Ali was diagnosed yesterday

:cry: My 7 year old cat, Ali, was diagnosed yesterday. After the initial shock I have been trying to educate myself on how to handle this. My vet has prescribed insulin shots every 12 hours but did not mention anything about home testing. We go back to him on Monday so maybe he'll discuss this at that time. I have read SEVERAL posts on here and admitt that right now I'm a bit overwhelmed but am I reading correctly that it is suggested to do a glucose test twice per day before each insulin shot is given? We haven't yet discussed the food changes but have found the information on here very good. I think he will go into more detail on Monday, as I was pretty distraught at yesterdays visit. I also have a concern about our other cat, Tyson. He and Ali are brothers and I wonder if this is hereditary, as it is in adults? He is showing no symptoms of the disease but weighs 22 lbs. (It's difficult to put one cat on a diet. If you have suggestions for this I'd appreciate them!)

 

I wouldn't expect that your vet will tell you much about hometesting or diet change, as the sad truth is that most vets know very little about FD.
Can you tell us which insulin you've been prescribed? Folks here (correctly) advise to start at a very low dose (perhaps 1 unit every 12 hours) and see how
kitty reacts (via your drawing a drop of blood and testing it on your meter often throughout the day) - then you'll know whether you'll need to increase or
decrease the dose. Also, what is your cat's current diet? What exactly are you feeding him?

Please don't be afraid - you've come to the right place, and your cat CAN be regulated and could even potentially not need insulin some day...

 

Everything you need to know is here and yes the learning curve is steep, but well worth it having a
healthy cat, even if they don't come off the juice.

I am still a newbie, my Payne was Dx on 10/11 and almost died. Had I not found these people,
she would not have made it, much less the beautiful girl she is now. You need to read everything!
post your questions often and understand vets know little about feline diabetes, much less on
having a healthy cat who happens to have diabetes .....

There are people here who will hold your hand and explain EVERYTHING to you, so don't be too
over-whelmed! we have all been where you are, some more recent than others! I look forward
to watching your journey.

 

Welcome Vanessa and Ali to the best site on this planet, to help YOU, help your dear Ali.
If your Vet already hasent mentioned hometesting, he/she probably wont. I *could* be wrong but...in the mean time read the FAQ's and go to your Vet loaded with questions. Let him know, you WANT to be proactive in the treatment of Ali's diabetes. This way he will know you are willing to do whatever you need to do, to get your baby feeling and acting like her old "self".

There is much to read and tons of experienced people here, dedicated to paying it forward. I'm sure they will be here to welcome you. Be warned they will have questions for you AND they will be able to answer some of yours.

Again WELCOME,
jeanne

 

Our vet prescribed the Humalin N and is starting us off at 5 units twice per day. Ali weighs 14 lbs, his lowest in years and is a large boned cat. We currently feed them dry cat food (in an automatic feeder...I know, I know...not good) and he loves to eat off of our plate. We usually give him a bite or two of what we are eating at supper time but never more than that. He LOVES chicken and I wonder if I can continue to give him this occasionaly as a treat. We also feed them wet cat food a couple of times a week, especially since we noticed him loosing weight. Our vet did mention that after we got the insulin regulated we needed to look at putting him on Purina Weight Control (I think) and limit it to feedings at his insulin time and not leave their food out all day. I have already looked into purchasing the meters and strips and plan on discussing this with our vet on Monday! Thanks for the advice...I already feel better!

 

Whoa!!! 5 units of Humulin N twice a day? Let me see if I'm understanding this right...You are meaning 5u in the morning and 5u in the evening right so a total of 10 units a day?

Mel, Max & The Fur Gang

 

welcome.
first 5 U is way too much to start out on.
N is a very harsh insulin and rarely does a cat do well on this. there are better insulins and a lot gentler. pro zinc, lantus and levimir
best food is lo carb wet and both cats can eat this. a lot cheaper for you also. here are some links viewtopic.php?f=14&t=115
cheapest meter and strips is the relion confirm or mini/micro from walmart (can never remember the names)
I would start out at no more than 1u and you must test. even this could be too much after switching to the healthier diet on the chart
I am sure others will be along and add or confirm

 

more links on testing ect. viewtopic.php?f=14&t=287
and yes, chicken can be given as treats

 

How do you "disagree" with a vet's recommended dosage??? Also does it matter that his sugar level was 484? Yes I am doing 5 units in the am and 5 units in the pm. I'm glad I started it on the weekend since I have been home with him constantly since his first dose last night. I will not be able to get the meter and do tests myself until tomorrow evening.

 

Soooo...Vanessa, where do you live (City, State)....In case we have a member near
you to help you.

I'm shocked that the vet would start your kitty at 5u 2x per day.
I need to be blunt here, but that is a potentially disastrous dose....

Oh, and by the way.....a dry food diet is often the cause of too much weight
(your other kitty). It's the carbs in dry food diets. BOTH kitties would
benefit to be on a canned food diet.

BUT....don't switch your diabetic kitty's food until you lower that dose.
The carbs in the dry food are protecting Ali from that high insulin dose.

I suggest you read up on symptoms of hypoglycemia (Low blood sugar from too much insulin).

If Ali shows any strange behaviour, especially lethargy or staggering or unusual meowing...
anything out of the ordinary, please come here for advice on treating a hypo.

Cats are not dosed by weight, and also the BG at diagnosis is not a good indicator of the
eventual regulation dose. Most cats are regulated on .5 to 2.0 units 2x/day.

 

You can disagree by not giving 5 units of N twice daily. Unlike dogs, which you vet may have more experience, cats are not doses by weight, The normal starting dose i is 1 or sometime 2 units twice daily. Some caretakers have posted here in the past about starting with high doses like years and the cat's blood-glucose (BG) level has went too low. Or sometime there was little drop in the BG over the corse of the day because the does was too high and body was compensating. However, the body can't compensate forever and frequently the BG will goo too low. We are giving advise here based on the experience of caretakers who visited this board. However, one in a while, there are cats that need a high does of insulin like you vet prescribed. However, it is usually better to increase the dose rater than decrease the does.

 

Holy schnikies! 5u of Humalin N twice a day

Honestly, that scares me. I know many that have used less than that on numbers in the 400s and still had the glucose dropping too low. Relion brand meters and strips are really cheap and available at your local walmart or sam's club. The Micro or Confirm Relion meter should run about $9 and a box of 50 strips will be about $20. I urge you to purchase these this weekend so you can see how this is effecting the glucose levels. That way on Monday you can go in with data that shows how this insulin works with your cat at home and away from the stress of the vet's office.

Now the other issue is that prescribing Humalin for cats with diabetes is sort of the old school way. There are new insulins out that have been proven to work well with cats and are much more gentle acting. Humalin N hits hard and peaks at 4 hours after the shot and quickly goes out of the system, giving you sky high numbers again at shot time. Lantus, levemir, and prozinc are all much longer and more gentle insulins. You should also talk to your vet about switching to one of those or maybe someone here can send you a vial/cartridge to start you off.

 

Sorry but I have to agree with Karen on this. The dry food diet is probably the only thing keeping Ali from a hypo. Perhaps thats why your Vet started out at such a high dose? I know he/she means no harm to Ali.

I have to say though, shooting that much insulin without testing is a dangerous practice.

I understand you want to put all your trust and faith in your Vet. Afterall we are nobodys on the internet...That said about at least 75% of the people here, have been down the same road you are on. There is much learned, shared and taught here. The information gathered here at your fingertips is invaluable. Try to keep an opened mind. ok?

jeanne

 

How has Ali been acting in general since he started that dose?

Have you give him is evening dose yet? If you haven't please hold off until we can get more eyes on here to help. I'm not terribly familiar with working with it, but I do know it hits very hard and drops the BGs down very quickly, but also works through the cat's system very quickly.

I also know from what I have learned from these good folks that is WAY TOO HIGH of a starting dose.

You may want to edit the title of your original post to read "Newbie- 5u b.i.d of Humulin N --needs advice" That will tell folks exactly what kind of advice you need to decide to withhold insulin tonight (if not already given) or to shoot a reduced dose. Since you can't get a meter until tomorrow.

I will cross post in community for you so we can get you the best help to help you help Ali.

Just Breathe, it gets better, and these folks will hold your hand through it all.

Oh and how to disagree with your vet...Well if you really like him for the everyday stuff and he's open to learning, arm yourself with the knowledge here and teach him. =) If you don't like him at all, shop for a new vet, and if you like him for the every day stuff, but he's not willing to learn from you....just smile and nod at the clinic and then take care of Ali yourself, the folks here can help. He's your furry son, and you have the right to treat him as you see best.

Just keep asking questions, we've all been there before.

Mel, Max & The Fur Gang

 

Please, Vanessa, that bg number at the vet might also have included a stress factor. Please, 5 units of N as others have stated, is an abnormal number for any vet to start a cat on. It is scaring all of us reading it. Also, with N, you should feed a good 1/2 hr. before shooting so food is on board. Fast acting, short duration, and I cannot even remember in over 12 years here any cat that even worked up to 5 units of N b.i.d. Don't even bother discussing hometesting with your vet on Monday. Buy a meter tomorrow and immediately start testing. Even if you are watching your cat tonight IF you shoot another 5 units, not even cat shows a hypo symptom. Some just crash, hard and fast, and you will end up praying you make it to an ER facility.

Please, tonight, drop that dose to 1 unit until you get a meter.

 

Vanessa, I have a wonderful Vet I love her. But even she made the mistake of dosing my kitty with 3 units of "H" twice a day. THAT was too much. Sometimes in the world of insulin, less is more.

It took a battery of posts like the ones you are seeing to knock it into my head. Lucky for me, my Vet was open to working WITH me and we learned together. Trouble eventually no longer needed insulin, he did quite well on a controlled diet. It's quite possible Ali can do the same.

Unless your Ali has other health issues such as ketones, I with all the best intentions ask, that the dose be, at least, cut in half.

Do me a favor please read this post. Yeah it's a little long but...well just read it

viewtopic.php?f=28&t=35549

 

All I can say is WHOA Too high a dose and not a good insulin.

No vet should be starting ANY cat at such a HIGH dose of insulin; it does not matter that the BG was 484.
That dose is DANGEROUS to your cat.

As has been suggested, go to a pharmacy, pick up a regular BG meter, many use relion, but you can get a one touch or bayer or any one you like. Get test strips and lancets, then start testing at home. If you have any questions, just ask because there will always be someone around here who can help you to get started on home testing.

Now, back to the dose. Some cats never get to a dose that high, ever.
Start at 1u BID and IF you need to give more, then you can increase.

Thank goodness you are feeding dry food because if you weren't, I bet for sure your cat would have hypo'd.

Once you get a meter to home test, you can see exactly how that dose is affecting your cat.
You can reduce the dose to 1u BID and get your cat onto low carb wet food.

If your vet disagrees, get another vet.

 

It is hard to see all these posts that make you possibly doubt your vet. We love our vet, but she was not experienced with feline diabetes. (Vets are like gps; they know a little about a lot of things, but not usually a lot about diabetes in cats. In their training they may have one workshop on it.) My vet started us on 4 units twice a day and left us with dry food and didn't mention testing at home. I came here, just like you, and wanted more information. We got the supplies and started testing. We changed the food. Although it doesn't happen for every cat, Oliver was off insulin in 6 months.

I still love my vet and go to her. She does ask her diabetic patients if they want to learn to hometest. She does recommend wet lo carb. She has done a lot of reading and learned a lot about feline diabetes. I like to think Oliver had a small part in that.

Everyone here has or has had a diabetic cat and is treating them safely and effectively. We love to help others with their cats; we are all paying it forward for the help we received. I hope you will let us help you.

 

Ok...now you all have me worried. I have given Ali a total of 4 shots at the 5 units and he seems great! Maybe I have misunderstood the doctor. He showed me on the needle where to draw the insulin to and it says 5. Does that mean it is 5 units? I'm positive that is what he said but now I'm not so sure. I KNOW that I am giving him the amount, on the needle, that the vet recommended. Our vet is wonderful and has told me about having other cats and dogs with diabetes and one of his own even actually had it. He did tell me that Ali may only need 3 units but that we needed to start adjusting it. I am getting the meter and strips this morning. I tried to read about the BG curve and was a little lost but I'll go back and read it again. I have set our schedule to do doses at 6:00am and 6:00pm but if the Humalin makes it spike after 4 hours then both my husband and I will be at work and unable to help if he goes hypo. I don't know what to do!!!! Please tell me if perhaps the "5 units" isn't the same as the "5" on the needle. It doesn't seem like much insulin.

 

Wonderful that you are going to home test. This will really set your mind at ease and let you see what how the insulin is working. What do the needles say on the side of the box?

Here a list for the store:

What you need to start hometesting

A human glucometer. Any one that sips and takes a tiny sample is fine. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 25-26 gauge is good. Any brand will work.

Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

 

The needle we were given say Easy Touch 31 gauge .5cc 5/16" The needle itself reads from 5 to 50. The 5 is the first number and the first larger line. If I were to give him less would I just go by the smaller lines???? I'm hoping that I misunderstood that this is actually 5 units. Hubby is on his way to get meter now. Will start testing in the next hour or two. Thanks again!!!

 

I'm sorry; I am not the best one to answer your needle question. We used U40 insulin and you are using U100. Why don't you post another topic and ask for help with needles. We do have people who are very knowledgeable; I hope they are around this morning and can answer your questions.

Will be watching to hear about your test. Don't forget to heat the ear. Very few of us got blood on the first try. If you have trouble, post and ask for help. We all have tips that helped us.

 

A .5cc syringe means it holds 50 units of U-100 insulin. The first large line, 5, means 5 full units of U-100 insulin which N is. Each line UNDER the 5 is a unit. You do not judge the amount of insulin by looking at how much liquid is in a syringe. If you pulled up just 1 unit of water and squirted it on the counter, it actually is just a drop. That drop may not look like much but in a cats' body it is amazing what it can do. Please, stop shooting 5 full units and cut it back to 1 unit or at the max 2 units. Remember to test first to get a true bg reading, then feed and make sure kitty eats, then wait a 1/2hr. before shooting with that N insulin.

 

Picture of a 3/10 cc syringe.......

which means it holds only 30 units so lines are easier to read. A 3/10 cc insulin syringe is better to use than the 1/2cc ones you have. Click on the link and scroll down past the insulin bottles and you will see a picture of a syringe. It will give you a good view of the lines......each tiny black line is a unit and when you get to the 5 that means a total of 5 units. http://commons.wikimedia.org/wiki/File: ... yringe.jpg

 

Sorry to be adding more worry to this for you, but we are frankly a little scared for Ali as well on such a high dose. Having a meter and being able to test at home will give you a much greater peace of mind. For now I wouldn't give at the very most 2U twice a day. Especially if you are in the process of switching diet to all canned wet food. As we just had a kitty last night start heading for hypo on 2u of Humulin N.

I love my Vet as well and he is great with everything but diabetic cats, but at least he admits he doesn't know jack about it and was willing to work with me to learn how best to treat my Max. He was clueless with my first fd kitty, but working with me, he now calls me, when he has a new FD patient for links and food lists etc.

Mel, Max & The Fur Gang

 

My Mali was diagnosed 5-1/2 years ago. Up until about a month ago all we did was follow the vets advise about doseage and diet, brought him in for a curve about once a year. We knew wet food was best but he was a very fussy eater and prefered dry, so his diet was about 75% dry, 25% wet.

He lost a tooth in December (he's 17 years old) so we started giving him all wet food, surprisingly he ate fine so we continued giving him all wet food. I didn't realize how much difference there was between wet and dry, within 3 days he started twitching a bit off and on. He was also on antibiotics at the time so we though the twitching was a side effect of meds (he has a history of bad reactions to meds). The twitching got worse and he had a full-blown seizure. We rushed him to the vet and he stayed about 1 full day for tests and observation (cost about $800!). His BG levels were quite low (lowest was 29). That's when I went into proactive mode and did mass amounts of research online (good for you for being so proactive from the start!!).

His original dose was 3-1/2 units (of Lantus) twice daily. The vets did a curve and said we should reduce it to 2 units twice daily. I got a home monitor (Relion from Walmart) and started testing him (it took a few tries at first but I've got it down now). His numbers were still quite low so I've reduced it to a little less than 1 unit twice daily. Even with that reduction his numbers STILL seem a little low so I am doing my very first curve tonight.

As you can see I'm quite a talker. But I wanted to share my experience because 1) My kitty has had diabetes for 5-1/2 years - it is not a death sentence. and 2) I want to make sure you know what a drastic difference switching from a dry food diet to a wet food diet can have. He's gone from a total of 7 units daily to less than 2 - and the only thing we did was take away the dry food. Switching your kitty from dry to wet is a very good thing to do, but don't play around with diet too much until you get comfortable with home testing so you can monitor how the diet change affects BG levels.

 

You don't adjust the insulin amount by starting 'high' and then reducing it.

You adjust by starting 'low' and raising it.

Start too high and you risk an over-dose.


5 units in a syringe doesn't look like much---about 1/2 inch drawn up....but it's a lot of
insulin for a cat.

 

Just a quick update on Ali: Since my last post on Sunday we have taken Ali to a new vet for a 2nd opinion. We loved him and have decided to make him our new "best friend"! (He owns Best Friends Veterinary Hospital). He took SO much time with us to discuss this disease. He changed Ali's prescription to ProZinc 2 units twice per day. He also advised us to feed him wet food at shot times but that we could leave dry food out for them during the day. He did a urine culture to make sure there weren't any underlying bladder infections and wants Ali back in a week to do the glucose curve. I did purchase the meter and was able to test it twice although I had a very unhappy kitty. Our new vet did say that there shouldn't be a need to do home testing before every shot. He stated that the human meters can sometimes be off as much as 60 points and didn't recommend a newby like me relying on it to adjust dosages. He said that the glucose curve should tell him what he needs to do. I feel so much better after hearing from all of you and discussing things with our new vet that I wouldn't have known to ask!!! I can already tell that the water consumption has gone down so that is a good sign! Thanks again for all of the advise!

 

Hi Vanessa,

I am glad you have found a vet you like better. His prescription of ProZinc is a good step. It is a much milder and longer lasting insulin.

But I do disagree with his discounting testing before each shot. You just don't know when the insulin will start to work, or when the food will. When we switched over to wet, Oliver dropped 100 points, overnight. If he hadn't been testing, we would have given the usual amount and overdosed him. You can keep track of the numbers you get and fax them to your vet for dose advice.

 

The only time there might be a 60 point discrepancy is when the numbers are very high (like over 300). They are very accurate the lower the numbers go, which is when it really counts. There will always be up to a 20% discrepancy. So if the number is 100, then the actual number could be anywhere from 80 to 120. This goes for the alphatrac meter they use in the office for the glucose curves too. The only way to get around the discrepancy is to use the lab for all the glucose readings.

Also, glucose curves at the vet can be 200 points or more off due to stress levels. Those are even worse odds for basing a dosing decision off of. Plus you are taking one day's numbers out of a week or more to base the dosing adjustment off of rather than a week's worth of a pattern. We all know that kitty can do wonky things every now and again. You need to be able to catch a hypo BEFORE it happens and not wait until you see symptoms of one. Hometesting is integral to treating diabetes safely. If your vet is worried about you making dosing decisions on your own, you can try assuring them that you will still go to him for that guidance and you don't want to go at this on your own. That is what my vet was the most worried about.

 

Hi and welcome! I just wanted to throw in my recent vet experience. My original vet thought I was a loony person for testing. She told me to test one day a week at most. I told her no way was that going to happen. Other issues arose with that vet and I just switched. Me and the new vet don't see eye-to-eye on everything about treating diabetes, but he insists that his clients learn to home test and that they test before each shot. His theory is that it could never be a bad thing to have too much information. He feels that if you would test prior to each shot with a human diabetic, you should do the same thing with an animal. I feel much more comfortable with this vet.

 

Without trying to overwhelm you...

I think the new vet is an improvement, and if you like him and feel you can work with him then there is no reason why you cannot.

That said...

2 units is a bit high to start with although with dry food it isn't as bad
Dry food is going to reduce your chance of Ali going into remission...it is like adding fuel to a fire
human glucometers are totally valid and NEVER add 60 to any of your test results
vet curves MAY be inaccurate and this has been documented in veterinary journal articles

My suggestion???? If It were my cat and I knew what I know now?

1 unit twice a day
No dry food
Home tests and no clinic tests, using human glucometer
working with the vet as a team. adjusting dose upwards only in consultation, adjusting dose downward as tests warrant...

Thoughts? Does this help?

Jen