Another newbie - just inherited a diabetic kitty!

It’s Monday afternoon and I’ve been lurking here since late last Friday having just “inherited” a diabetic cat. For 10 years, I have cat-sat for a dear friend, “J”, a woman almost old enough to be my mother. J unexpectedly passed away early Friday evening and I have had her diabetic cat Alice with me since. J had two other cats, two neutered males, both of whom are much younger than Alice and in good health (I will take them in as well if the family does not want them).

Sweet Alice was diagnosed in mid-April of this year. She’s almost 12, solid black and a real sweetheart, a cuddle bug. Alice has lost some weight recently, I suppose on account of the diabetes, but she still weighs a solid 15 pounds. For years I have been telling J to stop feeding her cats Meow Mix, Cat Chow and other junk cat food. J was a well-to-do widow and could certainly have afforded to feed her cats the best canned food, but, frankly, dry was just more convenient for her. I couldn’t even get her to switch to a grain-free dry food. Whenever J was out of town, I would feed her kitties Fancy Feast and they loved it. She would not even change her cats’ food a year and a half ago after another of her cats, Pete, died of diabetes complications.

So here I am, grieving the loss of my friend and trying to find a way to save her sweet kitty, Alice. I’ve read everything at catinfo.org, Dr. Pierson’s site, which is actually what led me here.

I don’t know anything about Alice’s previous blood work yet, but I do know she is on 3 units of Lantus, twice a day.

I spoke with J’s vet after the funeral this morning and she said she would pull up Alice’s records when she got back to the office and see if Alice “might need some blood work done”. (Alice hasn’t had any other blood work done since mid-April when she started on the 3 units, twice a day. And, just for the record, I do not like this vet practice and take my own cats to a vet hospital 45 minutes away.)

As soon as I was allowed to take Alice Friday night, I knew she was immediately going off the dry food. She hasn’t had a bite of it since Friday. She’s only had Friskies pate, which is what I feed my own 6 cats. Fortunately, she loves canned food. Having read Dr. Pierson’s site, with the drastic change in diet, I knew it was imperative that I reduce that 3 units, which I’ve done. Yesterday and so far today, I have just given Alice 1 unit twice a day, which I still fear is too much. My husband and I bought a Relion Confirm meter and strips yesterday and hope to figure out the home testing tonight. We both work full-time so our goal is to get in at least 4 tests a day until the long holiday weekend when we’ll do more.

I had promised J as recently as two weeks ago, that should anything happen to her, I would make sure her kitties were taken care of. Neither of us had any idea that moment would come so soon. Right now, I’m feeling overwhelmed both with grief for my beloved friend and concern for this precious kitty.

My mind was so full of questions, but as I’m writing this, I really don’t even know what to ask first! I guess the most important thing is … what about the dosage? Is 1 unit twice a day too high, too low? Should I just stop the insulin altogether as Alice gets acclimated to a canned food diet? I want to do the right thing, for Alice and for J, may she rest in peace.

Sorry for the long-winded first post!

 

Im so sorry for your loss, but its such a great thing that you are willing to take in her cats especially one that has diabetes. Your on the right track though for switching to canned only, have you see the list of diabetic friendly foods?
http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

I know you said your feeding fancy feast and you read Dr Lisa's info but just in case. I don't know much about Lantus, since Hidey was on Prozinc, but I would definitely lower the dosage while food transitioning if you cant keep a CLOSE eye on her. Its definitely great that you and your husband plan on home testing. When it comes to testing, I dont know what her temperament is, you may want to get some diabetic friendly treats, freeze dried is the best since its high protein. You could even use cooked chicken or tuna. The treats help distract them while your testing.

You seem to be doing everything right. You've switched the food, your going to do home testing, your reducing the dosage till you know what works, your doing your research, you've spoke with the current vet about past blood work.... Your doing GREAT even through this hard time. Once you start testing starting a spread sheet is a good idea, it helps a lot.

Once you start home testing it is a good idea to start a spread sheet to keep track.
viewtopic.php?f=6&t=50130

Good luck and we're here for any questions. This board is full of caring helpful people. I was so happy when I found this board because I was so scared and overwhelmed, I couldnt have done it with out them.

 

My condolences on your loss.

See my signature link Secondary Monitoring Tools for additional assessments you may make to evaluate the cats' health while you work on testing the diabetic. Particularly note urine ketone testing. Ketones form as a by-product of fat breakdown for calories. More than a trace is a medical emergency.

When I switched my GA Spitzer to low carb canned, his insulin dose dropped from 3 units to 1 unit.

The formula for Lantus starting dose:
What is the current weight?
What is the ideal weight?
Take the lower weight.
Convert to kilograms (pounds / 2.2) if needed.
Multiply by 0.25
Round down to the nearest quarter unit (we eyebal these as needed, or use calipers)

 

Condolences on the loss of your friend and bless you for adopting Alice.

You are already doing a great job by changing Alice's diet and learning to hometest. She is already on a good insulin that many cats respond well to.

 

So sorry for your loss. How wonderful of you to take in the diabetic kitty! Let us know what you need. Home testing will take some learning but you can do it!

 

My deepest sympathies on the loss of your friend "J".

Here are 2 links for you on home testing.

The How-to's of home testing.

Ear testing psychology, or getting your cat to accept the process.

A few of the keys to home testing are warming the cats ear, treats for the kitty (and you) and staying calm, cool and collected and not making a big deal out of the testing process. We suggest 3 pokes and you're out. Stop, give treats all around and try to test again later.

 

Thank you so much for the input everyone. It's been a crazy week and with it being a holiday week, I'm trying to get 5 days work done in 4 here at the office.

Alice is doing so well just after 4 and a half days on a canned diet. She has energy and a "sparkle in her eye" which I haven't seen in her in a long time (I've "known" Alice for over 10 years). In fact, last night I couldn't find her. Turns out she had gone upstairs. I called her and she came running down the stairs. Not as fast as my 1 year old kitty, of course, but at a pretty good clip for a cat who couldn't even jump up on her momma's couch last week.

DH and I have not tried testing her yet although we do have the meter and strips. It's just been nonstop this week with work and helping J's family with things after the funeral. I've been doing some of the ear prep work though, trying to lead up to the actual poke. Thank you, Deb, for the home-testing links. I knew I had read that info somewhere on the site but didn't save it, so posting the links was a great time-saver. DH and I will both be home Friday and that is definitely when we will start.

I hope it's okay, but I have not given Alice any Lantus since Monday. I've been watching her closely, even coming home for lunch each day to feed her and to check on her. She's eating well and loves the Friskies pate. I've even gotten her to eat a little bit of coconut oil, which my other cats love.

And tonight, DH and I are bringing home Alice's "brothers", John-John and Charlie. No one in J's family wanted them. They're both younger than Alice and have also been raised on dry food only. Fortunately, neither of them have any health issues. They'll be going canned only at my house! John-John loves canned but Charlie is one of those dry food addicts I've read about at Dr. Pierson's site. He's gonna be a problem, I'm afraid.

Anyway, I've got to get back to work but will try to check in more frequently as things calm down. Thanks again for all the advice and encouragement! I appreciate it so much!

 

If you're not blood testing and you're not giving insulin, you need to test for urine ketones.

Ketones form as a by-product of fat breakdown for calories when glucose can't be used due to lack of insulin. Too many ketones may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat complication of diabetes.

 

BJM - the ketone strips are the same sold for humans in the diabetic section of any pharmacy, right? I will stop by Wal-mart on my way home and pick up a box! Any hints or tricks as to HOW to get the urine on the strip accurately?

After reading Dr. Pierson's stern warnings about changing to wet food without lowering dosage, I've been afraid that whatever I give Alice will be too much. Saturday and Sunday, I gave her 1 unit twice a day. Monday, a half unit twice a day, and yesterday and this morning, nothing at all. Should I give her some tonight? I'm just so afraid that I'll do something wrong! The local vet (her vet) has not been any help and I can't get in to see my vet until next week.

We're picking up John-John and Charlie tonight. Once we get them settled, I will tell DH that we really must use the glucose meter tonight and not wait until Friday. This will be the first quiet night we've had since last Friday when I got the call about my friend's death.

Also BJM - looking at the Lantus formula you posted upthread, Alice's current weight is 15 pounds. Her ideal weight, I suppose would be around 8? She is definitely overweight right now. 8 divided by 2.2 x .25 is .90. So that's just slightly less than 1 unit twice a day or once a day? If her ideal weight is 9 pounds that would put her closer to 1 unit.

Thanks so much for your help ... I feel like the worst kitty mom ever!

 

worst kitty mom ever? NOOOOOOOOOOOOOOO! you just took in 3 cats! 1 of them special needs! You are an awesome kitty mom!

fwiw, if you need any help with the hometesting just post a general location like town and state and maybe someone is nearby that can help, especially with most everyone going to have the long holiday weekend available to them

 

0.75 units BID, ie twice day; you have to eyeball it.

 

So one of your new civie family members is a dry food addict you say? Well, my Wink was too when I took him home from the shelter. I used almost all of these tips and tricks Transitioning Feline Dry Food Addicts to Canned Food by Lisa A. Pierson, DVM to get him to switch. Took me 6 weeks which was really, really fast. Patience and persistence are key in getting a die hard dry food kitty to eat wet.

Let me know how it goes.

 

Another trick for dry to wet food diet conversion is to bake some of the canned food until dry, then make make it less and less dry with each batch. Of course, you have to be OK with the house smelling like cat food!

 

Happy Independence Day everyone! :RAHCAT

DH and I finally did Alice's first home test ... today! And it was higher than I expected - 294. :cry:
But on the positive side, Alice was a very good patient. Didn't flinch or cry at all.
I gave her 1 unit and fed her about 1/4 of a can of Friskies pate.

At +1, she was 272. We tried again at +2 but DH just couldn't get enough blood. After several pokes, Alice was getting fidgety, so we'll try again at +3 and/or +4. We'd like to get in as many tests as we can over the long weekend.

UPDATE: Editing to say at +3, she was 203. Is that good? DH and I celebrated like it was!

I tested for ketones Wednesday and Thursday and all looks good on that count. And that was easier than I thought it would be. All in all, Alice isn't giving me any trouble, the sweet girl. It's been one week since she lost her Mom. :cry:

:arrow: I started a spreadsheet, but now I have a really dumb question: how do I access it again? I started a Google account just for this and I can get back into my gmail, but I can't find the original spreadsheet. If I open the link in my sig, I go to the spreadsheet, but not to a version I can edit.

THANK YOU to everyone for your help, both in this thread and throughout this whole website. Alice and I have got a long way to go, but we could not have made it this far without you!

 

http://drive.google.com
You may need to login if you don't leave it logged in.

 

Greetings!

I had the same problem, but I impressed myself by figuring out how to do it.

If you go to the upper right hand side, you will see your picture (if you set one up), then something that says SHARE, then a bell and then a grid looking thing with nine squares (if you hover over it, it will say APPS)..once you click on it, the different apps appear, one of them being the google drive.....click on that and your spreadsheet should be saved there....

That is at least how I access mine to update.....

Molly

 

BJM and Skootersmom - Thank you! Your advice worked perfectly!

 

HA! I didn't see BJM's until I posted my response....


My guess is her direct link will work better LOL

my way will work if you have just TONS of time on your hands lol

 

Alice's numbers just now went UP ... from 203 at +3 to 206 at +4.

I fed her in between the two tests. About another 4th a can of Friskies pate. Is that normal for it to rise a little after eating? We were hoping to see "blue numbers" this time! I won't feed her for another 4 hours or so, so hopefully she'll get below 199 sometime today.

This is all still so confusing! @-)

 

Alice has the Blues! She just hit 199 at +6 ...

 

Congratulations on your first successful BG test and welcome to the Vampire Club!

 

Thanks for the congrats, Deb! My husband deserves the praise - he's the one who has wielded the lancet all day. :lol:

So Alice's PMPS was back up to 216. I gave her one unit, just like this morning. In hindsight, I suppose I should have given her more this morning, maybe 2 instead of just 1.

And 193 was her low number. Wish now we had done a +8 since +7 and +9 were both 193. I'm thinking that +8 might have been her true low number.

A couple times today DH had trouble drawing blood. Is there any other sweet spot to use if the ear isn't working?

Another good report: Alice played with Da Bird today! I got it out for John and Charlie, and there was Alice trying her best to swat it too! Made me cry. Her mom, my friend "J", would be so happy to see how far she has come in just a week. :cry: Alice was always her favorite.

 

I haven't commented on your post yet, so Welcome! And great job on starting the BG testing! The fact that she's started playing again is definitely worth celebrating, even with tears. ;-) That means she's starting to feel better.

Not with Lantus. You want to hold the same dose unless low numbers (below 50 on a human meter) tell you a decrease if necessary. Or high nadirs for more than 3 days/6 cycles, and even then an increase of only .25u for 3 more days/6 more cycles.

 

KPassa - thanks for the warm welcome! And thanks too for the advice about Lantus. A lot of this is still confusing to me! Particularly the dosing, so your comment about holding the same dose is very helpful! I appreciate it!

So Alice's +3 this evening was 148! I'm actually looking forward to seeing what it will be in the morning.

The spreadsheet is such an awesome tool and really helps to clarify the great advice I've been getting all week! I found this board one week ago tonight, in total despair and grief. I never even imagined that Alice and I would have progressed as much as we have in just 7 days.

Again, THANK YOU FDMB! Is there a hug smiley on here? There really oughta be a hug smiley!

 

Warming the ear enough with that rice sock? or rubbing it?
Have you tried both ears? sometimes one bleeds better than the other
How about 2 pokes, very close together to get two small blood drops to form a larger single blood drop?
Are you using the larger 26-28 gauge lancets for poking? These have a larger pin to poke with and the box is often be labeled "For alternate site testing".

It takes time to get skilled at the pokes and to consistently get blood every time. Even if your fried "J" was home testing, she might not have gotten blood every time.

You can try the paw pad for testing, if none of the above ideas work.

Yup, there is a hug smilie, but you have to click on 'View more smilies' to get to it :YMHUG:

The information on dosing changes with Lantus is posted over in the Insulin Support Group (ISG) Lantus (glargine) Tight Regulation forum, affectionately called TR for short. Look in the other Stickies at the top of the forum for some great information.

Here's the link to that Tight Regulation sticky, STICKY: LANTUS & LEVEMIR - TIGHT REGULATION PROTOCOL

So excited to hear that "Alice played with Da Bird today!" It's a sign that she is feeling better and adjusting to her new home. It can be so stressful for a kitty to go to a new home and hearing that she is playing is telling us that she is starting to settle in there with you and DH.

Well, maybe you both deserve the congrats. DH may be doing the tests, but this is a family effort all around. Not just your family in your home, but your new family here at the FDMB message board. "It takes a village to care for a diabetic cat." You, family members, your vet, cat forums like this one, friends, maybe a cat sitter when you need to travel. We don't do this alone or in a vacuum. We reach out to others and are rewarded in all sorts of ways.

Don't be surprised if Alice's BG is actually higher in the morning. Cats that have been in high numbers and then get a lower than normal number like that 148 can "bounce". Bouncing is a built in safety mechanism that releases counter regulatory hormones and gets more glucogen into the cats system. It protects them from what the body considers a lower than expected BG levels. See, the cat's body has been accustomed to some higher numbers so it thinks that 148 is too low. Oops! I see that Alice is a contrarian and gave you a 110 this AM!

You have 3 choices with that low of 110. Hope you are stalling (not feeding and retesting in 20 minutes), skipping the shot, or giving a reduced dose and around to monitor Alice.

 

The counter regulatory hormones release glycogen from the liver, which is broken down into glucose. And up it goes!

 

Deb and BJM - I guess Alice had her bounce after all! From 110 this morning up to 324 at her PMPS. DH freaked out, thought we had ended up hurting her by skipping the morning dose. What a difference a day makes ... 148 at +10 last night, 248 at +10 tonight.

On a good note, Alice had two short sessions with Da Bird today!

 

Just an update: I did Alice's last two ear tests myself today! :RAHCAT

I didn't think I'd ever be able to test without DH here. But I'm able to come home at lunchtime and he's not, so I knew I had to overcome my fear and JUST DO IT so I can get that midday test starting tomorrow. I used a small plastic tube with a lid (Spry gum container) filled with very warm water and I really believed that helped. Alice was well-behaved as always but naughty girl spotted her treat and gobbled it down first, lol!

Her PMPS was 334 and DH really really wanted me to give her 1.5 units. But as I understand the "Start Low, Go Slow" protocol, I should stay at 1.0 for at least a week before increasing to 1.5 units. Her afternoon numbers have pretty much remained in the yellow, so if that's still the case come Friday, I think we can raise it then.
Plus I ordered a box of the 1/2 unit marked syringes from adwdiabetes.com and I should have them by Friday, if not sooner.

:?: Two questions though:
1. Furshots - Just now, I think I *might* have had one. Her fur was not wet at all, but my finger did smell like band-aids (which I read is a sign). I did not prick my finger and her fur was not wet. We're going to test her at +2 and if her levels have not gone down from 334, would that be an indication that I should dose her again?

2. Air bubbles - I know how important it is to avoid shooting an air bubble into a vein, but what about into the scruff of a cat's neck? Neither DH nor I have seen air bubbles in the Lantus vial, but there was most definitely an air bubble in the syringe tonight. DH tossed it ( :shock: - wasn't sure if he could inject it back into the vial) and we used another syringe. No air bubble. Was that the right thing to do? And is there a way to avoid having it happen again?

We've both been home for the last three days, but tomorrow the real world kicks back in. nailbite_smile

 

Never re-shoot - you don't know how much got in and could unintentionally overdose.

The dose is increased by the nadir, the lowest glucose between 2 shots, not by the pre-shots.

A tiny bit of air under the skin is unlikely to cause a problem.

 

BJM - Thank you for reminding me of this. She did go up tonight. From AMPS of 334 to a +2 of 348. :sad: Should we expect a pretty high AMPS tomorrow morning? This is a real rollercoaster ride!

We've only tested for three days so far and her nadirs have been 193, 168, and 198 respectively.

Whew! That's good to know!

 

Those nadirs are looking decent for starting out.

On the first dose, it can take 5 to 7 days to stabilize.
For each adjustment after that, it may take 3 to 5 days to stabilize.
Thus, it is really important to be patient with Lantus ( and Levemir) in monitoring and adjusting the doses. If you do need to increase, it'll be by 0.25 units, since the nadirs aren't real high. (There is a protocol for that, though.)

Take a look at my signature link Secondary Monitoring Tools for some other assessments you may find helpful to make, particularly ketones. Ketones form as a by-product of fat breakdown for calories. Too many may indicate diabetic ketoacidosis, a potentially fatal, expensive to treat complication of diabetes.

 

Ah, I knew there was a catch to all this ... patience! :lol: Where do I get THAT?

Alice's +4 came down a little bit tonight to 312.

I was doing a little reading tonight and realized that I might have contributed to Alice's higher numbers this weekend. As her test treat, I was giving her Blue Buffalo tuna "Kitty Yums" simply because I had those on hand and my other cats love them. Actually took the time to read the ingredients tonight. Brown rice? Oatmeal? Potato starch? MAPLE SYRUP? What cat needs maple syrup?!? Alice had 6 of those today and at least 6 yesterday! ohmygod_smile What a dummy I am!

Fortunately, DH and I have a trip to Petsmart planned for tomorrow night and PureBites are on the list.

Edited to add: Alice loves the chicken PureBites! THANK YOU to all those who recommended them. :smile:

 

Patience pants, I hear a plea for patience pants. Hope you like these from my vast and never ending lending closet of patience pants.
Something nice and cool but in a nice sunny color.