SweatPea (sugar baby), new to forums, here's my life story

Hello everyone, my name is James and I'm new to the forums. Been reading things a little while but this is my first post. Please note that a few months ago, I didn't even know cats could get diabetes so I'm relatively new to this although I'm learning a lot. (Also, I am sorry this is so long. I'm just trying to give as much information a possible. Thanks in advance for reading.)

Anyway, my wife and I have always been cat lovers. We started out with one about 10 years ago. 2 years later we adopted a sibling group of 3 for a total of 4 cats. Storm is our first and eldest (10 years), the others are Max, Halley, and SweatPea, all (8 years). They never really had any health problems until more recently. They always ate dry food freely whenever they wanted. We've fed them Iams, Purina ONE and most recently Blue Buffalo. We changed them to wet Friskies twice a day, and no longer fed any dry food about 5 months ago (July). I'd rather feed something better like Fancy Feast but that will cost us over $200.00 per month which isn't really doable right now. (I am open to other ideas including homemade, cooked or raw.) We switched to wet food when we took all of the cats to the vet for a well visit in July and SweatPea was diagnosed with diabetes. None of the other cats had any health issues.

We suddenly lost Halley about 1 month (August) after that well visit to diabetic ketoacidosis. We didn't even know she was diabetic. In her life she was never overweight, never acted sicked and was always happy. Not to mention when we took her to the vet for her annual in July she was apparently in good health. It all started one day when she suddenly threw up after dinner (Thursday) and didn't want to come eat her food the next day. We took her to the vet on Saturday. They did blood test, physical, etc and just said her sugar was a little high and thought she had a belly ache. This cost us $400.00. We took her home, gave her the prescribed meds for the stomach ache. Of course this all happened over the weekend and she got worse. We again took her to the vet on Monday, they checked her blood again and then checked for ketones and said we needed to take her to the emergency clinic for care. We ran her down to the emergency center where they took her back right away to start treating her, giving fluids, etc. A while later they came out with the check list of everything they needed to do to make her better which included several days at the hospital, blood cleansing, etc. They told us it would be $4,000.00, it might not work, and she might have another episode of the same. Unfortunately it was too much money and just not doable for us. We were heartbroken, but we had to put her down. The emergency visit still cost nearly $800.00.

As I said earlier, SweatPea was diagnosed with diabetes in July. She used to be overweight and had these weird coughing episodes when she was younger. We've been through several vets over the years and had SweatPea there many times. They've done xrays, ultrasounds, etc. The only thing they could come up with was that she may have some issue with her heart that was genetic. She used to be around 23-24 lbs. None of the other cats were overweight, they all had the same access to food, etc. Currently she is down to around 13 lbs. After her diagnosis we tried self regulating with only wet food which seemed to work for a while, keeping her BG in the 200s. About 3 weeks ago she started to act strange and suddenly didn't come to eat. Alarms went off and we immediately took her to the vet. They checked for ketones which she had none. We decided to start insulin since food alone wasn't working anymore. The said to start with 2U twice a day. Thankfully, SweatPea did start eating a little bit and she got her first dose on 11/17/17. At that time we were feeding all the cats Fancy Feast but it was just getting too expensive combined with everything else. I'd be willing to just feed her FF and the boys Friskies but SweatPea won't eat without the boys next to her. See the attached spreadsheet I started. You can see more recently her sugar is jumping real high some times right before her dose which I thought maybe was the bounce effect I read about. I tried bringing her dose down to 1.5U thinking maybe 2U was bringing her down too low causing the bounce. I did a full curve today and it appears I must be wrong. Right now the 3 cats split one 13oz can of Friskies twice a day, one in the morning, one at night. Whatever they don't eat from the meal before stays down and is gone by the next meal.

I work all day and my wife is a stay at home mom with our twin boys. Since July we've spent around $4,000.00 on vet bills so we are pretty much tapped out.

Any advice as to what I should do moving forward or any changes?
Am I not giving her enough food?
Is it bad for them to not finish all of the food off at once?
Do you need more info from me?

Thanks again for reading.

https://docs.google.com/spreadsheets/d/1KC-T8dlQ2s0dOnKCb_ujTB12p0Bm6_aoqHfF-Ntasqk/edit?usp=sharing

 

Here's a picture of the 4 cats together soon after we got the younger ones. Halley is the black one, SweatPea is the calico looking one, Max is the tiger, and Storm is grey with white paws.

 

Hi James and welcome! First of all, I'm so sorry you lost your sweet Halley! DKA can take our kitties so quickly and sadly we have seen far too many kitties around here not able to survive it. Has your vet talked to you about how to monitor for ketones at home? Test strips are about $10-15 at most pharmacies and since SweetPea's sibling had them, it might be a good idea to monitor at home. We can talk more about that later.

For now....great job getting started with home testing! It looks like you're doing a great job of learning what you need to know to take care of SweetPea. And you were right - 2u is too much! (at least right now - insulin needs do change). That 34 is too low. She shouldn't go below 50. I think your decision to reduce to 1.5 was good. So tomorrow, if her AMPS is above 200, I would recommend trying 1.5u for a few days. Are you or your wife able to monitor during the week? Or are you both at work? You certainly don't need tests every hour like that, but it's great if someone can grab a mid-cycle test or two. If you're both at work, no worries, we can talk about how to make that work too.

And just to confirm: are they completely off dry food now? And are you feeding Friskies pate? or one of the other types of Friskies?

I know that was a lot of questions! And please continue to ask any questions you have - there is a lot to learn around here!

 

We haven't talked to the vet about monitoring for ketones but I did by some test strips from Walmart a while ago. We haven't tried to use any yet. They are ReliOn Ketone Test Strips - Reagent Strips for Urinalysis. Has a few numbers on the front in red hue colors. Not really sure how to get any urine from her, especially since she isn't the only cat in the house.

I thought the 2U may be too high but with the testing I did today 12/3/17, her sugars went as high as I've seen them. After I posted this I read some more about DKA and read something about not getting enough calories and that perhaps I'm not feeding her enough. That the insulin might not be the problem. I'm really worried with her sugars getting so high that she'll go into DKA and we'll have to put her down. As I mentioned in my first post, I'm pretty much out of money at this point and can't go for another ER visit. Tonight I already feed them, gave more food than usual, and gave her the 2U. My wife is a stay-at-home parent so she is here all the time, but with the twins she has a lot on her plate. She is able to keep an eye on her though and take a mid cycle test if needed. I've been taking the lead on trying to treat her.

Correct, no dry food and hasn't been any for several months. Friskies Chicken Pate. No other types. It fits in our budget so I hope it works.

 

Friskies is great. A lot of us feed that, and my kitties prefer it. They won't even eat Fancy Feast anymore.

The highs you're seeing are bouncing. It's awful to see, but it's a pretty typical part of the process. Just giving more insulin can actually make it worse, not better. Dosing is based on pre-shot and nadir (lowest point). Your nadir was 92, which is a great number. It means that the 1.5 is a good dose for now. The nadir on 2u was 34 which is hypoglycemic. You already know how dangerous DKA is, but hypos can be dangerous too so it's important to be careful in both directions.

Ketones are usually a combination of not enough insulin, not enough calories, and an infection or inflammation of some sort. I completely understand your concern about this. Ketones are scary. As far as getting the ketone tests done, it's not easy, but it's pretty simple. You basically have to camp out near the litter box and stalk your cat. The more you can study her patterns, the easier it gets. Most cats have a rhythm - they get hungry around the same times, pee around the same times, sleep around the same times...so start to watch closely and make note of when she uses the litter box, then you'll know around what time you'll have your best shot of catching her. If she'll pee while you're in the same room, you can just hold the strip under her while she pees, or hold a long handled spoon under her. If she won't pee while you're in the room, you can try putting plastic wrap in the areas of the litter box where she pees most, press down a little, and then try to catch her before she covers it over with litter. You only need just a little bit of pee to dip the ketone strip in it. Then time it carefully to read the color (in good light - it can be hard to discern the shades if you aren't in good light). If the litter box is somewhere that it's hard for you to monitor, consider if it can be moved to a more convenient location. There are meters that test for ketones with a small blood sample, but they are expensive, so becoming a cat-stalker is probably the best bet.

A typical nadir on Prozinc is around +4-+6, so if your wife could grab a test sometime in that range, it will help us know when the dose needs to be changed. If the twins are keeping her busy, anytime is fine though.

Oh, and do you leave food out for the kitties? Or do they just eat two meals? Many of us have found that either leaving food out, or giving multiple small meals throughout the day works best for our sugar kitties. I know it can be extra tricky when you have a whole group of kitties to feed though!

 

Hi James! Djamila has give you great info so I'll just add a few things. First, ketone tests are super important but it isn't necessary to get them every day. So the good news is you can be a cat stalker (lol!) and figure out how to get a sample, but you don't have to do this daily. When they're in higher numbers (like pinks and up on your SS) you want to get a test more often, and when they're in lower numbers, you can back off some (but still do get those tests!). The blood meter for ketones is more expensive and we usually suggest that only to folks who've dealt with DKA so it can be detected more easily in the future. You can always go that route if you prefer, but I think you'll find that it really isn't THAT hard to get a pee sample...and if it turns out that it IS for whatever reason, it's an option for the future!

I know DKA is scary especially considering what you've already gone through. Just keep an eye on SweetPea though. Those ketone tests at home will help, but also, as Djamila said, it's a combo of things...and you're giving insulin and she's eating so right now, all is well.

Leaving food out so they can finish it later should be fine. A lot of folks let their cats graze...mine (all civvies right now) usually eat when I put the food out, then go back within an hour to eat more...it's usually all gone within 3 hours or so of it being put out. But that way, they don't have to eat it all at once. I did that with my sugar kitty too and it was fine.

And yep, you can feed Friskies to them all if they like it! Just choose any of the classic pates...they're all under 10% I believe.

I don't want to overwhelm you so I'll stop now with just a reminder that we'ere here! Ask any questions you have and we're happy to do whatever we can to help out!

 

Welcome, James! You've been through a really tough time with DKA, etc. My guy had a bout 2 months after diagnosis and it was very expensive to treat. Luckily he got past it.

You've been given really good advice by Rachel and Djamila. Urine ketone testing can work if you have a multi cat household but it requires a little spy work on your part. I have three cats and only one large litter box but I've learned my diabetic's routines so I've been able to catch him in it. I use the shallow spoon under the backside trick.

I like the 1.5 u dose for now. If your syringes have half unit marks, it's possible to eyeball 0.25 u fractions. You might need to do that eventually because the good dose can fluctuate up and down a bit over time. The reds on your spreadsheet are bouncing from those recent very low numbers. You're doing everything right!

Also - Friskies pates are fine to feed and easier on the wallet when you're feeding a bunch of kitties.

 

Thank you for all of the responses!

Any thoughts on the possibility that the 2U is right and she just wasn't getting enough food? As I said before, I was splitting a 13oz can at breakfast and a 13 oz can at dinner between the three cats. They would eat it all pretty quick and usually act hungry throughout the day, pesting for food. As of last night I've been giving a 13oz can and a 5oz can at each meal instead. They didn't eat it all as quick today. Tonight I gave them the same extra food and gave the 1.5U as suggested. I guess we'll see what the AMPS is and nadir tomorrow. Can you expect to see the result of changes on the next cycle or does it take a few cycles for it to fully show you the results?

 

It depends on the kitty. Some respond in the first cycle, others take a few cycles to show what they'll do with a particular dose.

Yes, it's possible that she'll need 2u as her eating shifts, but I think first we want to try to stabilize the numbers if we can so they aren't bouncing so dramatically. Some kitties just bounce no matter what, but most kitties will settle down as the dosing gets sorted out. So first lower just a little to 1.5u for a few cycles and keep posting so we can keep an eye on her. Then if the nadir ends up too high we can start to make some small changes (0.25u at a time, and holding for 3-6 cycles each change).

 

Alright, I'll do that and keep everyone updated. Thank you!

 

SweatPea's sugar is currently showing as "HI" on my ReliOn Meter which means she is above 600. Can I give her a little bit of insulin to help? What should I do? Can't really afford vet right now

 

No, don't do that. Wait until it's her proper dose time and give the same dose as you gave this morning. Erratic numbers are fairly common, especially in the early days. You need to be very consistent in order to get her to settle down - same dose AM and PM , hold dose for a few days, fairly strict 12/12 dosing schedule, etc. Many people are frightened into dose tinkering based on a single BG measurement and it creates a lot of havoc and confused responses.

A single odd number like that might also be from a faulty strip. It might not be explainable at all. We call them, "Look, a squirrel!" numbers.

 

I called her vet which wanted me to wait as close to her normal dose time (9:30PM) to give insulin stating 2U. However, I mentioned that SweatPea is not acting herself and is laying around. She said I could give her food, and give her dose now, adjusting the dose time for tomorrow to get back on schedule. Sorry, I didn't see your response until after I talked to the vet. I came home in a panic after my wife checked her at +4 which was 332 and said SweatPea wasn't acting normal.... flash backs to Halley.... I'm so scared of delaying or pushing something off and then that's the end of it. I wouldn't be able to recover her from DKA.

It isn't just the number, she isn't acting normal. But yes, it is easy to get scared.

Thank you for your immediate response... you're the best!

 

Yes, you can adjust the dosing schedule back to what it was. How many hours early is this dose? The previous dose might still be having an effect. Is she willing to eat? - very important post DKA.

 

Yes, she came running for a can of FF before I gave her 2U. It's 4.5 hours early.

 

This dose is likely overlapping the previous one. If you can fit in a couple of extra BG tests between now and bedtime that would be a good idea to see if she's dropping too low. Is your plan to wait until the morning dose now?

 

It looks like Sweatpea dropped almost 300 points in an hour. Please make sure you are getting extra mid-cycle tests. Either the HI reading was a wonky test, or that is a huge drop and should be monitored. Please give us an update when you can. We tend to care and worry over all the kitties here

 

Unfortunately I didn't think to try another test strip and my vet didn't suggest it either so it may have just been inaccurate. I'll be doing more tests to check, so far so good.

 

From your spreadhseet it looks like you gave two units at regular shot time tonight?

Vets are great in so many ways, but they know very very little about feline diabetes. They do their best, but most folks around here have found them to be less-than-reliable sources of information about proper treatment. Bless their hearts.....

 

No, she got her dose at +7 - AM.

You're right about the vet. When I was talking to them it almost seemed like I knew more than she did.