Another Newbie with Questions

Hi everyone - My 12 year old male cat, DJ, was just diagnosed with diabetes on October 13. I had noticed a drastic increase in his drinking and urinating and brought him to the vet for testing. His BG was at 634, but other than the symptoms I mentioned, he was/is doing fine. He has a good appetite and is acting normally. I had just had him (and my other cat, Sugar) in for a wellness exam in May, and his numbers were all good at that time. So I am thankful that it appears we caught it early. After the initial shock, fear and sadness, I am doing much better. There is a lot of great information on this board and I am so thankful for that!

After reading the articles and message board, I have a few questions that I would love your advice/thoughts on. My vet has prescribed Lantus for DJ and I am giving him one unit twice a day. This is my third day, and so far the injections are going very well. He is a very affectionate cat, so all I have to do is sit down and he is on my lap a few seconds later. Sometimes he doesn't react to the shot at all, but a couple of times he has looked around like he was bitten. He is really making this easy on me so far!

Anyway, on to my questions: When I was shown how to give the injections at my vet's, they told me to pull out the syringe, then place it into the bottle and push in the air. So, that's what I have been doing. Now I just read on the Lantus MB that I should not be doing that. I am scared that perhaps I have compromised the insulin - any thoughts?

Also regarding the injections, when I was trained they said to try to aspirate in order to make sure I hadn't hit a vein. Even though DJ is making it easy for me, it's really hard for me to do that all one-handed while still tenting his skin. Is the aspiration necessary?

Finally, for years my cats have been eating (free feeding) Hills Science Diet Oral Care (dry). I tried many times to switch their food to an all natural food, but they won't have it. They just refuse to eat. Additionally, they will not eat wet food. They will eat the newer Fancy Feast Appetizers (which is just shredded chicken and broth). So when the vet told me I had to switch to a prescription diet, she gave me samples of the Purina (DM, I think) and the Hills W/D. They won't eat the Purina, but will eat the Hills W/D (I suspect because it's similar to the Oral Care). So after reading the recommended food list on here and seeing that A. they should eat wet food, and B. they should eat a much lower carb food than the Hills W/D, I'm freaking out a little. I'm I doing DJ a huge disservice by giving him the Hills W/D? I don't want him (or Sugar) to stop eating, especially now that DJ has been diagnosed. I would really appreciate any thoughts/ suggestions about this as well!

Sorry for the long message, but I really think the best place to go for advice is from those who are going through this as well! Thank you all, in advance, for your help.

 

Hi and welcome. The people here are experiencing feline diabetes on a daily basis and the group is caring and helpful.

I didn't use Lantus for Maggie - I used levemir, which is similar. I understand that pushing air into the bottle may make it "poop" out sooner than it would otherwise. I don't think it's the end of the world, but you might want to stop doing it. 1U twice a day is a good, safe start.

As for the actual shot, I just made a "tent" in Maggie's scruff, put the needle in, pressed the plunger and took the needle out. The process took a few seconds. But maybe Lantus is different. Someone who is more familiar with Lantus should be posting soon.

Are you going to home test? Most vets don't mention it, but you don't need the vet's permission. It will tell you how DJ is doing and if his blood glucose (BG) is high enough to safely get insulin. We use human glucometers to do the testing.

About food. My Maggie wouldn't eat canned food, either. But others here have successfully transitioned their cats from dry to canned, so it's worth a try. There are also low carb, grain free dry foods out there. Wellness CORE is one. Whatever you pick, i needs to have no more than 10% carbs. So check the food charts and try some low-carb canned.

Others will be here soon with more advice! Welcome again!

 

Regarding injecting air into the vial, it really does not make much difference since air will leak into the vial anyway. However, air does tend to degrade the inulin. Most people her use the disposable pens or cartridges for Lantus. They come in a pac of five 3 ml pens/cartridges. You use a regular syringe and draw out the insulin. Opposite the place where you take out the insulin there is a movable rubber stopper that moves to compensate for the removed insulin. Therefore, you do not want to inject air into the cartridge/pen. Per ml the pens/cartridges are more expensive but it usually ends up being cheaper since you have to through out less when it finally goes bad/loses effectiveness.

 

I use Lantus for both B.K. and Chester. What you have been told about injecting air into the vial/cartridge is true. I use the SoloStar Pens, so I can make adjustments as I'm removing insulin from the cartridge.

As for the injections, I just tent the scruff and shoot. So far, after all these years, I haven't had a problem.

As far as the food goes, you are right that low carb wet food is best for diabetic cats. Perhaps mix some of his current food with a small amount of low carb wet and keep transitioning him a small amount at a time?

 

Hi and Welcome!

Can't really give you a ton of advice on Lantus since Max and I just started using it. But I did want to pop in and tell you hello, and remember to breathe, this is all over-whelming and terribly scary when you first start, but take it in baby steps and ask a ton of questions and soon you will be able to do it in you sleep.

But I really want to encourage you to learn to home test. It can be the difference between life and death for your kitty, as well as giving you a much greater sense of peace of mine. Almost all of us use a regular human glucosmeter to test our kitty's blood before giving them their shots to make sure it is safe to give. We get the blood by pricking their ears, most of them don't even seem to notice after awhile and will even purr while being tested.

I just adopted my Max this friday as a diabetic and if it wasn't for being able to test him at home I could have gotten him in some serious trouble by giving him insulin when his numbers were too low. Since he is new to me and I don't yet know what normal behavior is for him. In just a very short time and change in diet to low carb wet canned food my Max is already down from the 400s when dxed to the low 100s. So diet plays a huge part in the treatment of this disease. As well as being able to test your DJ at home so you can see how his body is reacting to the insulin. We can help you learn, plus being able to test at home will save you money in few vet trips.

Just keep asking questions and we will do our best to help. I know it can be hard to take advice from a bunch of folks on the internet, but everyone that posts either has or has had a FD Kitty, that we are treating.

Good luck to you and DJ and welcome to the FDMB family.

Mel

 

Remember its a process not an event.

The best food in the world is absolutely worthless if the cat won't eat it.

There are lots of finagles folks have used for transitioning - you may have to try several approaches over weeks to switch food(s). For example, if you have to stick to dry for now, you might take a better dry food, crush it, and sprinkle it over some of the current food. Or set some on a separate plate. Or use it as little toys to toss and chase. Whatever works for your cats - ECID - each cat is different.

I started with a clouder of 11 which were eating a mix of canned Friskies poultry platter and IAMs dry, with the upstairs cats also getting Taste of the Wild dry. Then Spitzer was diagnosed with diabetes. I began shifting the downstairs cats to Taste of the Wild dry (higher protein, which breaks down slower) and got them switched to that. Then I picked up some wellness Core dry ... and the older (mostly downstairs) cats threw it up, so that was a bust. I started putting out more of the canned and less of the dry and over a week, got them on all canned. But OOPS - without a glucometer.

The vet's go home insulin dose of 3 units twice a day is too high. And the latest tests are showing that 1.5 may be too high too, though he hasn't been on a stable dose long enough to really know for sure.

Did I mention its a process?

 

Thank you all so much for your thoughtful responses. I've continued to do research and am going to get a couple different brands of wet food and see which ones they might accept more easily!

One more question about the Lantus. Was told at the vet to roll it a few times back and forth before filling the syringe. On the Lantus MB here, it said not to roll it. Any thoughts?

 

Well, that's disturbing. Previous insulins like PZI you did roll (never shake).

Do not roll or shake Lantus. PZI was a suspension and had to be gently mixed. Lantus is clear
and rolling/shaking is bad for it. Vet needs educating on the new insulins like Lantus and Levemir.

Insulin that has gone 'bad' is a common cause of raising the dose. Then when a new vial is
obtained, that same dose on the good insulin is way too much...instant hypo.

 

No, you do not roll Lantus. BTW, did your vet mention that the 28-day limit on viability is for human use only. For felines, Lantus remains viable much longer than 28-days. In fact, for those of us who purchase pens (with the smaller cartridges), we can often use the entire cartridge without having to throw away any insulin because it lost its punch. Vials are a different story...because there is so much insulin in one vial, many of us ended up having to throw away vials that were still 1/2 to 1/3rd full.

 

Okay, so now I'm just really disturbed. The vet sells me Hills W/D and Purina DM, tells me to inject air into the vial, tells me to roll the vial in my hands, and tells me at home testing is not necessary. And all of this information turns out to be untrue and potentially harmful to DJ. Aren't we supposed to be able to trust our vets to give us the right information and help, not hurt, our loved ones?!? Up until now, I have really liked this vet and felt that she was very good for my two cats and dog. Now I am really very concerned.

I am in the Schaumburg, Illinois area, and I'm just wondering if anyone out there on the MB is from the same general area and might have a recommendation on a good vet to take my DJ to. Any and all suggestions welcome.

And sorry, one more question...how soon should I start seeing an improvement in DJ's drinking and urinating? This is day four (so 8 injections so far) and I'm really not seeing an improvement. And given all that I am finding out, I am back to being worried.

By the way, went to the store to get some different kinds of wet food...tried the Blue Buffalo brand and they both turned up their noses. Also got a small bag of Wellness Core dry food since it is high protein, low-carb, and they aren't eating that either. Guess I'll just keep trying!

Thank you all so much for your replies!

 

Food: It's sometimes better to introduce the new food gradually. Try mixing some of the new food with the old. Start with a little bit and keep upping the ratio.

As for it being day four: Remember diabetes doesn't get better over night. It's a marathon, not a race. And if you are not home testing you really don't know what's happening with DJs blood glucose. Please consider learning to home test.

Vet: Most vets are like GPs - they are not necessarily experts at everything that go wrong will all species they treat. If you like your vet and your vet is willing to work WITH you, don't write him off. Lantus and Levemir are human insulins and are handled different from most veterinary insulins. At least your vet picked a great insulin and started DJ at a reasonable dosage. My vet hadn't even heard of Lantus or Levemir until I brought in printouts from this site. She was willing to try them after reading the information and checking around herself.

 

Since I'm not in IL, I can't help you with the name of another vet. What I can tell you is that your vet is probably doing what s/he truly believes is best; however, treating diabetes is often a learning experience for vets as well. Unfortunately, they get stuck relying on what the sales reps from Hill's, Purina, etc., tell them is the best food, and only learn about insulins that are made for animals. Since Lantus is a human insulin, your vet likely didn't get much in the way of information about it.

Hang in there...I'm sure there are people here that can help you with ideas for a vet in your area.

 

I'll vote for home testing too. If I hadn't started it, I'd prob. still be injecting cat who didn't need insulin as he's in the honeymoon range now.

Try mixing a bit of the wet in with the dry, changing your ratio every 5 days or so. That's what I did, and now Joey hasn't had a bit of dry in almost 3 months. He loves his Friskies low carb selections - I rotate 'em, altho I doubt there is really much difference. I can't bring myself to taste-test em.

 

Hello and welcome to FDMB.

Since you've already gotten lots of replies, I'll keep it short --

BEFORE putting the needle into the insulin cartridge, I push on the plunger to squeeze out all the air first. That helps prevent an air bubble sticking to the plunger inside and reducing how much insulin is sucked in.

The old insulins needed to be rolled gently -- the new ones DON'T.

I have a bunch of kitties who were dry food fanatics. I took the food change very slowly because EATING is more important than the quality of the food.

We used to feed Science Diet Senior Indoor -- then changed to Blue Wilderness dry (18% carbs) with some low carb Fancy Feast -- then changed to EVO Cat & Kitten dry (8% carbs) with FF and canned Wellness.

Now my kitties eat canned Wellness (chicken & turkey flavors) with occasionally treats of EVO dry.

The dry food will require more insulin to process the sugar than low carb canned food, but if you learn to hometest - you can monitor and adjust as needed.

If you like and trust your vet -- keep him/her. Most vets are general practitioners and spend about 3 hours of their 8 year education learning about diabetes care for several species of animals. If they are willing to learn -- great!

 

Thanks again to all of you who took the time to reply. The things I am learning on this forum are invaluable and I really appreciate it. I left some wet food out when I left for work this morning, and it was gone when I came home. The only problem is that I don't know which of my cats (or both of them) ate it. I'm hoping it was both!

I'm taking the process slowly and trying different foods. Hopefully I will stumble across one that's a winner for them. In the meantime, I am doing some research on glucosometers and will hopefully begin home testing soon.

Thanks again to everyone!

 

Hi DJ's mom,
i have a website here called newbie kits with just about everything you need to start testing right away. if you press the link below you will see what i have to offer. if you have'nt been tested for ketones you might want to mention that if you order.
this is a free service i can do made possible by the collections from members here on the board. you simply pay thru paypal for the shipping and you can leave a donation as well if you are able.
take a look.
i can have it out the same day you order it.
Lori
and tomtom too!

 

The information you get on this board is the best. My cat was only diagnosed 9/23/10 so I have not been doing this long but everything that was suggested here has turned out to be right on the money with the experiences I have had. Because of this board:

* i was ready to respond appropriately and calmly when my cat had a seizure - ( i broke down later when he was better)
* I know that starting with a high dose is NOT the thing to do
* I understand more about the "shed" and what happens when it is fills up
* I know i HAVE to do a BG test at home BEFORE I give a shot - otherwise my cat could hypo and I am not putting any of us through that again. (There is a protocol on when not to give a shot)
* I know the Reli-on meter requires half as much blood as the AccuCheck Aviva did so BG testing is much easier.
* I know that I should feed only a high protein, low carb, CANNED food since dry makes the BG level higher
* I know that the freeze dried chicken treats (75% protein) really help when we are trying to home test
* I mix the canned food with water so that he does not dehydrate

I am sure that there is a lot more that I have learned but I can't remember right now but this has been a VERY valuable source of help.