Introducing Alley, just diagnosed

Hi everyone,

What a relief to have found this group. I'm new to the forum and diabetes. My 10 year old Alleycat was diagnosed last week after she stopped eating, drinking, and using the litter box normally. I initially thought this was a stress related response to several weeks without her mama--I had been away on a six week fieldwork trip abroad, Alley was home with a live-in sitter. My usual holistic vet thought Alley was simply stressed and constipated, even though I recall her mentioning a 'nail polish remover' scent to Alley's breath, which in hindsight I realize was a major clue something more significant was in play. By the time I got Alley to the clinic in town the following day, her blood glucose was over 400, her urine test revealed glucose and ketones, and other blood work indicated pancreatitis.

In terms of food, Alley has been on canned food almost exclusively for years (Diamond Naturals Chicken Dinner, Chicken Soup), meals twice a day. Dry food I use for treats (Taste of the Wild) or as a bit of a supplement from time to time. I will be making the switch to a low-carb canned option soon, though my vet advised me to let the pancreatitis subside before making any major changes. I should probably also be home testing to ensure she doesn't drop too low during the switch, right?

In addition to feeling overwhelmed with Alley's diagnosis and new needs more broadly, I am moving overseas in December and am heartbroken at the prospect that Alley might not be well enough to come with me. The stress of travel on her body is obviously a huge concern, but my main worry is that I'll be moving to a developing nation where my access to quality veterinary care and supplies (insulin, testing supplies, the correct type of food, etc) will not be a given as it is here in the states. I'll also be living at high altitude, over 11,000 feet. Trying to take things one day at a time and not project too far into the future, but Alley and I have been a packaged deal for the last decade, so that's been hard.

Any insight or words of encouragement from those of you who've been on this ride for a while would be very much appreciated.

Many thanks,
Kerri

 

Welcome Kerri, I am so glad the posting problems are resolved and you were able to introduce yourself and Alley. In my opinion, home testing is absolutely essential so that you can see how the insulin and the diet are affecting her blood glucose, and to protect her from hypos. Hypos are low blood sugar events that can be dangerous and life threatening. Humans always test before injecting insulin, and also test other times as needed. Our kitties can't tell us if they are feeling bad or off, in fact they are masters at hiding discomfort and pain.

It sounds like you live a very exciting life and for right now, at least, I think you have a good attitude about taking things one day at a time. There is a wealth of information for you to read on the board, plus many long time members with vast experience and knowledge. We are here to help you on the newest adventure in your life.

I encourage you to post questions and concerns on the Feline Health (Main Forum) so that more members can see and respond. I think one question would be: do you have to wait for the pancreatitis to subside before beginning to transition to low carb wet food?

Are you already giving insulin? And do you have the supplies for home testing yet?

 

Hi and welcome.
I don't think a switch to low carb food now will make any difference to the pancreatitis, but it will help the diabetes.
But if you change over to low carb you need to be testing to ensure Alleycat is not dropping too low. Swapping to low carb food will lower the blood sugar levels(BSL) even without insulin.
If Alleycat is showing ketones he should have been started on insulin straight away because ketones is not something that can be left to 'wait and see'.
The best insulins for Alleycat would be Lantus or Levemir or Prozinc as they are long acting insulins, and are gentler insulins than the faster acting ones.
As far as taking Alleycat overseas is concerned, hopefully you will have things under control enough and know how to handle things, to be able to take her. The actual flight might be tricky as far as insulin and feeding is concerned....you would have to find out more ....but you could take supplies with you to last quite a long time. You have 5 months to sort all that out. For now I would concentrate on getting Alleycat onto insulin and low carb food.
Also check with your vet about the ketones. Were they small or large? I would recommend you buy some Ketostix from the pharmacy today and start testing every day for ketones in the urine until they disappear.
Ketones in the urine need insulin, food and fluids and any infection/inflammation treated.

Yes definitely I think you should be home testing . Great you are willing to do it. It will keep Alleycat safe.
Here is a link about it. Any questions about it, just ask
http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

I would suggest you post over on the main forum as suggested by Idjits Mom as you will have more very knowledgeable people to help you there.
Ask lots of questions...it is a steep learning curve and overwhelming at first....but it gets better!
We all started where you are now, so we understand.
Here is the link to main forum
http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

 

Thank you both so much. Yes, Alley started insulin last week when she was at the clinic She’s on 1unit of Lantus every 12 hours. I began home testing yesterday, opted for Relion over the pricier pet-specific meter, so I hope that won’t skew results too much. Based on the few numbers I have, her insulin is perhaps too low. She was above 300 most of yesterday. This morning pre shoot she was at 232. I’m going to try to do a curve so I have some numbers substantiate my concerns about her dose.

I think the vet was concerned about food aversions with switching diet during pancreatitis bout. She’s been insanely picky in the last week. I have no fewer than 12 different types of food in the fridge at the moment, half of which are low carb, the rest fairly conventional. I’ve cut all dry food and the treats I was giving her before (I had NO idea how carb-laden these things are). I’ll pick up some of the ff tins to see if those might tempt her. In the meantime, where does one buy the freeze dried treats? I’ll be testing her a lot today and I want to make sure she’s properly compensated

 

one of my cats is named Ally too!

A 232 is actually a good number for a newly diagnosed cat! So great you started testing already. The numbers will be lower then the vet because it's a human meter, but the numbers are closer at lower levels. Normal on a human meter is 50-120 and on a pet meter it's 68-150.

December is 5 months away. She will surely be in better shape by then, but do plan ahead for sources of supplies you'll need. You must likely can order things from the internet and be shipped to you.

And we are here for advice.

Since you're cat had ketones please pick up some ketone urine strips or ketone blood meter to make sure that they are gone. They can get deadly fast.

 

If she has had pancreatitis she could well be nauseous. Many cats with pancreatitis need anti nausea meds such as cerenia and zofran to help them during the recovery stage. Ask you vet for some.

 

The freeze dried treats you can get at petsmart, petco and order from chewy. Purebites is popular (cheaper if you buy the dog food ones). My crew like vital essentials it's dehydrated freeze dried raw comes in flavors and different kinds of forms (kibble, treats, mini patties for complete meal).

 

That’s helpful. I eased up on the Cerenia thinking she’d only need it if she was vomiting. I’ll give her some now. I’m guessing that’s why she’s been eating less in the last day

 

How is Alley today? Is she eating any better?

 

Thanks so much for checking in. Alley still isn't doing well, ate a bit last night, very little this morning. I syringe fed her a bit this morning for her injection. The vet seems to think this is a function of her pancreatitis as her levels aren't crazy high or low. Highest yesterday was 251, lowest 207 (I'm using the ReliOn meter). First test today 272, +2 250. But overall she's been super lethargic, will climb up for a snuggle from time to time, but otherwise has been sleeping on her side and just seems uncomfortable and out of it. Gave her the Cerenia again this morning and have been keeping up with the buprenorphine for pain. Otherwise, I'm at a complete loss. I just want her to feel better.

Is there a way to test for ketones that doesn't involve trying to catch her in act and holding a strip under her urine?

 

What's the best way to test for ketones? Do I need to hold the urine strips in the urine stream? That sounds tricky.

 

You don't need too much urine to use the ketone strip.

Once a cat starts peeing they don't really stop, so I found it easier to test for ketones than I thought it would be. I usually keep a tiny plastic cup (a little bigger than a shot glass) and just get a bit in it when she is going, and dip the test strip after. I've caught her mid stream with the test strip itself before, but I find that harder to aim. I think I've seen the recommendation of using a long handled spoon as well to grab some liquid while they are going.

I'm sure others can pop by with more advice for those cats who are a bit trickier to collect from.

Welcome!

 

Thanks for the tips! This is all getting interesting...

 

Sometimes b 12 methylcobalamin can help with energy.

There are ketone meters that take a blood drop like a glucose meter. If I were to test for ketones that's what I would use personally. A lot easier and my cat hardly ever pees in front of me.

They sell them on amazon.

 

KETO-MOJO Blood Ketone and Glucose Testing Meter Kit, Monitor Your ketogenic Diet, 1 Lancet Device, 10 Lancets, 10 Ketone Test Strips, Carrying Case. Does NOT Include Glucose Strips https://www.amazon.com/dp/B0789G8KTG/ref=cm_sw_r_cp_api_kcluBbCRJ1R3S

 

If Alley is very lethargic he could be dehydrated and in need of some sub Q fluids. Cats with pancreatitis get dehydrated. Sheba always needed subQ fluids when she got pancreatitis and often needed more than one lot. Her symptoms of dehydration were lethargy and not eating well.
When you pull up her scruff does it fall back easily or slow to return to normal. If the latter he is probably dehydrated. Also check his gums. Are they slippery and wet or tacky? Also press on the gum. Does it return to normal colour straight away or do it slowly. If you are unsure check with the vet.

 

A quick Alley update: She seemed to regain her appetite last night. I syringe fed her in the morning, but by dinner she was eating on her own again!
This morning she had a huge appetite and ate a solid breakfast. Switched to ff pates and she didn’t mind. She even had enough energy to pop up on the couch and look out of the window at me when she heard my car in the driveway. I sure have missed seeing that little kitty head profile from above as she waits impatiently for me to come upstairs. Testing has proved more challenging now that she’s actually moving around. She’s a very feisty cat when she’s feeling well, so we’ll see how we both do

How long after diet changes does it generally take to begin to see shifts, however subtle, in BG numbers?

 

That’s great news!!! A few days usually shows a change

 

Sulo's blood glucose levels dropped the next day after switching to appropriate food. Though he's bounced up again now after two days, so I suppose the weekend will tell how permanent the shift was.

 

I tested Bama's urine for the first time yesterday. I used a clean lid off a cottage cheese carton and slid it under his rump after he finally quit digging and turning round and round and sat down. Then I carefully picked it up after he stood up. It had some litter in it but enough urine that I took it into the bathroom, dipped the stick, timed it and compared it to the ketones chart on the bottle. Solidly negative, I am thankful to say. Walmart has a box of 50 sticks in their Reli-On brand for just under $7 where I live. Instructions say to discard 6 months after opening the box.

 

Hey everyone,

I updated Alley's spreadsheet. Until this morning, she's been exclusively in the yellow. She's been eating well, has been more energetic, using the litter box normally, driving me crazy while I work, so mostly back to normal. This is great; it's also making BG tests and shots increasingly difficult. So, two issues:

First, for BG tests: I'm plying her with treats every time, but she's over it, and I'm feeling really discouraged. One of the problems is that I'm having a tougher time getting a bead of blood to form. It wasn't an issue before, but I'm having to pinch her ear a bit to get enough blood, and I think this is what's bothering her the most. It's stressing both of us out. What can I do to get a good bead to form? I've watched all of the videos I can find on technique, and Alley won't hold still for the warm sock thing.

Second, I'm not sure that she's getting the full dose of insulin. I'm using the Lantus pen with generic screw on needles, she's at 1 unit twice a day. She's been really squirmy the last few doses, and even though I'm trying to keep the syringe in for several seconds while I press the button, there's often a little bead of fluid on the tip of the needle when I withdraw it. Wondering if that might be the cause of her high numbers today? Or maybe a pancreatitis flare as she woke me up around 3am dry heaving, no actual vomiting though.

 

Have you tried Slippery elm bark powder with Alley? It is very good for digestive issues such as dry wretching.
Just buy some from a health food store or somewhere like iherb.
Make sure it has nothing else added.
To make put 1/2 cup cold water in a saucepan with a teaspoon of SEB powder. Mix it and put on stove stirring all the time. Bring to boil and boil for 2 minutes stirring all the time. Then take off stove and store in a glass jar in frig for up to a week. You can double the amounts for a larger amount.
Give a teaspoon a couple of times a day, either in food or stock.
I used to give it to Sheba at 3 pm and 3 am ( in an auto feeder) in a small amount of food. This stopped the small vomits she used to get in the couple of hours before shot time because of an empty tummy which caused an acid tummy.

With the drop in the needle after the dose is given....this is common. I used syringes so I don't know if it is the same with pens...but I used to hold down the plunger until I had withdrawn the needle and there was no drop.
However with the pens, I don't know if holding down the button would cause you to give another dose or not. You need to check that before trying.
Try pressing the button and holding it down while holding it over the sink to see if only one dose comes out and if there is still a drop on the tip of the needle.

What sized lancets are you using to prick the ear?
Are you able to get tests after the PMPS?

You might like to start posting over on the main forum where there are more eyes to see and answer your questions
http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

 

I'm using Lantus pen with generic needles as well (BD if the brand matters) and I get that small drop sometimes as well after withdrawing the needle. I was instructed to hold the button down for 10 seconds to make sure the whole dose gets out of the needle, but even after holding down for 15 to 20 seconds there might still be a tiny drop of liquid. And as you said, it's not easy to hold the cat still for too long!

I simply haven't worried about it too much, assuming (perhaps incorrectly) that such things have been accounted for when planning the pen, the needle, and the dosage.

 

Have you tried putting a thin layer of Vaseline on the area beforehand? That can sometimes help a lot with getting the blood to bead up.

 

This actually sounds like a really good, simple way of doing it; I'll have to try it myself.

 

It's time to raise Allyson dose