. It's something that, from another recent discussion, makes all of us a little nervous. But with home-testing it's also something you can spot as her levels drop towards the risk area rather than having to wait for her to show symptoms. It may never happen to her, but it can and it is definitely something you need to be aware of.

    I know it's difficult and it's a lot of information to take in all at once - Rosa was only diagnosed a month ago and I've gone through (and am still going through some days) a lot of the confusion and feelings that you have. But you're getting informed and that's the start of being able to take charge of the situation and make sure you're doing the best you can for Trixie.
     
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  14. BJM

    BJM Well-Known Member

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    Home testing is a tool to help keep your cat safe. It determines if it is safe to give insulin, how effective the insulin is, and if you need to intervene to keep the numbers up in a safe zone.

    An inexpensive human meter, with feline specific reference numbers will let you do this. Many of us use the WalMart ReliOn Confirm or Confirm Micro (aka the Glucocard 01 or 01 Mini sold at ADW), matching test strips, and lancets intended for alternate site testing (26-28 gauge). Pick up some Neosporin Ointment with pain relief to reduce the annoyance of testing, help the blood bead up, and help the prick heal.


    Pick up some KetoDiaStix, which test the urine for ketones and glucose, from your pharmacy, too. Ketones form as a by-product of fat breakdown and high levels may indicate diabetic ketoacidosis, a potentially fatal complication of unregulated diabetes. Glucose in the urine will give you an idea of how the glucose was controlled since the previous void.
     
  15. phlika29

    phlika29 Well-Known Member

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    Everyone is nervous about the risk of hypo but you are doing everything right. It doesn't have to happen but it can do. You and your vet aren't looking to get your cat into really low numbers straight away but rather bring them down in a controlled manner. If a cat does have an incident of blood glucose lower than we want then that needs to be managed but it doesn't need to involve panic. For me it meant adding honey to remi's food to bring him up and monitoring him closely for a few hours.

    Reading up about how to hometest, switching to a low carb food, etc is a really good start. As April said regulation is an ongoing process so as much as it's nice to get the vet to help in the end it's a dynamic process and so the need for insulin amounts change over time.

    I would concentrate on switching the food (she has no other health issues? ) and getting and practising the hometesting.
     
  16. Marquene Klimchok

    Marquene Klimchok New Member

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    Feb 11, 2015
    Thanks. Just speaking to my husband about home testing. And buying the right supplies. Changing her diet today. What time do you test BG normally?
     
  17. BJM

    BJM Well-Known Member

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    Test before meals/insulin (always before insulin - until you have data showing it is safe, do not give insulin below 200 mg/dL)
    When you can - weekends, days off, sometimes overnight - test about +5 to +7 hours after the shot when giving insulin. This will let you see how well it is working.
     
  18. Marquene Klimchok

    Marquene Klimchok New Member

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    Phlika no real problems besides the increased thirst and urination at this time...
     
  19. manxcat419

    manxcat419 Well-Known Member

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    As Trixie's not on insulin just yet, you can choose your test times - as long as she hasn't eaten in the 2 hours before the test. If she's fed twice daily, before each meal can be a good time. If she's free-fed then it'll need a little planning to take her food away 2 hours before you plan to test.
     
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  20. phlika29

    phlika29 Well-Known Member

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  21. Marquene Klimchok

    Marquene Klimchok New Member

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    Thank you all. Going to make a Walmart run after dinner
     
  22. Marquene Klimchok

    Marquene Klimchok New Member

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    Do you test daily?
     
  23. manxcat419

    manxcat419 Well-Known Member

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    Yes, it's important to get into a routine of testing every day. I'd have thought twice daily would be fine for now while she's not on insulin - @phlika29 can you confirm please as I've never done testing with Rosa not on insulin. Once Trixie's on insulin, then it will need to be more often than twice daily as you'll want to find out how low the insulin is taking her when it's at its peak effect. Starting the testing without the insulin gives you a chance to learn to test without having to do it quite as often.
     
  24. Marquene Klimchok

    Marquene Klimchok New Member

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    Well just tested Trix for the first time. Now granted we don't know how much dry food she ate prior and she is not on insulin. BG was 323. So we put all the dry food away and am starting her in the lo carb wet food tonight. Will retest tomorrow. Thank you for your encouragement tonight. I am so grateful that you are here to support us!
     
  25. BJM

    BJM Well-Known Member

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    Change the food 20-25% per day to avoid GI upset.
     
  26. manxcat419

    manxcat419 Well-Known Member

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    Well done on your first successful test! :D Her reading could be a lot worse than 323 without insulin too - it's not a great level, but if you look at Rosa's ss, she was a lot higher than that even with insulin to begin with.

    Good luck on switching her food. I hope she takes to the wet food easily for you.
     
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  27. Marquene Klimchok

    Marquene Klimchok New Member

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    Thanks all. And ok on the diet change. I'll put some dry out for her to pick on in between feedings of wet. Well thank goodness for my hubby who volunteered to do the prick while I held the kitty. Very lucky I am!
     
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  28. Marquene Klimchok

    Marquene Klimchok New Member

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    Wow yes Rosas were very high but look how far you've come! That's inspiring believe me!
     
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  29. Critter Mom

    Critter Mom Well-Known Member

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    Hello Marquene,

    Way to go on your first successful home test. You're a natch! :D The ability to check Trixie's blood glucose will give you much more peace of mind.

    I know that you want to help Trixie as quickly as possible, but the suggestions above to do a gradual food change are well-founded. The good news is that as soon as you begin the transition it will start to help Trixie from the get-go. As April observed above, Trixie's BG could be a lot worse than 323 without insulin.

    Things are very nerve-wracking in the early days following diagnosis but as you learn more it will get less overwhelming. Promise. :bighug:
     
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  30. manxcat419

    manxcat419 Well-Known Member

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    I've also been lucky to have a wonderful hubby who helps with testing - and is prepared to stay up with me on the nights when Rosa's dropping low. The support from people here is invaluable, of course, but some in-person support at home makes a huge difference too even when you're both learning.

    It really is amazing what a change of diet and the right dose of insulin can do - just a month ago, Rosa looked as old and tired as our 18 year old CKD kitty. So much so that I was terrified I was going to lose her at just 11 years old. Now, already she looks just like her twin again and is running around full of energy - seeing the difference once they start to get regulated makes the worry, long hours and at times overwhelmingly steep learning curve more than worth it! :)
     
  31. Marquene Klimchok

    Marquene Klimchok New Member

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    Must admit I am the wimp of the household so tomorrow will be my real test when I do the BG test on my own. My nineteen year old son will hold her while I do the work. I got this (or will keep repeating this at least lol). I lost a seven year old kitty a year and a half ago to kidney failure (she had lots of medical issues from the start) so this diagnosis has thrown us all for a loop. Like all of you at first. The wealth of knowledge here is amazing. I must admit I wanted to run from this at first but just doing the first BG successfully has given me hope!
     
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  32. Critter Mom

    Critter Mom Well-Known Member

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    Marquene, you're doing great. The learning curve is definitely vertical but diabetes is manageable. :) I'm really sorry to hear about the little kitty you lost - and so young. :( I can understand that Trixie's diagnosis must be doubly scary for you. :bighug:
     
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  33. Critter Mom

    Critter Mom Well-Known Member

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    @manxcat419 - April, I'm very glad to hear how well Rosa is doing! I remember how worried you were a little while ago. It's great to hear you sounding so much more positive. Isn't it amazing the way our little ones can recover with the right treatment! :)
     
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  34. Marquene Klimchok

    Marquene Klimchok New Member

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    Thank you so much ! Just have to get her healthy and get this under control....we will succeed with the help of you all...I do have faith
     
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  35. manxcat419

    manxcat419 Well-Known Member

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    Marquene - you can do this. Some help with holding her to begin with will definitely help until she learns that it's all over quickly and then she gets a treat. I still get help with holding Rosa especially on the days she has to have frequent tests - she can get wriggly because it's when she's feeling good with low numbers and I'm trying to test her every half an hour!

    Aine - I am feeling much better about the future for Rosa now, thank you. I was so scared for her when she was first diagnosed because she just seemed so weak and ill. But now, apart from the shots and testing, you wouldn't know there was anything wrong with her by her looks and behavior. The difference is incredible! :)
     
  36. Critter Mom

    Critter Mom Well-Known Member

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    Faith will get you far, Marquene, and patience pants will get you the rest of the way. :)
     
  37. phlika29

    phlika29 Well-Known Member

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    I would recommend setting up a spreadsheet to record your tests in and use the comments to track the changes in food , etc.

    http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/

    For now I think I would test her before her breakfast and then perhaps again before her evening meal or maybe even during the day say an hour after she has eaten to see what the food is affecting.

    With regards the food I personally would not feed the dry and wet separately but rather swap 25 % of the dry for wet today (and mix together if she will eat it like that). Then tomorrow make the mix 50% of both, the next day 75 % wet to dry. I would also give more smaller meals, not just two big ones. That way you will hopefully begin to even out the blood glucose. Does she eat set meals or does she graze.
     
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  38. Marquene Klimchok

    Marquene Klimchok New Member

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    She usually grazes throughout the day. What I thought I would do is a can in morning before I go to work, half can when hubby leaves for work (around 11am or so), another half can when my son gets home from school (around 3pm) and then a full can when I usually feed her wet at night , around 7pm. That's the 5.5 oz cans. Is three enough or too little? Once we get her all to wet I don't want to give her too little since her weight is a little high but not drastic (she's 11 pounds)
     
  39. phlika29

    phlika29 Well-Known Member

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    It certainly sounds reasonable but I would give more meals in the evening as well. If you cat doesn't scoff it all in one go you could even just free feed. What many people do here is to buy a timed feeder. You can leave wet food out for 12 hours at a go with no issues but it can get a little dry. If you use a timed feeder like the pet safe 5 then you can portion it down and It will stay covered until the time comes. If you add water it helps to stop it drying out.

    You need to work out how many calories your cat needs and how many calories each can will provide and then just split up the amount over the day. I am not going to be any good with this as maths is not my friend. What food did you decide on?
     
  40. Deb & Wink

    Deb & Wink Well-Known Member

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    Marquene,
    So, here are some patience pants to help get you "the rest of the way".
    pink pants cat knees.jpg
    Pink ones, with some cute kitties on the knees!:p
     
  41. Marquene Klimchok

    Marquene Klimchok New Member

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    Well wet food has been very successful. Can I tell you that she has so much color in her ears today. She has been kind of pale lately so I wonder if her blood sugars are a bit better or maybe just hopeful thinking. I got wimpy and could not do the BG test tonight. I know I'm not going to hurt her but again I have to get over my fear. Ugh. Have to wait for hubby to help me tomorrow I suppose until I get this right. Now I am feeling quite ridiculous and very disappointed in myself
     
  42. Marquene Klimchok

    Marquene Klimchok New Member

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    Can I order one of these now Deb? Need all the patience I can get just to get the BG test routine down!
     
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  43. Deb & Wink

    Deb & Wink Well-Known Member

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    Oh yes! Orders are filled very quickly from my vast lending closet of patience pants. Just let me know your favorite color and I'll get them right out to you!

    It takes time to gain confidence, get good at the BG testing and become proficient at getting those tests each time.

    Are you bribing with some freeze dried meat treats or something else pure protein?

    3 tries and you're out?
    Warming the ear first?
     
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  44. Marquene Klimchok

    Marquene Klimchok New Member

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    She's not the problem! It's me...lol. If I don't laugh a bit I'm going to cry. She is great. Can you believe I work in health care and am not a fan of needles or blood! 50 years old and a coward. Unbelievable !
     
  45. Critter Mom

    Critter Mom Well-Known Member

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    I think you could do with a couple of these to go with your patience pants...

    :bighug::bighug:
     
  46. Deborah & Gadget

    Deborah & Gadget Member

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    Jan 19, 2015
    My diabetic displays no symptoms either. He may be possibly peeing more ? but I never see him drink now or ever. He's chubby and he loves all food! Well except Tiki Cat and Wueruva. My two other cats got a little constipated over the food change but one dose of Metamucil cured that. My point is we are lucky to catch it before they do display symptoms....I think! Maybe they have avoided organ damage? My kitties number are not great. He has been on insulin since Dec 14 I think and his numbers are a roller coaster. Right now they are high because I messed up and gave him a dose 2 hours late :( and a few days ago I shot his insulin straight thru his skin in one side out the other. Boo hoo. Real learning curve on this stuff but I just know you can do it! I think we are doing the right thing for our kitties even though the obvious symptoms are not there.
     
  47. phlika29

    phlika29 Well-Known Member

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    I am interested to see how the numbers are changing with the change over to wet food. Please post up when you have some. :)
     
  48. Marquene Klimchok

    Marquene Klimchok New Member

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    Hi all. Well I have been doing BG s before the evening feed only. BG at doc was 426, first day home 320 and since then mid to high 200s. We have an appt for Trixie on Monday to get started on PZI. Think we'll no, I know it's time and I can't wait for her to feel a bit better, not that she feels that bad but.... Will keep you posted. Thanks for all the advice!
     
  49. phlika29

    phlika29 Well-Known Member

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  50. Marquene Klimchok

    Marquene Klimchok New Member

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    Thank you so much for your help. Going to review this right now
     
  51. Marquene Klimchok

    Marquene Klimchok New Member

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    I have to tell you honestly that just scared me to death. I am sooooo scared that she is going to go hypo.
     
  52. Deb & Wink

    Deb & Wink Well-Known Member

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    Deep breath, hold, release, deep breath, hold, release, deep breath, hold, release......................

    We are all scared that our cats BG levels can drop low. But you have a great tool in your home glucose meter, you have the resources of this board and you have your vet to call on.

    Yes, it's good to have a hypo toolkit on hand in case your kitty does drop to low BG levels. You can be prepared.

    Not giving your cat any insulin can be life threatening too. It's a difficult choice, but getting your kitty on insulin is the right thing to do.

    We will be here to help support you as you embark on your new journey and learn the steps of this sugardance.
     
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  53. Marquene Klimchok

    Marquene Klimchok New Member

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    Thanks Deb. Thank goodness for people like you. Not sure what I would do if I didn't have some people who are willing to go on this journey with me, even if it's on the web!
     
  54. phlika29

    phlika29 Well-Known Member

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    Sorry I didn't mean to frighten you. You are already one step ahead by hometesting. I would discuss starting with a conservative dose with the vet and if need be work up slowly from there. You will get used to the pattern of it all and as deb said we are all here to help you.

    When you do get back from the vets tomorrow start a new thread in main forum to discuss dosage, etc.

    Again not to scare you but today I would get your hypo kit ready (just in case). @manxcat419 is a relatively new member who can perhaps give you insight on what it's like to deal with low blood glucose. Honestly it probably isn't as stressful as you are imagining if you are prepared, have the low blood glucose link printed out, plenty of test strips.
     
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  55. manxcat419

    manxcat419 Well-Known Member

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    Jan 14, 2015
    I sure can!! Rosa's an expert at throwing me a low number every few days - she doesn't like me to be too relaxed!

    I'll be honest, the first time you see a number below 50 come up on the meter it's scary. But once you've dealt with it once, although it's always something you respond to quickly, you kind of fall into a routine even with that (I know, I wouldn't have believed that either a month ago). You'll find after the first time, when you'll probably want confirmation from someone on everything you do to deal with it (I did), that you'll be able to respond quickly but still stay calm because by then you know you can bring Trixie back up when you need to. You won't be left alone to deal with it as there's always someone around who'll help even if I'm not available at the time. If I am here, I'll stay with you until Trixie's back into better numbers. And remember, just because you see a number in the 40s doesn't mean Trixie is about to go into a coma - it just means you don't want her going any lower, so you need to be ready to bring her back up above 50. Rosa's been down into the upper 30s and has shown no sign of hypo - she just gets ridiculously hungry, eats everything in her food bowl and then goes hunting for more! The important thing is not to fear the numbers, to be aware of how Trixie's acting and to know how to bring her back up.

    It is very important to have your hypo kit ready. It's called a hypo kit, but we actually use it as soon as those numbers drop below 50 - we're trying to avoid a very low symptomatic hypo. That way, when you do get a low number you're not running around trying to find the food or syrup you need to deal with it - you'll have enough to think about without having to look for things. And I'd read the notes on how to deal with low BG levels a few times so you know what the cut-off numbers are for the different types of action you need to take without having to go and find the information. And I'd agree, print out the link in case you do need to check something quickly - it's much quicker than searching for it.

    As long as you always have high carb food, and honey or syrup available, you'll be able to deal with it. And never, ever run low on test strips - if possible, always have a spare pack of them available. I don't let the supply of them here go below 50 - it would only take Rosa to have 2 low cycles when I couldn't leave the house to buy more and I'd be through those 50 in a couple of days.
     
    Last edited: Feb 22, 2015
  56. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Marquene,

    Sarah has given you good advice above. I know that it's quite unnerving getting a hypo kit ready, but once you learn what needs to be done and have your supplies ready, it's actually quite reassuring: you'll have all the tools you need and you'll have rehearsed in your mind what to do. Also, remember that if the situation were to arise where you were dealing with low numbers, you can post here and people will help you. And keep you company. :)
     
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