Blaze diagnosed 8/16/2019

Hello, my name is Sarah and my 7 year old boy named Blaze was diagnosed this past Friday. I am feeling completely overwhelmed and scared. I want to do everything right so that I can give him the care he needs to get him feeling better. He currently has some liver issues being treated with Denamarin for one month and Metronidazole for 14 days. He was prescribed 2 units of Humulin every 12 hours, I got the generic version called Novolin N. My vet told me I don’t need to glucose test at home but after everything I have read here, it would make me feel so much better knowing what his BG is instead of waiting two weeks for his next bloodwork appointment at the vet. I bought the ReliOn Prime glucose meter today but did not have any luck with getting a reading. I think the 33 gauge lancets are too small to poke a big enough hole to get any blood. Would I be better off with a different sized lancet? Is this glucose meter okay?

 

Hi again Sarah, glad to see you here in the Main Health forum. Blaze is a handsome kitty and we are so pleased you are here.

I promised link and tips for home testing: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/
and one by member JanetNJ
How to test your cat's bg at home: Video I made showing how to test your cat's blood sugar

What is Blaze eating? A low carb diet is best for our sugar cats, and we can help out with information and suggestions about that.

A visit to the FAQs forum is going to provide you with reading material so you can be prepared for an emergency, plus an Index that you can comb through at leisure.

Next, the insulin, Novolin. There are other insulins that are longer lasting and gentler, and you may want to research and consider down the road, but it's what you have right now and it's important to know as much as you can about it.
http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-novolin-humulin-nph.186097/

I think that's enough to go on for a good while. Please ask questions, post often and let us know if you are confused or struggling. We all started at the beginning too, and will help all we can.

 

Hello and welcome!!!

Yes, you will definitely have an easier time of it with the larger-sized lancets. We usually recommend that you start with the 26 or 28 gauge. Once you've been doing it a while, Blaze's ears will "learn to bleed" and you can move back to the 33's.

Lots of folks around here use the ReliOn Prime, so no problems there!

Looks like Blaze is eating Fancy Feast Classics, so that's a good low-carb option (the pates, at least-- the other styles are also good to have around for when you need to add a few carbs). Quick question: has he been eating those for a while, or did you just switch? I ask because you want to be very careful when switching to low-carb from high, some cats have a very strong response to diet and their insulin needs go way down. This is why it's good that you are starting to test!

 

Hello again!

So before his diabetes diagnosis, he was eating dry food for the most part with occasional wet food here and there. Once we got the diagnosis this past Friday, I bought Fancy Feast Classics paté and Friskies paté but had read that it’s dangerous to go straight to wet food when starting insulin so I have been feeding him both dry food and wet food, so we can transition to wet food only at some point. Is that okay? Or should he continue eating only dry food for right now? I have been giving him wet and dry food yesterday and today. My vet said we would talk about changing his diet at his two week appointment. How much and how often should I be feeding him also? I want to make sure his blood sugar isn’t too low and since I haven’t started successfully testing yet, it scares me not knowing if he’s low. I find myself watching him incessantly after giving his 2 units of insulin.

I am feeding him at 5:30 am and 5:30 pm right now and then giving 2 units of Novolin at 6 am and 6 pm. Since I’m not testing YET, what should I be watching for in regards to hypoglycemia? He just ate and got his insulin at 6:00 pm and now he’s sleeping. I don’t want to be paranoid and confuse this with lethargy or signs of hypoglycemia. Hypoglycemic scares the heck out of me so I want to make sure I know what to look for.

As for the Novolin, once I get through this first vial, would I ask my vet to prescribe something different that is longer lasting/gentler? And how is it to switch insulin? Is it safe and does the dosage change?

 

Okay that makes me feel better about the gauge size. I wasn’t successful for the 33 sizes gauge so tomorrow I will get the 26-28 sizes gauge lancets and try again. It will be after work though, and I just gave him his night time insulin, he will get another dose at 6 am, do you think I’m okay going without testing him until tomorrow evening?

As for food, he used to eat dry food with some occasional wet food here and there, pre-diabetes diagnosis. When he was diagnosed this past Friday, I bought fancy feast classic paté and friskies paté but have been giving him both wet and dry food. Is that okay? I want to eventually get him on wet food only but I know right now with him starting the insulin, it’s not good to go straight into wet food only.

 

From the "How to treat HYPOS" sticky in the "Health Links" forum:

SYMPTOMS
Some cats may have NO symptoms whatsoever, but here are the most common ones:

MILD HYPOGLYCEMIA
Sudden ravenous hunger
Shivering
Weak or lethargic

MODERATE HYPOGLYCEMIA
Disorientation
Trouble with vision... bumps into furniture
Poor coordination, such as staggering, walking in circles or acting drunk
Changes in head or neck movements
Restlessness
Urgent meowing
Behavioral changes, such as aggressiveness

SEVERE HYPOGLYCEMIA
Convulsions or seizures
Unconsciousness

As you note, it's the one about "lethargy" that causes the most stress-- I mean, these are cats we are talking about, "lethargic" is kind of their natural state 23 hours out of a typical day! So it's hard not to worry when all you have is the outward signs, but at least there are (potentially) lots of other signs to watch out for. And soon you'll be testing and have that extra peace of mind of knowing.

Definitely stick with the dry+wet combo until you are testing regularly. Not only will that help to lower the risk of hypos due to sudden decrease in carbs consumed, but having that dry food out all the time can potentially help stall any hypos that might be developing. The "ravenous hunger" symptom is a really common early sign, and lots of cats will go out in search of food on their own at that point. Having that dry food available will help keep him safe.

 

Oh Sarah, I had to chuckle a little bit..you are a typical helicopter mom of a newly diagnosed kitty. I would wake poor Idjit up just to check on him..and I got The Look, believe me! Read this: http://www.felinediabetes.com/FDMB/threads/letter-from-your-kitty-to-you-during-this-time.131186/

You are quite right, again, about changing his diet. It's best done gradually to help prevent gastric upset and because changing to an all wet low carb diet can significantly reduce blood sugar. You do not want that happening too abruptly, especially if you aren't testing.

http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

Most of us feed our sugar cats several small more frequent meals, but with the Novolin, you need to be sure there is food on board before 'shooting'. Most unregulated cats can't process food as efficiently and they are HUNGRY. Poor babies. So, feeding less, more often helps keep those tummy acids from building up, prevents vomiting acid bile stuff, and helps even out the effects of the insulin. Do you work, are there other kitties in the house?

Sarah, hypos scares the heck out of all of us at first, but soon you will be testing consistently and by reading the HYPO Instructions, and have your HYPO Tool Box ready, you will be able to handle it. (FAQs forum) If you get a low number, you post and ask for help. 50 is the take action number with a human meter. That's when you steer with some medium or high carb food to bring up the BG. If it gets very low, there are other steps to take. If it's very low like in the 40s or below, you post with a 911 icon in the thread title and you will get help.

Just saw Nan & Amber's post..spot on! Thank you Nan.

 

Hi Sarah and Blaze and welcome to Fdmb.
So glad to see you are learning to test the blood glucose levels. I would get anxious too if I was giving insulin and not checking the levels so your instincts are correct!
And well done getting the signature up!
All this helps us help you!

I am not a Novolin N user but their information page recommends a starting dose of 1 unit. It is a fast acting harsh insulin so I would reduce to 1 unit if I were you and see how low that is taking Blaze.

Others have given good advise about swapping over to low carb food and testing the BG.
Apart from a good amount of food before every shot, I would give some food during the first half of each cycle as well.

I would also read up about the longer lasting gentler insulins like Lantus, levemir and Prozinc. These are more suitable for cats.
Good luck with the BG testing.
We were all overwhelmed in the beginning so try not to worry. Educating yourself is key to understanding FD and feeling more relaxed about it.
You have done a great job so far.

 

Through my reading on this board for the last year plus, I learned Lantus, Levemir, Basaglar and Prozinc are longer lasting and gentler. The first 3 are "depot" insulins and build up in the body in order for there to be a reserve to draw on. Prozinc has been effective for many. Check out the Lantus and the Prozinc forums, read about them and that will help you make a decision.

http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

 

Yes the lethargy definitely causes stress because how the heck do you know if your cat is lethargic when he mostly lays around and sleeps a lot anyways?! But like you said, there are other signs to look out for, thankfully. And testing soon (hopefully successfully tomorrow) will give me more peace of mind.

I will continue the wet/dry combo like you said, until I’m testing and have a better idea of where his BG is. And I will keep some dry food out during the day too, since I’m at work during the day, that will make me feel a little better about stalling any hypo situations and make sure he doesn’t feel “starved” right now. He definitely seems to want to eat a lot right now, so I’m glad to know that’s an early symptom and that will subside once things are better controlled.

 

Quick clarification: I just realized that you said that you've only just started the wet food in the past couple days, that before that he was just eating dry. Until you're testing, I'd lean more heavily on the dry food to make sure he's getting the carbs he's used to, especially on a hard-hitting insulin like Novalin N. You'll have plenty of time to transition to the wet later!

Good luck, and don't forget to breathe! The first week or two after diagnosis is such a whirlwind of information...

 

I definitely feel like a helicopter mom right now! Poor Blaze! I will get better as time goes on and I learn more and get more comfortable. Especially once I’m testing.

I will keep doing wet/dry food combo and leaving some dry food out during the day when I’m at work, like suggested. The last two days I have fed him at 5:30 am/pm and gave insulin doses at 6:00 am/pm and left some dry food in the bowl during the day. Does that seems like enough food?

I work Monday through Thursday as a dental hygienist and I typically go to the gym after work, but with the 6 am and 6 pm “shoot” time, that gives me time to feed him 30 minutes to an hour before his insulin dose. And thankfully, my fiancé gets home from work before me so he can feed Blaze and give his insulin dose if needed.

I do have two non-diabetic cats also, so this is a transition for them also. I would like to get them off the dry food at some point as well, to avoid diabetes to develop in them and to make it easier for me to feed them the same food and at the same time.

I have some things saved on my phone about hypo symptoms to look for and how to treat and I also bought some Karo syrup and some fancy feast gravy lovers because I read it’s higher in carbs and good for hypo situations. I think I’m so freaked out about hypo situations because I’m not testing yet. But I’m getting there! All this information is so helpful and I feel so relived to know there are people who have been where I am and have so much information and support to offer. It’s amazing.

 

Yes, I have been doing a wet/dry combo as of a couple days ago, when he was diagnosed. I didn’t go straight to only wet food. I have been feeding him fancy feast classics paté with dry food mixed in, and leaving out dry food during the day as well, and giving dry treats here and there. I’m trying to be very cautious since the wet food is low carb. I will definitely do more dry food until I’m testing to be safe. Thank you so much! I’m trying to breath! There’s so much to learn and know!

 

Sarah, please read Nan & Amber's latest post and Bron & Sheba's post, re: the diet and the Novolin N dose.

You are doing well, being aware that you don't know much yet, but very willing to learn. It's going to get easier, and not feel so strange and bizarre. Give yourself huge credit for what you have already accomplished.

We will have to figure out what's going to work with the feline kids with the diet, because even if Blaze goes into remission, he should not ever eat high carb food. Hopefully all the kitties can get on the low carb wet food, it's just better for them all.

 

I’m learning so much and am going to get larger gauge lancets tomorrow to start testing, I have everything else but the 33 gauge lancets weren’t working today to draw enough blood to test.

As for the dose of Novolin, I gave 2 units twice on Saturday and twice today. Is it safe to drop to 1 unit tomorrow morning or should I wait until I have the lancets and can test his BG? I leave for work tomorrow morning shortly after his first shot, so I want to make sure it’s safe to start tomorrow morning with 1 unit instead of 2.

 

Do you think dropping from 2 units to 1 unit of Novolin is okay? Or should I wait until I can test?

 

Thank you, I appreciate that so much! I’m learning a lot and know I have so much more to learn. I appreciate everyone here and all the information being shared!

And my other cats have no problem with the low carb wet food, THEY LOVE IT. I think they prefer it so it shouldn’t be too hard of a transition for them. I’m just going to feed all three of the wet and dry food combo right now until I’m testing Blaze and can transition him and the others to wet food only.

 

Getting the testing started is the best way to provide info to the experienced people on this forum so that they can help with dosing advice. While we want to make our cats better instantly, diabetes is a complicated disease and the body reacts in unexpected ways that are counterproductive. The general wisdom is that change should be made gradually. And that while high BG is not a good state, extreme low BG or hypoglycemia can result in death.

The stickies at the top of this forum and the other forums contain a lot of useful info. You'll be rereading them several times, getting more info out of them once you have more experience and context.

I use the ReliOn Prime meter from Walmart and medium lancets; I have not had any problems with testing. The strips for the AlphaTrak meter are very expensive so many people here prefer human meters. The ReliOn is the least expensive (50 tsrips = $9). There are several others that are also used, but the strips are more expensive. The trade off is that the other meters require less blood. (0.5 vs 0.3 microliter).

You've come to the right place. The people here are the best and most experienced and can help you and Blaze navigate the path to diabetic management.

 

I'm not a Novolin user either, and so I am not comfortable giving a lot of specific dosing advice for that insulin, but if it were me, I'm with Bron, I'd do the 1U just to be cautious. If it's not enough, you'll know soon enough and will be able to take him back up. Just as long as he's never had ketones or DKA (and you'd know if he had!).

 

As long as Blaze didn't have ketones in his urine when he was diagnosed, which you haven't mentioned, then it is safe to drop to the 1 unit twice a day. The vet should have mentioned ketones if he had any.

 

Sarah, I know Bron will respond, it's her daytime in Sydney Australia and she does pick up her grandkids from school, etc. But, I would trust her recommendation about lowering the dose. It would be better to have Blaze a little higher tomorrow than too low and you not there to help him. It may prove out that the 2 units was too high, and you will see what the one unit shows with the testing.

 

The vet did not mention ketones in his urine but she did say he has some liver inflammation, which he’s taking Denamarin for a month to help with that. And she said he has pancreatitis also. But no mention of ketones in the urine. Is it okay to give 1U before I leave for work tomorrow morning? Or is it better to wait until tomorrow evening when I’m home to give 1U?

And if 1U is not enough, how will I know? By testing BG? And I would I bring him back up with dry food, Karo syrup? Or just going back to 2U when he was due for his evening dose?

 

Okay thank you! That’s what I was wondering, if it was “safe” to give him 1U tomorrow morning before I leave for work. Sounds like it’s a good idea to do so I’m going to start him with 1U tomorrow morning after his wet/dry combo breakfast, I will get the larger gauge lancets on my lunch break so I can test him when I get home and give his second 1U after his dinner!

 

Much less chance of low BG with a lower dose of insulin. This will help keep him safe, sometimes (actually many times) we see vets prescribe a high (higher even than 2 U) as a starting dose and that can cause the BG to drop too low, then kitty's body reacts to save itself, causing BG to go high again.."bouncing". Vets are basing dose on ONE number that they get in the clinic, not counting on travel and vet stress that can raise BG quite a bit.

Better a few days too high than a moment too low.

I will be eager to read what test results you get tomorrow.

 

Sarah, I'm going to turn in..I know it's early but I had a very late night last night helping a new member and I have to face it..I am an "older". Bron is one of the best, and will be available to help out. Please know that you are doing just fine, get some rest yourself so you don't screw up somebody's pearly whites tomorrow. Blaze is probably sprawled out somewhere, being CAT and he's ok. Give him a little head kiss for me. See yas tomorrow.

 

That definitely makes sense! Blaze does not like being in the carrier or in the car so usually he’s pretty worked up by the time we get into the vet, so I can see how that could raise the BG. I feel better about giving him 1U tomorrow before leaving for work. Although I will still probably worry about him all day! But I’m hopeful that with the correct sizes lancets, I will be able to get a test in tomorrow evening before his second dose. Thank you so much for your help! Here’s a picture of him giving me “the look”.

 

Thanks Lou, I’m heading to bed too. You’re right, I need my sleep so I can clean some teeth tomorrow! Blaze is currently sprawled out, getting his beauty sleep. I will give him a head kiss for ya! Talk to you tomorrow.

 

Very cute pic!
Leave some food out for him when you go to work. Will the other cats eat it?

 

I have two timed feeders so I could set them to go off around noon, halfway through his doses. They usually don’t eat all of it during the day. Especially now that the two non-diabetic cats are getting wet food, they seem to be holding out for that. So there should be some dry food out Blaze to eat while I’m at work.

 

Great you have timed feeders. Can you set one about 4 hours after the insulin? That would probably be about when the insulin would be the strongest. And food then would help keep his BG levels up.

 

Yes! Just set them for 10:00 am and 10:00 pm to dispense some food since his doses are 6:00 am and 6:00 pm. I’m going to give him 1U tomorrow morning also, so that will help not lower his BG too low while I’m at work, like you suggested. Thanks so much for all your help. Blaze is fast asleep right now

 

If you can leave some extra in the feeder so he can come back later to have more if he wants, that would be good too. Is that possible?

 

Yes! He’s eating his wet/dry combo food right now before just 1U dose and there’s a little bit of dry food in the feeder bowls right now and then at 10 am it will dispense a little more, and then at 5:30 pm I will feed him the wet dry combo before insulin and then the feeders will dispense a little more dry food at 10 pm also

 

Great plan for today. Love that the two non-diabetics ("civvies", as we say here) are so into the wet food!

 

Oh gosh, they all love the wet food so it’s definitely going to be easy to transition! I just need to make sure Blaze still eats the dry stuff too while we’re in this wet/dry combo with dry food here and there phase. Just gave Blaze his 1U, he’s lounging around now.

 

Just left for work, this is Blaze’s first day home alone since he’s started insulin. Feeling a little stressed leaving him but he ate his breakfast this morning and only got 1U so I know I need to just take a breathe and try not to worry all day.

 

I was able to get the larger gauge lancets on my lunch and head home to test Blazes BG. After THREE attempts, I finally got enough blood for a reading and his BG was 448. I know that’s high. Could attempting to test three times cause it to raise the BG? Blaze wasn’t a fan of me messing with his ears. I’m heading back to work now but where do I go from here? Test again when I get home, before his dinner and 2nd dose? Does this mean that 1U isn’t enough for him?

 

It's hard to say right now if the 1U is enough or not, it's going to take more data than one number, or even a few more. He might have elevated BG a few points if he was getting stressed out, yah, but not significantly.

Yes, please test when you can, the more data the more we can see how the dose of insulin is working. Also try to get a before bed test if you can. It's going to take some time for both of you to get used to the testing process, You are going to fail sometimes, join the club, we all have shirts and membership certificates!

Give him his reward testing treat, before & after if that works, and always, even if test is successful or not. Conditioning works. The more you test, the more relaxed and in control you are..and the more relaxed he will be.

One thing, I know you are concerned about the 1 U dose, but it's better to have a low dose than a dose that is too high, and you can always increase, under advisement, if needed. His body has hardly had a chance to get used to any insulin dose at all, so we need to just be patient and see what the numbers tell us.

Please set up the spreadsheet if you can tonight, and start plugging in the numbers so we can see what they look like.
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

Don't forget to give yourself a reward..heck, you are doing all the work, right? (and paying for everything too) A glass of wine, a chocolate bar, ice cream or other special edible treat, whatever works.

Take a look at Buster's ss..http://www.felinediabetes.com/FDMB/threads/8-19-buster-ambg-75.218330/
and Jerry's ss http://www.felinediabetes.com/FDMB/threads/08-19-jerry-amps-106-2-86-3-64-4-69-5-81.218327/
look in the signature for the spreadsheet

They are on different insulins, but you can see that progress does get made over time. So, please don't worry about one number, you are working the problem and you have us!

 

Congratulations on your first test!!!!

Too soon to say on the dose. For right now, your primary goal in testing is to keep him safe when you give shots. So, you are correct, you will want to test before his next dose (and every other dose from now on). The usual order is test, feed, shoot. With Novolin N, it's especially important that he has food on-board, you want to make sure the meal is a good half-hour/hour before the shot.

With that 448, he'll probably still be pretty high at next test time, but in general you want to have a no-shoot (or at least "proceed with caution") number in mind beforehand. For new caregivers, a reasonable no-shoot number might be 200, or even 250 for a hard-hitting insulin like Novolin N. One thing you can do if you get a low-ish number but don't want to skip altogether is to stall; don't feed, test again in a half hour to see if he's moving up or down, and post here for advice. Once you have more tests and more data, you'll get to know how he responds to the insulin and might be able to lower that threshold, but in the meantime, safety first!

Speaking of more data... next task for you is to set up a spreadsheet-- and I see that Lou has already given you the instructiions for that, so I won't repeat them here. You'll find it very helpful for keeping track and seeing patterns, and it's critical for the rest of us when giving advice.

Congratulations again on the successful test!!!

 

Sarah, I am so impressed with all the help you've gotten "over here". I just said hi in the intro thread, and look how far you have already come!

 

What a relief to finally get BG tested though. I can see it just takes time and practice to get it right. Thank you!

So how often should I test? I think I saw to test BG in the am, then feed, then give insulin and then the same for the pm, test BG, feed and give insulin. I won’t always be able to go home on lunch so is it okay to test twice a day?

I will definitely work on the spreadsheet. I need to sit down with my laptop to do that, I’ve been using my iPhone to chat in these forums so far. Will I be able to input info into my spreadsheet on my phone, or will it always have to be input on my laptop?

As for reward treats for testing, what is a good low carb treat? Someone mentioned baked chicken. I definitely want to reward him every time we test his BG, so he becomes accustomed to it and doesn’t hate me touching his ears so much.

I did feel more comfortable with giving the 1U, I was terrified 2U would be too much and I wouldn’t be home during the day if something happened. So definitely like the idea of 1U.

Thank you SO MUCH for all your help and everyone that has posted info for me. I would not be getting through this without you guys!

 

Yes, always test before giving a shot, that's to be sure the BG is high enough to inject insulin. Nan posted this above:
With that 448, he'll probably still be pretty high at next test time, but in general you want to have a no-shoot (or at least "proceed with caution") number in mind beforehand. For new caregivers, a reasonable no-shoot number might be 200, or even 250 for a hard-hitting insulin like Novolin N. One thing you can do if you get a low-ish number but don't want to skip altogether is to stall; don't feed, test again in a half hour to see if he's moving up or down, and post here for advice. Once you have more tests and more data, you'll get to know how he responds to the insulin and might be able to lower that threshold, but in the meantime, safety first!

I don't have an IPhone, but I do and did enter data on my cell phone. I had Google Drive already on it (I am late to smart phones, somebody else set it up for me)..then I d/l Google Sheets from Google Play and found my spreadsheet. I don't always have my laptop on so I just enter testing data on my phone. Many people only have cell phones to work with for the spreadsheets.

I do use small pieces of chicken meat for a treat and for snacks. I have an Instant Pot and just throw frozen breasts and/or thighs/legs in and pressure cook. Then I freeze slices or chunks flat in the freezer, transfer to a freezer bag, thaw what I will use in a couple of days in the fridge and we are set. Much less labor intensive. Whether you pressure cook, poach or bake, just no seasonings and no bones or skin if cooked. Some others use PureBites or Orijen Freeze Dried meats. If you get PureBites, get the package for dogs..same thing, bigger bag, less cost per ounce. Just break them down a little smaller.

You are very welcome for the help, I got lots when I arrived, terrified, confused and frankly terribly unsure we could care for a diabetic cat.

 

I am not going to edit my previous response but wanted to add about how often you should test. Midday tests are good, but of course you can't always come home at lunchtime. A before bed test would be great on weekdays. Then on weekends try to get more midcycle tests done, even in the nighttime cycle as you can.
This is going to show a bigger picture of how the insulin is working. When you get better at testing you can try a curve, that's testing every 2 hours for 12 hours or every 3 hours for 18 hours. Most of us can't keep that kind of schedule, but for as long as you can. On the weekends test at different times, like 2 hours past shot, and then 5 hours past shot..then another day at the 2 hour mark then 6 hour mark..fill in the puzzle pieces. It's going to be up to just what you can manage, but the more data the better.

 

I know! I’m so thankful to have found this community of fellow diabetic cat parents. It’s really helped ease my mind of all the overwhelming thoughts and feelings of having s newly diagnosed kitty! I’m learning so much!

 

It was brought to my attention about this mention of Pancreatitis, Sarah. And I missed it. Was this told to you at diagnosis and was there a test done to confirm that? Is the Metronidazole for the panc? Panc can be very painful and some cats feel bad enough that they don't eat well, which is always concerning. It does sound like Blaze is eating, or have you noticed he's off his feed at all? Does Blaze appear to be in pain, or is he moving well, playing, peeing, pooping, purring etc?

It would be a good idea to test for ketones each day, with Ketostix that test fresh urine. They are available at any pharmacy, and are about $12 a bottle. You can slip a long handled spoon or a little lid under his bum when he goes to pee, get a sample and test with the strip.
Tips for getting a urine sample: https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

 

Yes the liver inflammation and pancreatitis was mentioned at the diagnosis. She said there was no signs of ketones in his urine or keto acidosis when they did the urine analysis. I brought him to the vet Wednesday after work because he was eating little to no food, I noticed he was losing weight and he was getting boney and weak, drinking a lot and peeing a lot, stopped grooming. The vet wanted to do bloodwork, urine analysis and take an ultrasound. She she did the ultrasound, she said his liver was inflamed and after examining him more, she said he had jaundice. She kept him at the vet overnight to give him IV fluids, try to get him to eat and to get the bloodwork and urine results. Friday afternoon she called me and gave me the diabetes diagnosis and told me he had pancreatitis. He came home Friday night and she said the Denamarin is to help with the inflammation of the liver and the Metronidazole is anti-diarrhea med, she didn’t give me anything for the pancreatitis. She made him an appointment for the 30th (two weeks after diagnosis) for me to drop him off in the morning to do bloodwork and urine analysis again.

He seems to be eating pretty good so far. He eats his wet/dry combo at 6 am and 6pm and I’ve seen him nibble on the dry food that I leave out, as instructed here. He doesn’t seem to be in pain. I haven’t seen him play for probably a week or so but I just assumed he is/has been a little under the weather. He jumps up on the couch or in the window and he puts every time I pet him or talk to him. I’ve seen him in the litter box so I know he’s peeing and pooping too.

Should I be concerned? The vet didn’t seem to make a big deal about the pancreatitis and dusty give me any meds or special instructions for it. Was it okay to lower his insulin dose to 1U with the pancreatitis?

With testing ketones, how often is that done?

 

@Bron and Sheba (GA)
@MrWorfMen's Mom
@Chris & China (GA)
Post #1 and post #22
I am not experienced with pancreatitis, so I am going to tag in some more experienced people. I wouldn't panic at this point, and I didn't mean to alarm you. It's just best to have the whole picture and go from there. I'm glad he's eating and doesn't seem to be in pain (crouching in the meatloaf position). Let's see what they have to say.

 

Okay, I hope I didn’t make any mistakes. The vet didn’t tell me to do anything for the pancreatitis. I will get some ketones strip and try to catch him while he’s peeing. I hope he’s going to be okay.
I just tested him again (took two times to get enough blood) and he was at 415, so slightly lower than 12:00 which was 448. I’m feeding him now, wet/dry combo food, and then I will give him 1U. He doesn’t seem to be in pain at all, seems like his usually lazy self. Sprawls out and sleeps, seems to be eating good.

 

You haven't made any mistakes, and things are probably fine. I just like to dot every i and cross every t. Just good to check the ketones in any case. i wish you luck with that..Idjit goes outside and I would have to follow him around with some sort of container..short fat old woman stalking her cat for a pee!

 

Oh thank god my cats are inside cats! As soon as he ate his dinner tonight, he went right to his box and peed. Wish I had the ketone sticks right then, but I will get some tomorrow. Waiting till 6 pm to give his second 1U dose and then I will test him in a couple hours before bed. He ate all his dinner and is laying next to me now, relaxing

 

Since I was tagged, I'm here but I may have missed some information so if I repeat something, just ignore it.

1st...it's good that you have the bigger lancets and it will really help. As you poke more and more, the ears grow in new capillaries to help heal the "injury" and it becomes easier and easier to get blood. We call it "learning to bleed".

With Blaze running in the 400's and the reduced dose of Novolin, I'd hurry up and get the dry food out of the picture. Just watch for signs of tummy troubles....if they crop up, slow down, but you can usually swap out 25% per day as long as it doesn't cause diarrhea

Have you considered using a different insulin? We've had some cats do OK on Novolin, but there are some much better choices like Lantus, Basaglar, Levemir and Prozinc. They are much gentler and last longer too.

Did your vet actually test for pancreatitis? Or just say they thought there was some involved? There's a blood test that needs to be sent out but it'll give you a better answer. Here's a Primer on Pancreatitis that will give you more information that you could need to know!

If you can't test in between the AM and PM shots due to work, it's even more important that you get tests on the PM cycle…..Yes, feline diabetes tends to come with a lack of sleep!!….LOL

Getting our spreadsheet going will also really help. We're very data-driven here and really depend on it. If you need some help getting it set up, I'd be happy to help. Just click on my name and choose "Start Conversation" to send me a private message so I can get some information.

You can access the spreadsheet on both your iPad and PC ….since it's a Google document, it automatically saves your entries as you make them on any device.

 

I’m not 100% sure if the vet tested for pancreatitis, this is a photo of everything that was done when I brought him in, plus the two meds at the bottom that were prescribed. When I went to pick him up, the vet and said he had liver inflammation and pancreatitis. I can call tomorrow and see if they can confirm the pancreatitis diagnosis or not and post when I get that information. They did do bloodwork and when I called to check on him, they had told me they were waiting for a few more blood test results to come back so I’m wondering if it was for pancreatitis testing.

As for the dry food, right now I’m mixing a little bit into his wet food and then leaving some out during the day while I’m at work. Should I just leave less and less dry food out every day until I’m not leaving any out and only feeding wet food? And if so, is feeding him wet food twice a day enough food for him?

I’m definitely open to trying a different insulin, I’ve just been so overwhelmed with starting Blaze on insulin, I just went with what he was prescribed. We are only on day 3 of insulin, the first 2 days were 2U twice a day, and today I did 1U. I take him back on 8/30 for bloodwork again, should I talk to my vet then about switching him to another type of insulin?

I’m going to work on getting my spreadsheet started so I have more info share !

 

Just for our information, when you test next will you post please.
And provide the times/dates and BG of the other tests you have so far so we don't have to scroll back through past posts to find them. Just until the ss is up and we can see that.

I love the pic, he looks very happy and contented. Smooches from Auntie Lou.

 

You can add extra water to canned food and it will keep it from drying out during the day or a lot of people make "food-sicles" by adding water to canned and then freezing it in ice cube trays to leave out for a "fresh" meal later.

It's better for him to eat multiple small meals but as long as you're on Novolin, he needs to eat a normal sized meal about 30 minutes before the insulin because it's harsher and tends to hit hard.

I would definitely ask for another insulin....Novolin is great for dogs, but cats have a higher metabolism and it just doesn't work as well

 

Like Chris, I'd be curious about whether the vet actually tested for pancreatitis (snap test or lab bloodwork) or was simply meaning it was a possibility due to what she saw on the US. I don't see a link to a photo of the bloodwork done in your post above.

Pancreatitis like any inflammation/infection can elevate BG levels but reducing the insulin dose right now will not aggravate pancreatitis. Given Blaze is eating fine, showing no signs of pain, no vomiting etc. it doesn't sound like Blaze is in the midst of a pancreatitis flare.

ETA I guess the pic got posted while I was typing. OOOPs!

 

@Chris & China (GA) , thanks for answering the tag! Great info and advice as usual.

One thing about getting the dry food out of the picture: since Sarah works during the week and can't usually monitor closely, I was thinking that having the dry food out to graze on for a few days would be prudent. Just until we have a little more data to know where Blaze's numbers are typically, and what the Novolin is doing for him.

Sarah, looks like they ordered a pancreatitis test (Spec fPL), but it's the one that usually has to be sent out for analysis. Pancreatitis can only really be treated sympomatically, so if he's eating and drinking normally and doesn't seem to be in pain, that's good and I wouldn't worry about that specifically until the test comes back.

 

You can call the vet and ask for a copy of the lab results. Well within your rights to do so. And good to keep for your own records so you can look back over time.

 

Yes. As of 12:00 pm today he was at 448 when I tested his BG. And when I got home from work at 5:00 pm, I tested again and for 415 BG. I then fed him and gave 1U on insulin at 6:00pm. I will test again around 9:00pm and am going to work on my spreadsheet after dinner so more info is available.

 

That’s a good idea, I will call tomorrow and ask for that! Thank you!

 

Oh I like the idea of the food icesickles, I’m going to try that for when I’m at work. Thank you!

I have been feeding him 30 minutes to an hour before his insulin too because people say this insulin is harsher and kicks in quicker.

And I will ask for a different insulin when I take him in on the 30th. Are the other insulin’s available at wal-mart? That’s where I got the Novolin and was told they have the cheapest prices.

 

They did not give me a copy of his bloodwork results but I will call and ask for it. The vet didn’t say much except that he has some pancreatitis, but didn’t tell me how to monitor it and didn’t prescribe anything for it. She said she couldn’t give him any steroids because of the pancreatitis.

He seems to be doing pretty good. Eating well, no signs of pain, no vomiting, he purrs when I pet him and seems happy.

 

Lantus, Basaglar (a bio-similar of Lantus..same basic insulin glargine) and Levemir are human insulins, so yes, they'd be available at WalMart, but that's not the cheapest place. A 5 pack of Lantus pens runs about $450 here.

Most of us are buying our insulin from Canada because it's 1/3 to 1/2 the price. A 5 pack of Lantus pens is $165 plus $25 shipping....that's 1500 units which is enough to last most cats at least a year...and many cats up to 2 years! Basaglar is even cheaper! That makes it about $8-10 a month for insulin which is down right cheap!

Here's the Information on buying insulin from Canada

It does take about a week for the first shipment to arrive, so it might be worth the phone call to see if your vet will even prescribe it. If they will, get a written script and you can take a picture of it to send to Marks Marine Pharmacy.

If money is an issue, you can contact Diabetic Cats In Need. They help low income caregivers with costs of treatment so they can stay in their loving homes instead of euthanizing or sending to a shelter due to cost concerns. You can PM me for more details if you want to.

 

Money isn't an issue, I just can't afford to pay and arm and a leg every month is all, but want what's best for Blaze. The generic version of Novolin was $30 at Wal-Mart, but that is supposed to be good for 30 days. I am going to talk to my vet about getting him on a different insulin when I take him in for his bloodwork on the 30th. I want to get comfortable with everything right now, testing BG, feeding and giving insulin but I want to switch him to a better insulin soon so once I talk to my vet, I will PM you about more details. Should I ask for a specific brand of insulin to switch him to?

What are Lantus pens? And do they not expire or go bad after a certain length of time?

 

Is anyone able to help me with my spreadsheet? I created it, got it linked to my signature and now I don't know how to find it/add data to it. If I click the link in my signature, it opens the spreadsheet but does not let me add data to it. Am I missing something?

 

Sarah, you have to access your spreadsheet through Google drive/sheets not through the link in your signature. The link in your signature is for view only and it doesn't recognize you as the owner entitled to make changes.

 

Sarah, when you have time look at this: http://www.felinediabetes.com/FDMB/...info-proper-handling-drawing-fine-dosing.151/
Scroll down for pictures of vials and pens. Members use the pens as a mini vial, with a syringe, that way they can dose finer than 1 Unit increments.

Most members use the insulin in the pen to the last drop, they keep it refrigerated after opening. The vial contains so much more insulin that even refrigerated only lasts about 6 months, then it begins to lose effectiveness, and it's a waste because most kitties need such small doses.

When Idjit was diagnosed the vet prescribed Lantus in a vial and helped us research there at the clinic the best price. Now we knew nothing about buying insulin or even that pens existed. So we spent almost $300 on a vial. Idjit was on insulin for 11 days, and I kept the vial in the fridge cause I was afraid the remission wouldn't last long and I would need it. It's been 15 months. We had to discard that almost full vial and it just made me sick. We are a couple of seniors on Social Security with a small pension. I wish I had known about options before running out and buying that Lantus.

 

I found it and figured it out, thank you!

 

Oh my gosh, that's awful. That's what I'm afraid of, having to throw it out since they say Novolin is only good in the fridge for 30 days.
So Lantus in a pen is most cost effective because you're getting more insulin at a cheaper price? And in the pen, it can last longer? I just want to make sure I understand all of this, sorry for dumb questions.

 

Not dumb at all, no way. Yes the pens are more cost effective. The exp date on the pens is usually about a year or possibly more out.

From that link I just provided:

• The manufacturer of Lantus recommends discarding the insulin after 28 days of use. However, with proper handling and refrigeration, many Lantus users have been able to use a vial/cartridge/pen for six months and longer. Some use pens and vials to the last drop.
• The manufacturer of Basaglar recommends discarding after 28 days of use. It's too new to know for sure, but we anticipate Basaglar to last as long as Lantus with proper handling and refrigeration.
• The manufacturer of Levemir recommends discarding the insulin after 42 days of use. However, with proper handling and refrigeration, many Levemir users have been able to use a vial/pen for six months and longer. Some have used pens and vials to the last drop.

 

Wow, that's amazing! I'm going to talk to my vet about prescribing Lantus, sounds much better price wise and how long it lasts AND better for Blaze. Thank you Lou!

I tried BG testing before bed just now, I attempted 5 times and was unsuccessful all 5 times. I wasn't getting enough blood. I feel defeated. I feel bad continuously poking over and over with no results. When do you say enough is enough and try again in the morning? I'm not sure what I'm doing wrong but I'm not getting enough blood. I either don't get enough blood for it to register or I get the E13 code which says, not enough blood. I wish I could get this down so I could track his BG levels. Feeling frustrated. Is it okay to let him be for the night and test again before feeding him tomorrow?

 

yes, let the little guy rest, and you too! It's hard at first, the ears actually need to "learn" to bleed. The more you poke, more capillaries form to heal the "injury". Warming the ear really helps. We use a cotton sock with raw rice heated in the microwave for about 15 seconds. Test on your wrist like with a baby bottle contents to be sure it's not too hot. I used to rub it all over his face and between his ears too, he would start purring. I hold it on the edge of the ear I'm using, kind of fold it over or stroke with it.

It just takes time and practice.

 

Gosh I feel so bad poking him so much, it’s definitely hard. I know today is my first day testing but I figured after getting two successful tests earlier today, I would be able to get one before bed. I have been trying to rub his ear to warm it up but I don’t think it’s working and he’s not a fan of it. I’m going to try the rice in a sock. I definitely need more time and practice, it’s just a bummer because I know how important those BG tests are. Thank you for the kind words of encouragement. I will try again in the morning

 

Here a thread recently about ordering from Canada
http://www.felinediabetes.com/FDMB/threads/troubles-with-shipping-lantus-from-canada-to-us.218224/

I also think I remember reading another thread that some vets don't want to fax a prescription to a Canadian pharmacy. But you can get a written script and mail it or take a picture of it and email that. I will try to find that information. just haven't been able to locate it yet. I will search a little longer tonight and keep looking around tomorrow.

 

FYI - Your Novolin will last longer than 30 days if kept in the fridge. Not sure where the 30 days came from because Novolin N has been tested for 42 days by the manufacturer. The manufacturers only test insulin for a certain period of time because they are testing it for human who take far larger doses and go through it much faster than we do with cats. If stored correctly, it should be fine for up to 3 months. Watch for any precipitating or cloudiness in the vial and obviously if you suddenly start seeing higher BG levels, that could signify the insulin is losing potency.

On the testing front, with Blaze's black fur, it may be you are getting enough blood but it's disappearing into his fur. Been there, done that. Put a small skim of Vaseline on the ear where you intend to poke. This helps the blood bead up making it easier to see on those dark ears rather than smearing into the fur. The other trick you can use is to catch the blood bead on a clean finger nail and test from there. This is particularly helpful if you have a kitty who likes to swing their head around just as you are trying to get the strip into the blood bead.

 

The manufacturer of Lantus says it's only good for 28 days...You want to know why? Because they only asked the FDA to test it for 28 days so legally, they have to tell you that!!

A 5 pack of Lantus pens will last most cats at least a year...that's 1500 units. Each pen holds 300 units ….so if you keep them in the fridge, you should be able to use every drop from each pen and the box usually has an expiration date that's at least 2 years away. You can continue to use it until then!

 

@MrWorfMen's Mom Linda, do you remember reading posts in a thread about getting a script from vet that doesn't want to provide to a Canadian pharmacy? I remember reading about it just recently, and of course can't find it. Insulin is so expensive here, thanks to Big Pharma, and members had suggestions to ask for a paper script, say they will shop around for best price at different venues and then send it by mail or take a photo and send it. I know that once Marks has the Rx they will refill w/o having to have a new script.

 

The vet is legally obligated to provide a script if asked. Tell them you want to shop around for best price so need a paper script....don't say you are going to order from Canada. If you tell them you are going to order from out of country which technically is illegal, they can use that as an excuse not to provide the paper script. I would also ask for a script for syringes with half unit markings if obtaining syringes requires a prescription in California. Customs turns a blind eye to insulin from Canada. We even have caravans from the US come up here to get their insulin making the news so it's not like it's being done under cover.

 

OMG Sarah, if you had seen us when we began testing you would laugh your behind off. DH puts the lancing device together and inserts the lancet, while I set up the meter and strip. DH gets cat and sits in his chair in the living room, I am trying to see where the edge of the ear is, but DH's big fat stupid head is blocking the light. Meter times out. So, DH moves to a chair in front of the living room window, I reset meter and strip..I am bent over trying to see the edge of the ear and Again, DH's "self" is blocking the light. I aim, get to the edge of the ear and the lancing device falls apart in my hand! It's a wonder DH lived through that event.

No test that time. We moved to the kitchen, DH and cat facing the over the sink light and a window..everything on the counter where I can reach it and a warmed rice bag this time. It took 2 pokes and we got a drop in time before the meter timed out. We weren't always successful, we still aren't and sometimes I have to start over on the other ear. Don't feel bad, you get to have a shirt and belong to the failed BG test club like the rest of us. Live, laugh and learn!

 

Ok so one last piece of advice that I think needs to be in our helpful hints....

I once got dressed to go out in a nice white outfit. As per my usual routine, I decided to do one more blood test before going out. My girl was a pro at testing by then and was usually very co-operative and still. Not so this day. She promptly decided to fling her head around just as the blood beaded up spraying blood hither and yon all over my white clothes. Needless to say, I was late arriving at my social event with a funny tale to tell!

Lesson learned......test cat THEN put on your going out clothes!

 

Also, tomorrow morning, start a new thread with the title Blaze AMPS (the test result)
Then you can make comments in the message window if you like. You can edit the title with subsequent tests (+ the hour past the shot like +6) and then add messages. This thread it getting pretty long now. We encourage one new thread a day.

 

Okay great; thank you so much!