Newly Diagnosed

Hi everyone! Stumbled across your board on a professional site of mine. I have an 11 year old cat that has diabetes secondary to 1 Depomedrol injection for a chin acne she had. I feel terrible that this put her into this state as I am her vet as well as her owner. UGH! I have never had a cat do this to me in 26 years after one injection. I have never used Lantus but I know that it is the best for trying to get them into remission. She has been on a low carb moist diet since my fear was confirmed. She liked K/D dry to nibble on as well which i have stopped. She is a very skittish/secretive cat so I have not done a full panel on her as the drive would stress her out too much. Anyway, her urine last week was +1 glucose and no ketones (kudos to my daughter for holding her for me!); Culture was negative. I am not used to an insulin that has such a long effect, bounces a lot and is difficult to interpret. I have read a lot of your sticky notes in regards to this insulin. I would love your input as these low BGs are freaking me out when they happen! Hence, the units given have not been consistent. She is not a terribly good eater at one sitting,either. I am lucky if I can get her to eat half of the heaping teaspoon that I put down. Hence another reason why I get freaked out when she reads in the hundreds and it is time for her insulin. Your group appears to be very caring and helpful. I would appreciate a little hand holding from you veterans as my colleagues at work have not used this insulin either. Thanks in advance!

 

LT (long tail) and I have only been on here 2 months so I'm not one that can help. However, I can extend a warm welcome to you and Charlotte to a wonderful forum. The moderators are all over the world so there's always someone to help out day and night. The advice they give has helped us avoid some disasters. A real plus though is the camaraderie among the numerous members - always there to support you with kind words of encouragement.

 

Welcome to the LB&L forum. Yes, there are many on here who can offer you support and advice!

We used Lantus for about 18 months and then switched to Lev since my Luci is a big time diver. So since you're on Lantus and you've read the stickies AND you have a spreadsheet, signature and an avatar all set up - you're already way ahead of the newbie game!

It's unfortunate that she got the steroid for her chin acne - seems like the acne would have been easier to manage with a topical cream...ah, but that's hindsight isn't it?

Some of the things I've learned about Lantus is that it loves consistency, so changing the dose too quickly can cause really crazy numbers to happen. Also, once Charlotte hit those low numbers recently, she bounced the next day or so - as her liver recognized the new unfamiliar numbers and decided to dump all that glycogen into her blood stream to make up for the 'new' deficit. They adapt so easily to those higher numbers and now getting them down will be new territory..

If you haven't already, you can check out the food chart http://catinfo.org/chart/index.php and perhaps move away from the seafood - except on an occasional basis. Apparently fish based foods cause cats to worry about other issues - I don't use a lot of fish foods...so you may want to check into that. Chewy.com has a great variety of low carb foods available. I like Tiny Tiger as it helps get some variety into the FF mix.

Young Again and Dr. Elsey's have dry foods that are 0 carbs - sold on line as well.

You may also want to consider a human meter as we're all very familiar with the numbers on those - however there is a SS for the AlphaTrak/Pet Meter and it appears you're using the human meter SS - you may want to ask for help migrating to the other SS - or you can use both until you get comfortable with one or the other. Pet Meter strips are expensive and don't make any difference in the end for the readings you'll get on a pet vs human meter are pretty close.

I'm glad you're trying TR - looks like you're testing plenty enough. You probably noticed when using TR that you'll want to reduce if the numbers go under 50. Different threshold for Pet Meter.

Do you have your hypo kit ready? Some medium and high carb foods; honey/karo syrup? Extra test strips?

I'm glad you're here! I'm sure you'll have some interesting input and it'll be great to have another opinion of vets 'in the house'...my experience with vets hasn't been very positive regarding FD...so hoping your experience here can help the other vets understand more about FD and all the wonderful work this collective group of people have done to help so many cats! It's an exciting place on the internet!!

 

Welcome. Which meter are you using? Is it a pet meter or one for humans?

Lantus as a depo drug needs consistency so skipping around on dosing won’t work. It’s much better to stick to a dose you are comfortable with for a week and see what happens unless a reduction is earned. Since you got a 99 on the .50 dose I’d consider shooting 0.25. You caught this very early so I’m betting on a quick remission.

My boy had chronic pancreatitis that likely made him diabetic. I got him tightly controlled but never into remission. Feeding small meals often helped him with pancreatitis and also kept his BG well controlled.

My vet managed all Max's issues but left the rising to me and I gave this site to thank for that. You have come to the best place given the situation.

 

Welcome. We have had a few vets and their cats here over the years.

It is good that you dropped the k/d dry. It is crazy high in carbs - over 30%! And for some cats, it is like crack. Rover would do anything for a few pieces of it. May I ask you why she was eating it? It would be good to know if CKD is in the picture.

 

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I have a total of 6 cats and one of them ended up at an ER as he was crashing on me and we are not 24 hours. He had some unknown kidney insult so I just intervened with the younger ones with the renal care. The dry is like crack!! That cat is a monster if he doesn’t get some. I have to coax him to eat it with moist. Ugh!

 

Yes unfortunately I tried topicals but she was impossible to hold to medicate and she flipped out with a soft ecollar. Thank God she has gained my trust to test her.

 

Yes, we've heard the stories here - many cats are completely addicted to dry food and the transition off can be, well somewhat a test of wills...

There's a list of toppings that you can sprinkle on the wet food to make it more tempting...and one would hope, if she gets hungry enough, he'll eat the fabulous wet food that's presented to her

 

Thank you!!

 

If she refuses to eat the wet food, it could help during the transition to wet food to crunch up one kibble and sprinkle it over the wet food.
Also, Dr. Lisa has written an article on transitioning a cat to wet food. And here is the list of suggestions for stimulating a cat's appetite.

 

Yes I have read about the transition, thanks. She always ate both in small amounts so getting her to just eat a good moist meal is very difficult especially when her numbers drop to the hundreds. She’ll pick and nibble so I have tried one temptation treat smashed up and sprinkled over her food. She’ll eat but seems to be primarily searching out the crumbs. Ugh! Cats are definitely NOT small dogs!

 

Welcome

It is a wild ride but wouldn't trade a single day.

 

Thanks!! I do have the Karo and some gravy DM food and lots of temptation treats!! Thanks

 

Thanks!! I am using the ReliOn meter as of 10/7. Accu check meter prior to that. Both are human meters.

 

Welcome LOTS of LOVE and SUPPORT here!!

 

Thank you!! Much needed!

 

I’m glad to see you here and willing to make the changes necessary! We really do get horror stories here sometimes about some veterinarians (who are probably just very stuck in their ways, or don’t expect a caregiver to be able to handle the illness). I believe a good scientist will be open to continued learning. The support here is wonderful! And I hope your experience with your cat will offer you a chance to bring more to your practice. My veterinarian was extra helpful because of her experience with human diabetes in her family.


I’m going to echo a couple of things because you have a lot of great responses already:
Lantus is a depot insulin. Consistency is very, very key. I would definitely choose a dose and stick with it for several cycles (unless you experience a hypo event, of course).
Have you read the sticky that includes fine dosing info? You’re already starting out on such a low dose, and caught things quite early, so chance of remission is better, but that will mean teeny tiny micro doses at some point.
I have had a great response to crumbling freeze dried duck liver (PureBites is a brand you can find easily on amazon) onto food with any of my cats, to encourage feeding, even with the cat that refuses to eat much at once and has a chronic URI.

I hope she is feeling better soon!!

 

If you add that info to your signature we'll stop asking

 

I had but then messed up my signature and I had to leave the house. Will do though!! Thanks

 

Welcome Dr S. and Charlotte. Everyone has given you the most important info.

Lantus is your friend if treated properly. If kept in fridge it will last a few months. If using a pen use regular insulin syringes and draw from stopper like you would a vial. Do not inject air into pen. Getting it from Mark's in Canada is the most affordable place.

It might take some time for the body to rid the steroid for good.

For help with the food. This worked when trying to get my life long (13 yr) non diabetic kibble addict off dry. It took 3 yrs to get her off kibble but this worked. I used patties to crumble on wet and the nibs in place of dry food.

https://www.vitalessentialsraw.com/cat/food/?filter_pa_product-type=mini-patties

Will be following your progress.

 

Yes, I am using a pen which I keep in the refrigerator and draw from the stopper. What are these patties and nibs you are speaking of?

 

I’m super excited to see a vet on the forum

Lots of amazing advice already. I’d take a look at other member’s posts and SS and just observe what people do in what situations. If you want to see a kitty that bounces all the time, was on steroids, and on a high dose, that’s my cat

 

Welcome Dr. S and Charlotte! She's a beautiful kitty!

 

They are dehydrated freeze dry raw complete food. The link in post above will tske you to the site. Chewy has them. Once my kitty ate it dry i rehydrated little by little until it was semi wet. My gal is picky about texture. Once she was eating it i started mixing with fancy feast and over time transitioned out the patties.

 

Hi and welcome to you and Charlotte.

Have you tried any of the freeze dried foods that are available to pop on top of the wet food you are introducing? They are low carb. I think ZiwiPeak freeze dried foods is available in the US.

I'm sure you are aware but just want to mention that with the introduction of low carb foods the BG can drop up to 100 points so it is great you are testing the BG levels so you can keep an eye on that.

Here is a link to a thread for new members you may like to read
http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216680/#post-2457269

I can see looking at the SS that Charlotte has bounced both times after she hit greens.
I'm sure you know all this but I'll mention it anyway.......Bouncing can occur when the BG drops too fast, too low or lower than the cat is used to since contracting FD.
The liver dumps a type of glucose and regulatory hormones into the cats system and shoots the BG skyhigh!
Bounces can last up to 6 cycles. Some cats one bounce for one cycle but others bounce for up to 6 . It is completely normal and there is nothing you can do about it. Some cats are bouncier than others.

Lantus is a great insulin for cats. You don't need to feed a full meal before giving the Lantus as the onset is usually around +2 and it usually doesn't drop dramatically like the older fast acting insulins did.
But in saying all that, there are some kitties that like to dive .......the thing is to get to know what your cat does and the best way to do that is by collecting BG data for the SS.
You will find we are data driven here

Most of us feed several smaller meals during the day and night instead of just two meals a day. A timed feeder is a great investment if you need to work and sleep!

It's great you are getting some tests in during the pm cycle as well.
We find that a before bed test is a good test to get or a +2 test. If the +2 test is lower than the preshot number then it will most likely be an active cycle and you will need to test again to keep Charlotte safe.

 

Hello and welcome Dr. S and Charlotte. I love her relaxed picture.

As Bron said, multiple meals or grazing are fine on Lantus, it’s a much more gentle insulin. It’s nice to know you have time to get food in. We have had other members transition their cats with low carb freeze dried raw. Primal also makes some.

Bron also mentioned bouncing, which is very common for newly diagnosed cats. As Charlotte sees more normal numbers, the bouncing will diminish, but at Charlotte’s pace. It took my girl a year to stop bouncing to the 400’s. She was a little more complicated, with acromegaly and insulin auto antibodies adding to the mix.

It’s great you are seeing greens so early in this FD journey, I had to wait months. Hopefully you will be able to get some consistent dosing and 0.5 units will let you do so. Although other sites vary their dosing, we find that for the dosing methods we use here, a consistent dose works best.

 

Any particular SS you would advise me taking a look at??

Thanks for your suggestion! I will look into those treats as well! I have printed out a lot of those sticky notes and continue to reference them often. I will give it time and hopefully she will respond to it more favorably down the road!

 

Ah, thanks for the advice!! I will definitely look into all those treats everyone has so kindly mentioned. I will also make a point to do a +2 check. That is good to know about it being an indicator for the cycle. I will make a point to check for a timed feeder. It’s tough with 6 cats bc they always want what the other leaves behind! Ugh!! My husband thinks I’m nuts but he doesn’t really understand how complicated cats and FD can be.

 

There are timed feeders that require a microchip attached to a collar to open. I believe @Olive & Paula uses one.

 

Join the club! My whole family thinks I'm nuts... I don't care...at the end of the day I'm responsible for her well being. It was my choice...somehow they'll get over it

Those auto-feeders are really fabulous! I couldn't live without mine - but this is a one-cat household. You'll definitely need to go the chip route to prevent the 'others' from putting the raid on Charlotte's food ... and then vice-versa, make sure Charlotte isn't going to eat theirs...gotta be interesting!

You may want to look at some of the SS's for folks who've been here a while - and of course some of the newbies too. Just right click on the avatar and you'll see how long a particular person has been on the forum.

 

I have 4 cats and used to free feed dry to everyone. Now they pretty much all get fed separately in different areas their wet food, and my diabetic has her rooms in the house that are very much hers. I know that may not work for you, but it has helped me, and turned out not to be as difficult to separate them out during meals as I once thought.

And I had multiple people tell me I should put my Alice down because she was so sick and I needed help affording her care. Now she’s like a new cat because we worked hard! It doesn’t matter who thinks you’re nuts. We probably all are a little bit, but only because we love our cats so much!

 

I remember pics of Alice in the beginning...and now! Such a difference! Sometime you may want to post a before/after...she's come a long way!