Abby - Newly diagnosed

One of our 3 cats, Abby, was diagnosed a diabetic 12 days ago on Sept. 24. Just so happened to be my birthday. Happy Birthday to me.
Abby is 12 years old & very petite. Her weight on the day of diagnosis was 6 lbs, 1 oz.

I quickly started researching feline diabetes & found this website & forum. There is a wealth of information here & tips that have been very helpful during this early part of our journey.

Since Abby's diagnosis, it has been a roller coaster of emotions. On the day of her diagnosis, she was also found to be dehydrated & had an infection. She was given fluid therapy & an antibiotic. She was also given an appetite stimulant to increase her appetite. The next day we finally got a urine sample & the results showed she had ketoacidosis . Later that evening we were so worried about her, as she had gone downhill fast. Not eating & very lethargic. She was admitted into intensive care at the vets office, given her 1st insulin shot & put on IV. I don't know what type of insulin they started her on or how may units per shot but she was receiving it twice a day. Big mistake, too much too soon. Monday morning she had become hypoglycemic & was in a coma.

Insulin shots were discontinued for 3 days, in case of insulin resistance. In the meantime we brought her home. Thurs Oct. 1, we took her back in for the day, they started Abby on 1 unit of ProZinc, once a day & they did a glucose curve. Brought her back home & Friday, I gave her an insulin shot at home for the 1st time & began with home testing her BG's.
So far, Abby's BG's are still a bit high but she is no longer dehydrated & she is eating well. Next Tuesday we do a 12 hour home glucose curve. At this point I'm not sure what to expect but based on her results, a decision will be made on whether to adjust her insulin dosage or not.

Louise

 

Welcome Louise and Abby. Abby is such a beautiful girl! I'm so sorry she has been through so much. I'm glad you are home testing. Since you are using ProZinc, you may want to post on the ProZinc forum too. The people there are wonderful and have helped so many of us. Even though I switched insulins, I still go to them with questions. What are you feeding Abby? A low carb canned food is best. Most of us use Fancy Feast Classics, Friskies Pate, or 9 Lives Pate. Pates only, not gravy types, they have too many carbs. Since Abby has had ketones, you should regularly test her for that too. You can get test strips at any pharmacy. Again welcome and please keep us posted. BTW love the quote in your signature!

 

Welcome. She has been through a lot already. Posting on the ProZinc thread or Health thread would be best now for guidance.

 

Welcome Louise and Abby to FDMB! You have come to the right place for support. There are a lot of caring and experience folks here. You will be given a whole lot of information and at first, it will seem very overwhelming however in a couple of weeks, things will start falling into place.

Sorry to hear about the hypo event and glad that she is doing better now. Anyway, there are some things that you will be able to do to keep Abby safe. Below is a bunch of information and a few "homework" assignments. Just holler on the Health or Prozinc Forum if you have any questions.

Good Reading: This is a must read. It is an excellent 18 page informative document that covers feline health and nutrition. Don't take short cuts and read it all. www.catinfo.org

Also read other postings and their spreadsheets. You will learn a lot more from others.

Home Testing: Here, we all home test. It is mandatory to understand how your kitty is reacting to the insulin and the dose. You will want to test before each shot and some additional test in between the 12 hour cycle. Another reason to home test is to keep your kitty safe. Find a place in your home where you will always perform the test and give lots of hugs before and after testing. There are many videos showing you how to test. Hometesting Links and TipsHere is a picture of where you test on your kitty. http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html

Here is another good link on Home Testing:http://www.felinediabetes.com/bg-home-test.htm

Meters: There are many meters. There is a pet meter called the Alpha Trak2 and human meters. Some use the pet meter because it is what the vets use so the numbers will match up. The meter and strips are expensive though. Most use human meters that can be purchased at any pharmacy. It typically reads a little lower than the pet meter but we have ways of compensating those lower numbers. Many use Walmart's brand, Relion Micro or Relion Confirm, because it only needs a tiny drop of blood. They cost around $15 and the strips are around 35 cents each.

Lancets: These are used to poke the ear to get blood. 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.

Spreadsheets: Our spreadsheet instructions are here. If you look at the signatures of the members here, you will see a link to their kitty’s spreadsheets. We keep track of all our tests. This is basically a place to collect data and help you to determine patterns, doses, etc. It also aids those that may be helping you to better understand your kitty.

Food: There are many reasons why we are here but one is due to feeding dry cat food which is high in carbs. You will want to consider changing your food to wet, low carb food. It is recommended to feed food that is under 10% carbs. Here is a list of cat food to choose from food chartyou will note that the food with fish are lower in carbs however it is recommended that you only give fish once a week due to its mercury content. Many use Fancy Feast, 9 Lives, Friskies, etc. This list can also be found in www.catinfo.org If you are already giving insulin and you have not transitioned to wet, low carb cat food, be sure to test while you are transitioning. This is because by changing to low carb food, it could decrease your kitty’s number by 100 points or more. One last thing, many of us add water to the wet food so your kitty is getting plenty of water to flush out the toxins and to keep them hydrated.

Hypo Kit: Always good to be prepared for possible hypo events which means that your cat has reached dangerously low numbers. It can be fatal, hence, the importance of home testing and collecting data in a spreadsheet. In each of the Insulin Forums are stickie’s labeled Hypo Links. Here is one: How to Handle a Hypo. Please print and post on your refrigerator so everyone in your household is aware of hypo symptoms. You will want to create your hypo kit that would include and not limited to; extra testing strips, honey/karo/maple syrup, high carb food, medium carb food, vet information, etc.

Ketones: Diabetic cats are susceptible to diabetic ketoacidosis (DKA). It is best to buy testing strips that will measure (if any) ketones in the urine. One brand is Ketostix which can be found at Walmart or any pharmacy. You will want to test periodically unless you continue to get high numbers, then it is suggested to test more frequently. Ketostix typically costs around $10.

Treats: It is always nice to have treats available for your kitty. Some use it after they have tested to reward. I like using Pure Bites. I have found it at Petsmart and other pet stores. It is freeze dried and the only ingredient is the meat i.e. chicken, duck, etc. If your cat likes it, then I would go to the dog section where it is cheaper than the cat package. It is bigger chunks but no problem in breaking it up. Another option is to use Bonita Flakes. There is a link here somewhere that has a list of low carb treats but I don't have it right now.

Injections: Most folks here use one of these main insulins; Lantus, Levemir and Prozinc. Two hours prior to your insulin shot, you will not want your kitty to eat. Then you will test and then feed. It is best for your kitty to eat a little before your shoot. I shoot while he is eating. The reason why you do not want your kitty to eat two hours prior to your test is because food elevates BG numbers. So you do not want to dose based on a food influenced number. Here is a link on how to give injections.http://www.felinediabetes.com/injections.htm

Note: Please check your insulins as there are some (the harsher ones like Humulin, Novolin, Vetsulin, etc.) that would be best to allow some time after your kitty has eaten before you shoot.

If you have any questions, please be sure to post in the Health Forum.

 

Thank you Sharon14 & Woodsywife for your replies.

Yes, Abby is a beautiful girl & has a personality to match. She is so loving & affectionate, or was until she got sick. I'm hoping in time, she will return to her old self. Poor little girl has been through so much in such a short time!

I will definitely check out the ProZink thread for information & guidance.

Since all this happened, I have switched over to a much better quality cat kibble. Blue Wilderness Indoor Chicken. It is 100% grain free with no corn or wheat. I'm feeding it to my 2 other cats plus canned for a treat. Until now, I had no idea how kibble containing corn, wheat, etc. was so bad for cats. Live & learn!

I have not given any kibble to Abby since her diagnosis. For the 1st few days she was home, she was eating a canned tuna cat food which she quite liked. From the links on this website, I did read about feeding her Fancy Feast, pate only. I chose some of the flavors that were shown & bought several cans. It's trial & error with Abby. It's always been hard finding a canned cat food that she likes & will eat. I adopted Abby from my daughter when she was 7 years old. Stephanie had to move & couldn't take Abby with her. She told me during those 7 years, she tried umpteen types of canned cat food & couldn't get her to eat any. So, she gave her canned tuna (the people kind) as a treat. It was the only food out of a can she would eat. During the 5.5 years I've had Abby, I couldn't find any canned food she would eat either, until about a year ago. She would gobble up Friskies Indoor Classic Chicken Pate.

I will do as suggested & buy some Ketostix. How often should I check her urine?

 

Thank you Cindy & Merlin for your reply. Whoa, lots of information to take in there, some of which I have already read before I registered. Will for sure check out the links to more info you have provided.

Thanks again for all your tips & information. Really appreciate all the help & advice I can get!
Louise

 

Welcome @Louise

Poor Abby has been through allot already Good news is it does get better & easier especially since you found this place. Everyone here has lots of experience & is a wealth of knowledge so please ask any questions you have.

 

Poor Abby has been through allot already Good news is it does get better & easier especially since you found this place. Everyone here has lots of experience & is a wealth of knowledge so please ask any questions you have.[/QUOTE]

Jennifer, thx for your comment. It's nice to know I'm not alone in this & there is lots of help & information available.

BTW, your Vegetable looks very much like my Abby. Tiny too!

 

@Louise yes Vegetable is tiny like Abby & they do look alike. Abby is a cutie!

 

Hi again Louise, I'm sure Abby will be back to her old self before too long. I hope you can get her to eat the canned food. Lots of people here have had problems transitioning their cats too. You can try adding some tuna juice to the Fancy Feast, maybe the smell will get her to eat it. If you need more suggestions on how to get her to eat it, post a question on the health forum. It's good you're not letting Abby have any of the Blue Buffalo. While it is better than the average dry cat food, it is still high in carbs.-I learned that here. As for ketone testing, I'm not sure how often it's recommended. My cat, Colin, has never had ketones, but his diabetes is uncontrolled and his numbers are high, so I test him every other day. If he didn't have such a strong appetite, I would up that to everyday.

 

@Sharon14 So far, so good with the Fancy Feast cat food. I bought several of the flavors recommended here & she just devours it! Although her thirst & urination has decreased, she's still frequently hungry, so I feed her about 1/4 of a can every 2 hours (accept at night). The vet said to let her eat as much & as often as she wants, to get her strength back & gain some weight. Being such a petite kitty, she couldn't afford to lose the bit of weight she did. I'm pleased with her progress. She is getting stronger everyday & no longer looks anorexic!

 

Great news! It sounds like she is on the mend. How are her BG numbers?

 

@Sharon14
Abby has only been on Prozinc (1 unit, once a day) since last Thursday. After the fiasco the previous weekend when she became hypoglycemic, they discontinued insulin for 4 days.
I home tested 3 - 4 times a day from Friday - Monday morning. Her BG numbers are still a bit high. From what I have read, it could take a few weeks to see an improvement. When I called her BG's into the vets office Monday morning, they said to discontinue testing for a week & just watch her. I was relieved about that, to give her poor ears a rest. But for my own satisfaction & curiosity, I will test her periodically.
Next week on Tuesday they want me to do a 12 hour curve (they originally wanted me to do it on Monday but here in Canada it's Thanksgiving), testing her every 2 hours from 7 am - 10 pm. We shall see what her BG's are by then.

 

Cannot believe how frightening it must have been to see your kitty deteriorate so quickly and go into a coma. I feel sick for you just thinking about it. It's amazing that she is still with you. What a hardy little soul! I'm new here and learning a lot. It's daunting that handling this condition is really thru trial and error, but the stakes are so high for our little ones. Generous people on the board make the walk a lot easier. Best of luck to you and Abby.--Nora and Kali

 

@nora
Fortunately for me, it didn't happen at home. It was during the 4 day period when she was at the vets. I'm amazed Abby is still with us also. They told me afterwards she almost died. Lucky they caught it in time.
I don't know what I would have done had it happened at home. That soon after diagnosis, I was overwhelmed & completely ignorant of feline diabetes & what to do in case of hypoglycemia. I have since read all the signs & what to do. Keeping fingers crossed it doesn't happen again!
Thanks for your kind words!
Louise & Abby

 

Welcome to FDMB.
Check out my signature link Notes to share for some links to useful web sites and some Secondary Monitoring Tools.

 

Hi Louise and Welcome! You are in good hands as there is a wealth of knowledge here. Glad you are home testing as it is so important to keep Abby safe. While it is nice to give her little ears a break, I have to disagree with the vet saying you can discontinue for a week. The most important times to test are pre shots AM and PM. You want to make sure it is a number safe enough to shoot. Being a new diabetic cat, you don't want to shoot a number 200 or under. As she is on ProZinc longer and you have more data, that can change. Think of it this way, a human diabetic would never shoot insulin without first testing to see what the dose should be. The data we all get on our cat's BG we put onto a Spread Sheet. Cindi (Merlin) linked you instructions on how to set one up. If you need help, someone here will help you, just ask.

As you mentioned above, there is so much to absorb, we have all been there. The most important in the food change to carbs 10% and under and the home testing. As you go along in this "Sugar Dance" you will learn more and more and we will all be happy to help you. We are all paying it forward for all the help we received when we first arrive. Read as much of the post as you can and that will help you also.

I love this, "Until one has loved an animal, a part of one's soul remains unawakened", Helen Keller, I think?

 

Something that concerns me as well is the one shot a day. That could result in Abby being in good numbers for a while, then high for a while until the next shot. Most cats (and every cat is different) do better with two shots a day, as their metabolism is pretty high and process the insulin faster.

 

@Bobbie And Bubba & @Shiloh & Rhonda
Thanks for your feedback. I wondered about that, not testing Abby for a week. But I was trusting what the vet recommended. I will test her later today & tomorrow morning before her 9 am shot.

As I said in my original post, when Abby was first started on insulin, she was given 2 shots a day. Don't know what type of insulin she was given or how many units each time. She was in intensive care at the vets at the time. Since she became hypoglycemic on the 3rd day, obviously it was too much too soon. So, they switched her to Prozinc, 1 unit, once per day. Start slow & work up from there, depending on the results of the glucose curve I do next Tuesday.

I will look into starting a spreadsheet soon.

"Until one has loved an animal, a part of one's soul remains unawakened" is a quote by Anatole France.

 

Thanks for the name!

 

Just so you know that Prozinc only lasts for 12 hours. You need to shoot every 12 hours. Have you had chance to read about the Prozinc protocol? http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

It is very possible that you would not have such high numbers in the AM if you were to shoot at PM too.

 

@Merlin
Thank you for your concern & suggestion about Abby's dosage of Prozinc. I had browsed the Prozinc protocol & just reread it through again.
At this early stage I can't just arbitrarily adjust Abby's dosage without being instructed to do so by my vet. She's already been through one hypo episode because she was given too much insulin too soon. She went into a coma & she is lucky to be alive. They are going slow with her now, hoping to prevent it from happening again. Abby has only been on Prozinc for 1 week. On Tuesday, I have been told to do a glucose curve. I'm sure a decision will be made then about adjusting her dosage.

 

Hi Louise, I can understand your concern about the hypo event, many of us have been through one, some really scary and others just very concerning. As Cindi mentioned about in post #21 that prozinc dose not last 24 hours only 12 (must insulin work that way. Maybe you could ask the vet about taking her present dose and splitting it in 1/2 and dosing twice a day so that she is not without insulin for 12 hours every day. Just a thought.

 

You are doing a great job testing...data collection is so important. As you can see, that this data collection is so important in order to keep your kitty safe. If you are going to see your vet, I would print off the Prozinc protocol and your spreadsheet. I did and it helped so much to start that vet/kitty relationship. It will clearly show to your vet that you need insulin every 12 hours. We believe to start low and slow so your kitty is safe. Prozinc doses is based on your pre shot numbers and your nadir (+5-+7) numbers. Eventually, you will be the one making the decisions on the doses based on your data.

I would ask for the records from emergency and your vets office. It may be helpful to know what kind of insulin and how much they gave Abby so you would know what put her in that hypo state.

 

@Merlin
That is a very good idea. I'll ask my vets office what kind of insulin they 1st started giving Abby & how much. Thanks for the suggestion.

Also, not that I didn't believe what you & a few others have suggested about Abby needing more than 1 insulin shot of Prozinc a day, I went to their website to read any information provided https://www.prozinc.us/prozinc.html

It does in fact say: "PROZINC is a protamine zinc insulin -- ideal for diabetic cats -- with a convenient duration of 10-14 hours. It releases slowly to help maintain a consistent blood glucose level throughout the day. Just two daily doses deliver quick and effective results."

On the HOME TREATMENT page it says: "What if you don’t see immediate results? Do NOT adjust the PROZINC dosage by yourself. Talk to a veterinarian and follow his or her recommendations. Typically it takes up to a few weeks to become regulated on any insulin, including PROZINC."
Today is just Abby's 9th day taking Prozinc. I am in no rush to increase her daily dosage until we have done her curve of Tuesday. I will leave it up to the vets recommendations.

BTW, just tested Abby at 1 pm, 4 hours after her shot. Her read was 10.0 (180), her lowest reading yet!

 

She's making some progress. Be aware that the nadir or lowest glucose is around +5 to +7 hours post-shot. That is when you want to be most vigilant to ensure she doesn't go too low.

Have you got the How to Treat a Hypo info printed out and the syrup and oral syringe available?

And just a thought to discuss with your vet - parents of childrenwith diabetes are given guidelines for monitoring and adjusting the child's insulin doses. Your vet could provide you with the same kinds of info for management of your cat's diabetes.

 

@BJM
Yes, Abby is making progress. We do her glucose curve tomorrow & will know then how the vet wants to adjust her insulin.
I have saved the "how to treat a hypo" on my computer & have corn syrup handy just in case.
Thanks for your feedback & suggestions!
Louise & "Abby"

 

Just a thought. Since your vet thinks you should only need one shot per day and your vet wants to see the results of a curve....I would suggest continuing your curve into the night/early morning hours so he/she can see the affects of no insulin for a full 24 hours. Doesn't make sense to me that your vet is only looking at a curve that is in the daytime (12 hour cycle) when he/she has prescribed a shot that he/she thinks lasts 24 hours.

This is just another way to prove your point of needing insulin every 12 hours.

 

@Merlin
I understand your concern. But Abby's one shot a day is just for now, until I've done the curve tomorrow. She was originally started on 2 shots a day, it was too much & she became hypoglycemic & went into a coma. So, this time around they are starting her low & slow. I'm sure with the results of her curve, a 2nd dose (or perhaps half a unit) will be recommended for the pm.
I'm not about to continue the curve into the night & early morning hours. I do have to sleep. As it is, I'll be testing her 8 times between 7 am & 10 pm. Her 10 pm & Wed. morning AMPS will show that the previous days shot didn't last 24 hours.
As it is, Abby's poor little ears are going to take a beating, never mind poking her an additional 4 times! Being such a petite kitty, her "sweet spot" is not that big & I don't want to turn her ears into a dilapidated pincushion. If all this testing was only temporary, I wouldn't be too concerned about it. But no, this going to be an ongoing daily routine of testing her BG's. How much can these kitty's ears take?
I would like to thank you for your suggestions & concern. But I'm not going to make any changes with Abby's insulin dosage until I've been instructed to by the vet.

 

Which means the dose for each shot should be reduced, not that only 1 shot should be given. Please discuss with your vet who should understand that.
There are ways to measure half unit doses if the syringes don't have markings - you can use calipers, magnifiers, create a reference gauge, plus there is the option of using a conversion chart with U-100 syringes (each half unit tick mark equals 0.2 units of ProZinc)

As you get better at testing, alternate ears, and apply some direct pressure after getting the test (to reduce scabbing and bruising), the ears do pretty well. Some folks on this board have photos which show ears after years of testing - and they don't look any different than regular ears. You can search the posts here for those by going to the upper right corner and entering your search words in the the box, then pressing enter. Or create a new post and ask for photos.
Also, you can test on the paw pads, not just the ears, which provides you with more sites through which to rotate.