Newly diagnosed... need help

Hello,
My name is Liz and I have a cat that was just diagnosed with feline diabetes. She is currently on Purina DM as per vet instructions and I have not yet had her back to the vet to test for blood sugar levels. I am supposed to get a glucose meter and test strips and send in the results after 4 weeks. Getting close to the 4 week deadline and I need to get a glucose meter and strips. This is all new to me and I am on a disability pension with a very limited income. I have heard that it is possible to obtain a glucose meter free from the manufacturer as the test strips is where they make the money. Does anyone have any insight as to how I can obtain and what the process is. I will be taking my cat next week to the vet but I want to be in a position moving forward to be able to do the tests myself.

 

Hey Liz, I am sorry but I don't anything about the free meter thing. I can tell you this: Many of us use the Relion Micro or Prime from Walmart. The meters are very cheap, 20 bucks or so. I started off with the micro and switched to the Prime as the strips are 1/2 the price.( 50 strips for 9 bucks as compared to 50 strips for 18 bucks) Hopefully, someone else can weigh in about the free meters as I don't have that info. Here are two good links about how to home test.
http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html

http://www.felinediabetes.com/bg-home-test.htm


Next: you want to stop the Purina DM. It is too high in carbs and it is not necessary to give an RX diet as most of them are too expensive and too high in carbs. Most of us give our cats Fancy Feast Classics which are around 4 % carbs Or even 9- Lives PATE. You want to stay 8-10 % carbs for a diabetic cat. Here is a food chart we all use and you can look up brand name wet foods. Dry food as too high in carbs. foodchart

Keep in mind that if you switch to a lower carb food, her Blood Glucose could go down considerably making her dose of insulin to be less as well. Could you give us some more information? What insulin are you using and how much. Then we can help you set up a Spreadsheet to store your numbers (click in my signature under SS and you will see what one looks like, don't get overwhelmed, we will explain it all to you, I promise!)We are here to help and we have all been where you are, overwhelmed and stressed. Ask all the questions you need answers too.

 

Thanks for all the info provided. My cat is not on insulin as yet. When she was diagnosed just over 3 wks ago, the vet wanted to see if it could be controlled by diet and advised me to feed her the Purina DM for 4 weeks and then test her blood to see what the next course of action will be. He was very optimistic that insulin will not be required. I will see about getting the glucose meter, test strips this weekend from Walmart. I find that the cat hates the food and is eating less and less each day. She is constantly begging for handouts from the dinner table so I know that she is hungry, but when I put food in her dish, she pretty much turns her nose up at it and walks away. I have a feeding syringe from the vet and a couple of times have had to resort to feeding her from the syringe. Once she has had a bit of food that way, she then continues to eat. I also noticed that she seems to have more energy now. She has lost a considerable amount of weight as this is a cat that was quite obese and is now thin. I find that she plays with her toys almost every day now ( sponge balls, toy mice etc) whereas before she rarely played.

What do you use for a lancette? As this is all new, I am not sure what the process is. I watched the Vet test the cat on our previous visit but did not see what he used to prick her ear. Any and all info is much appreciated. Is quite overwhelming... and of course worrying. Just want to do the best that I can with the limited funds I have to deal with.

 

Welcome to FDMB.
Either the Walmart ReliOn Prime or the Target Up and Up are low cost meters, with inexpensive test strips.
Pop over to Cat Info to read about good feline nutrition and to get a list of over the counter low carb foods.

 

Ditch the DM as I said above, it is too high in carbs anyway. Many of us use Fancy Feast Classics they are around 4% carbs, you want the carbs to be between 8-10 %. Check out his food chart that we use, foodchart Also, many use 9-Lives Pate and Wellness No Grain.

As far as the lancets : There are many different sizes (gauges). It is recommended when you are first starting out to use a 26-28 gauge. Also, it would be a good idea to pick up Neosporin WITH pain reliever to apply on the edge of the ears and don't forget to alternate ears. Check out the video links I gave you in my previous post. I understand how overwhelmed you are, been there, have the t-shirt. Just keep asking questions as that is how you will learn and how we learned. I still ask questions! We are here to help.

 

Hi Liz, your kitty is beautiful. What's her name? Is she on the canned DM? My cat wouldn't eat that either, but loves the Fancy Feast Classics. If she's on the dry, then I'd switch her to the canned food now before you start insulin, that may be all she needs to get her glucose where it belongs.

 

The cat's name is Bella as she is on the canned Purina DM. I just purchased a couple of cans of Royal Canin DM today. Will have to see how that goes. I plan on getting glucose meter on Sunday as I am unable to get out to the store until then. I am crossing my fingers that her blood sugar will be good.

What are acceptable/ normal readings? I have no idea what range the levels should be.

 

I understand about alternating the ears as my brother is a diabetic on insulin and he alternates fingers for testing. I want to thank you for all the info. Lots to read and review. I appreciate the help especially like you said, it is quite overwhelming.

 

The Purina is liver based and most cats tire of the taste. And it is very expensive. The least expensive food (which is a fine choice and low carb) is Friskies pate.

Generally we consider a cat regulated if they are in the lower 200s at the pre shot test and in double digits at nadir (usually in the 5-7 hours after the shot) but not below 50, which is approaching hypo territory.

 

Welcome to FDMB from a fellow Canadian in Ontario. What area of Ontario are you in?

A couple of folks have mentioned the Walmart Relion glucose meter however, it is not available here in Canada. It's only an option for us if you are very close to the US border and can make a trip across the border relatively easily.
As you are aware, the highest costs for us here in Canada are the test strips. I believe the least expensive strips available here are for this meter which is only available online so shipping costs would apply unless you have a substantial order and obviously there is a time lag waiting for delivery.

I believe Bayer is currently offering free meters here. Check here for details. The strips are a little more expensive however they are readily available locally. Abbott may also have some free meters available. Whatever you choose make sure it only requires a small blood sample of 0.3-0.6uL.

Most meters come with a lancing device and a small supply of lancets however most of us find them too thin (Gauge 30/31) to adequately test our cats at least at the beginning. You need to get 26 to 28 gauge lancets as mentioned by Bobbie for the best results. These are usually available with meters that allow alternate site testing such as the Freestyle meters by Abbott.

There is an abundance of experience available here and everyone is ready and willing to help you out so don't fret. Keep asking questions and in no time that overwhelmed feeling will be a distant memory.

 

Linda,
Thanks for the info. I am in Barrie. I just spoke to my ex husband and he has a glucose meter, lancet and about 300 test strips that he no longer has a use for as he has his diabetes under control with diet. He is going to drop them off on Monday or Tuesday, then the fun begins!

Not looking forward to the ear prick for testing, as I don't want to have to redo it because it wasn't done right. I am not afraid, just want to be able to get enough blood to do the test on the first try. I know it will probably take a few tries and I am fortunate that Bella is a very patient and for the most part, docile cat. So, I will hopefully have an idea of what is going on early next week, once I start testing. I plan on downloading a chart for tracking on and will go from there. Fingers crossed that she will not have to go on insulin. I find that in the last 3 and a half weeks that she has been on the DM food, she is no longer hiding, is back to being social and now plays with her toys everyday on her own. She has not done that for a couple of years.

 

So we are practically neighbours!

Glad to hear you have access to a meter and some strips. That's great!

If Bella is a co-operative patient like my girl, you will have no problem testing her. Pick a testing place that is comfortable for both of you and try to test her in the same spot each time. Make sure her ear is warm before you test. You can put some rice in a sock and warm it in the microwave or use a pill bottle with some warm water in it, or if Bella is agreeable, just rub her ears for a few moments to warm them up. After testing for a bit, they grow more capillaries and the testing gets even easier. Bobbie provided a couple of links in an earlier post which should be helpful. The trick is to find what works best for you and Bella. Don't fret over hurting Bella. Their ears are far less sensitive than you think. They don't seem to notice the lancet prick at all!

Fingers crossed that Bella can be diet controlled. Sounds like the diet change has already made a big difference and that's a positive sign! Let us know how the testing goes and keep asking any questions you might have!

 

Linda, your cat is beautiful!

When you get ready to test, do you need to put an thing on the ear. I read somewhere to put Vaseline on, which will help stop the blood from absorbing into the fur. And, if you do put it on, do you do it before or after you warm the ear?

Sorry for so many questions, but I am hoping to have a successful first attempt and want to be prepared.

 

This sounds like a great plan! Since you have to wait to get it, I'd get Bella ready now. Pick a place where you plan to test. Some of us use the bed, the couch, the kitchen counter, between our legs. Take her there and pet her, praise her, play with her ears, give her a treat and let her go (Find a treat she loves and use it just for testing. PUreBites and Bonito flakes are popular at my house and low carb). Then add warming the ears (we used a rice sack. Put raw rice in a thin sock, knot and put into microwave until very warm. Hold it behind her ear till nice and warm). That plumps up the capillaries. Again, pet, praise, warm, treat and release. Once you poke, she may be used to the process and sit still for the poke, anticipating the treat.

Once you get the meter, try it on yourself or a friend first to be confident in how to use it. Put a flashlight behind her ear and find the vein running down the side. You are aiming for the capillaries that run off that vein to the edge of the ear.

And be aware, few people are successful on the first try. It took us a weekend of poking before we got a drop. And ask your ex what brand lancet. We needed a lower gauge lancet at first until the capillaries got big. 30/31 gauge works for humans. 25-28 gauge may work better for Bella. You should be able to pick some up at the drug store - ask for Alternate site lancets.

And remember to breath it is an important element in this process.

 

Thank you Liz...Menace is blushing! There are never too many questions or any silly ones. We've all been in exactly the same place as you and we understand that flurry of thoughts and concerns. The good news is that goes away and all this just becomes part of a routine.

You can put a very light coat of Vaseline on the sweet spot of the ear to help the blood bead up. You only need a tiny bit as too much can interfere with the sucking action of the glucose strips. It does make the blood bead easier to see (especially with a dark haired cat) and easier to get onto the strip.

Sue mentioned Purebite treats. They are available here in Canada but there is a more cost effective alternative available at Walmart called PureSnacks. Made by the same company but only available for dogs. I buy the dog treats and break them into cat size pieces.

Some people use the lancet device and some just poke free hand. You can decide which way you find easier. If you do plan to use the lancing device you'll need to make sure Bella is not going to be scared by the click sound the lancing device makes by clicking it near her ear a few times to see her reaction and get her used to it before actually testing her.

The lancing device has a cap on it that humans use to press on a finger or forearm for testing. Because kitty's ear is not as fleshy as human testing areas, it's often necessary to remove the cap from the lancing device. You should fold up a tissue or makeup remover pad and hold that behind Bella's ear to protect your finger when testing and make the "poke" site a little sturdier.

Many of the lancing devices have an adjustable depth setting. You can set this to the deepest setting at the beginning and then as Bella's ears learn to bleed better, you can adjust accordingly. I find holding the lancing device at a 45 to 60 degree angle to the ear works well for me so I can see where I am poking her but this is an individual thing and you will have to experiment to find what works best for you.

Sue suggested trying this on yourself first and that's a great idea but keep in mind that your finger is MUCH more sensitive than Bella's ear!

 

I picked up some Friskies Pate not sure if it is the same as FriskiesPate Classic and also got her some Purebites treats. I emailed Purina to find out if the Pate and the Pate Classic are one and the same. Not sure if they are. She was going crazy for the Purebite treats. Was nice to see some enthusiasm over the treats, as she has had little or no interest in the DM cat food. Hoping to have the glucose meter in the next day or two and anxious to find out where the blood sugar is at. Looking forward to getting some answers as to whether she will be insulin dependant or not.

 

Hi Liz, I understand how confusing it all can be . The Friskies is Pate not Classics. The Fancy Feast is Classics. I am going to link the food chart that a lot of us use which I hope is helps
foodchart

Purebites and Stella and Chewy are all good dehydrated raw foods.

Let us know how we can help.

 

Ok..... so now I have the Accu-Chek Compact Plus glucose meter and Lancing pen (Softclip plus that came with the meter). After several attempts (poor Bella she was starting to growl), managed to get a reading of 14.2

Now I am totally confused as it is below 50. Did I not get an accurate reading after all the poking?

I am going to give her poor ears a rest and try again this evening. I just don't understand the reading. I even did a test on myself before attempting on Bella and got a reading of 5.8. Any insight on this would really help. Also, I want to thank all of you folks who have been there with information and hsve been so quick to respond to my inquiries. Thx.... Liz

 

Your in Canada, correct? So to get the US equivalent multiply your number by 18. So 14.2x18=255.6. Well above a 50 hypo. Hope that answered your concern.

 

Liz, you can do a spreadsheet that will convert the numbers for you and for us. It is here:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

You want the World version.

 

Just so you know, your sugar reading was very good! No worries there! All these numbers can get so confusing but the spreadsheet does the conversion when we ask for help from our US friends so don't worry about that.

It may be that the gauge on the lancet is too small for use on Bella's ear. You want to use a lancet gauge 26-28 to make the testing easier for both you and Bella and I'm betting what you have is either 30 or 31 gauge which is really tiny (higher the number, smaller the lancet.) There may be a larger gauge lancet available for your device but if not you may find it easier/necessary to purchase a new lancing device. The one that goes with the Freestyle Lite and Freestyle Freedom meters has lancets gauge 28 lancets and has a depth setting which is helpful too. If your device has a depth setting, you may have more success by setting it to a deeper setting.

 

When you have a moment, could you add a few tidbits to your signature? It will help us give you feedback.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

Always click the Save Changes button at the bottom when you have changed anything.

 

I will get on that later today. The only thing is, I don't have Excel in my PC. Using Libra Office. Have downloaded the spreadsheet but have not yet figured out how to use it. I am told it will convert the readings for me. But I don't have a lot of experience with Excel and am not sure where to input reading results. The cat is not on insulin and only started testing with glucose meter today.

 

Can you use the Google document instead of the Excel one? Be sure you are signed into Goggle and choose the Google link in that thread.

 

Sue, I have been trying unsuccesfully to get the Google link and upload. I must be really dumb. I thought I was relatively tech savvy but this has me more than frustrated. I have been trying most of the day to do this since I received your suggestion have been trying that as well. I am giving up for today and have to babysit my grandson tomorrow, so I will try again on Wednesday. I have a few other issues that I have been dealing with as well, so hopefully things will calm down enough so that I can focus on this and give Bella the attention that she rightfully deserves. I did another test on her few hours ago and the reading was 14.5 which I assume is acceptable as the reading from this morning was 14.2 and I was told that it was good.

Hoping for a more successful day on Wednesday. Thanks to all for the help and suggestions. It really is appreciated.

 

Oh Liz, I think perhaps you misunderstood me. YOUR sugar reading of 5.8 was good. Bella unfortunately is still higher than she should be.

 

Oh boy.. I sure did misunderstand. Well, this is not what I was hoping to hear, but what can you do? What range is considered acceptable? Just trying to get an idea and feel for this. By the sounds of it, she will likely be going on insulin.

I will have to take it a day at a time as I have another crisis happening right now to deal with. Thanks for the reply. I am thankful that I have the support and information from this group to guide me through this.

 

Liz, I'm so sorry I gave you false hope. That certainly wasn't my intention.

Take a deep breath and relax. Deal with whatever else is necessary right now and get Bella and you comfortable with testing. The insulin injections are the easy part of this dance...testing is harder. If insulin is needed it won't be a big deal. Ideally Bella would be in single digit numbers most of each 12 hour cycle. Every vet has their own idea of what ideal is. Did you vet discuss this with you at all?

I use a pet meter which reads higher than your human meter so I will defer to those who use a human meter for exact numbers. It is important to note though that anything below 3.3 mmol on your meter is getting low and needs to be watched and possibly treated as a hypo event. It's somewhat up to you and your vet how tightly regulated you want to get Bella. My thinking is that Bella would be safely regulated if her pre-shot number was around 11 mmol and her nadir (lowest number in each 12 hour cycle which on insulin would be between +4 and +7 post shot) was around 5.6 mmol. Some folks manage to get their kitties a little lower than this so others may have a little different opinion on these numbers. Once you get the spreadsheet going, this will make more sense.

 

Cbiscuit and Liz,

I am out of the country and can't help directly. @Marje and Gracie can perhaps help you both. I tagged her to look at your posts.

 

Sorry I was off the board yesterday. I'm going to send you a private message...if you look at the upper right corner of this page, you'll see "inbox". Click on that and you'll see my message to you. I can take care of this for you in no time.

 

Ok....SS up and running.

Just a couple of things....when Gracie was first diagnosed, my vet also recommended we see if feeding lower carb canned foods would work as Gracie was never allowed to have dry and was already on canned food. IMHO, if you have been feeding the canned prescription food, even if the carbs are higher, and she’s still in yellow numbers this far along, you need to start her on insulin. The longer she stays at these high numbers, the more insulin resistance she builds and the harder she will be to get into remission. So I wouldn’t delay any longer on starting insulin.

You might also find these Testing and Shooting Tips helpful.

Please let me know if you have any questions. Welcome to FDMB!!! We’re so glad you found us and we will help you and Bella all we can.

 

The Vet called me today as I had left a msg for him last week. I gave him her readings and he was quite pleased as her levels are down from when he first saw her. He wants to wait 2 more weeks before putting her on insulin. I tested her this evening and was still high. But lower than what the Vet had tested. When he tested her she was in the 20's and yesterday and today she was in the 16's and 18's. Now I am kind of stuck if he wants to wait.

 

I gave you the wrong info.... she was in the 14's and today 15.8

 

Liz, unfortunately remission is not a guarantee no matter what you do but as Marje said, the longer a kitty sits at high numbers, the less likely remission is. Some vets prefer, for whatever reason, to keep cats sitting at higher numbers. Maybe it's out of fear of trying to control the glucose levels too close to normal readings but regardless, the decision is really up to you. She's your baby and if you feel strongly about something, don't be afraid to have a discussion with your vet! Most vets only have a few diabetic patients. There is considerably more experience here on this board than any one vet will ever have and the experience here is hands on.

Like you, I want to maintain a close and co-operative relationship with my vet. I worship the ground she walks on but I don't always agree with her either. Thankfully, my vet tells me what she thinks or what the accepted normal practice is but she listens to me and lets me call the shots for what I deem necessary to keep Menace healthy and me happy. I sadly, am dealing with a kitty who has not read the instruction manual and does not react like most cats to insulin. So while my vet hasn't, till now, seen the need for further testing, I explained my reasoning for wanting the testing done and made it clear, I am willing to do whatever it takes to figure out what is going on and do everything I can to get Menace to healthier glucose levels. I never questioned my vet's professional opinion, I simply stated mine.

If you are concerned and want to start insulin now, call the vet back and just explain that YOU would feel better doing something proactive for Bella rather than waiting and negotiate to start a small dose. This approach should make the vet know you want to do whatever is needed to keep Bella healthy but not be taken as a reflection of your respect for them or their professional abilities.

I think all too often, we look upon the medical profession, be it pet or human, as being so perfect, and we do not speak up when things just don't sit right with us. I have learned through my experience with both pets and humans over the years, that I need to go with my gut feelings and more times than not, I have been right.

You know Bella better than your vet. Do what you think is best for her and you!

 

When I told my vet I wanted to start Gracie on insulin, at the advice of members on this board, she checked with a veterinary endocrinologist who said not to wait and to get her on insulin. Your vet is likely using a pet meter, which will read higher than your human meter. So if you gave him numbers from your human meter, it might be why he thought she was lower. She might also have been higher at the vet due to vet stress.

As Linda said, it's your call. But based on my own experience and what I've seen in over five years here, If I were in your shoes, I'd seriously consider getting her started and approach your vet as Linda has suggested.

 

Something else you should take into consideration is that even if your vet uses a human meter, cats tend to have elevated glucose readings with stress, so while the readings may appear to be lower now than when taken at the vet's office, it's quite possible Bella's true readings have not changed much because the reading taken by the vet may have been artificially high due to stress.

It's your call but we want to make sure you have all the facts to make an informed decision.

 

I have placed a call in to the vet and left a message that I would like to be proactive and perhaps start her on low dose of insulin as well as advising that the glucose meter was a human meter not a pet meter. Waiting for a call back from the vet. Thank you for the information / support and trying to get my poor little kitty on the mend.

 

Liz, it's obvious you want to help Bella and I think you made the right decision. Fingers crossed your vet will be sensitive to your feelings and agree to get Bella started on insulin now. Keep us posted!

 

I most definitely will keep you posted. This forum has been such a wonderful source of support and a wealth of information. Given the other crisis's I am dealing with right now, I am more than grateful for the warm welcome and support everyone here has been more than happy to give.

 

I hope you got a positive response from your vet!

 

Just want to give a quick than you to all the wonderful people who provided information and support. My Bella kitty crossed over to the Rainbow Bridge today. Thanks again. ...... Liz

 

Oh Liz, I am so very sorry. Fly high and free sweet Bella.

 

So sorry for your loss

 

Requiem aeternum, Bella.
{{hugs}}

 

Liz, I am so very sorry to hear Bella crossed the bridge. We all know how much you loved her and tried to help her and she knew it too. You were her guardian angel and now she is yours! Rest in peace little Bella!