Boots has diabetes

I have just joined the group with Boots who was diagnosed with diabetes in February. So far we have had no luck stabilizing his BG. He is currently up to 5 units twice a day. I feed him 1 cup of Royal Canin Diabetic DS with 2 spoonsfull of tuna and water mixed in twice a day at 7:30 am and pm, then I give him the insulin, lantis glargine, about 20-30 minutes afterwards. The vet said we would look into something else if the 5 doesn't work (it's not) for him, the appointment was last Tuesday. This is my first experience with feline diabetes and at first I thought it was a death sentence until I read about it on the internet. I'm hoping to find out even more information on this site about how to proceed and how to do the very best I can for him. How high of a dosage is it possible to go up to? What else is the vet referring to? On Tuesday at 2 pm his reading was 320, is that horrible? The vet checks him every 7-10 days. Here is the story about how Boots came to live with us. He was inspecting homes in the neighborhood starting in January. He would peer into the cat window next to my front door (I started to fall in love with that little face then) or sit on the back patio and look in the sliding glass doors at the rest of the cats that live here, there are 17 others. They must have given him a good report because he chose us!. At first I thought he was a neighbors cat but one day found him sleeping in a cat nest in the vacant lot next door. So I started feeding him and finally was able to pet him by the beginning of February. On Feb. 9 he got in a fight with a raccoon, was bloody, beat up and had many puncture wounds, I came home to find him waiting by the front door. I brought him to the vet, and while he was there had him neutered. I waited and waited for him to recover, the wounds healed, he lost a lot of weight, started urinating so much, and he just wasn't right. One day, about 10 days later, he had bloody stool and looked really weak so back he went to the vet and I was sure he was a goner for the second time. That's when I found out about the diabetes and have been struggling since then to get him well. He is the sweetest cat and is so happy here. He hangs out on one side of the house with Baby Girl who pretty much doesn't get along with the rest of the crew. He took to sleeping on the bed fast. So I don't know how old he is, how long he's been sick, nothing at all except he's a very special guy and is loved very much. Is it normal to take so long to regulate the insulin? Any ideas and suggestions are welcome. Thanks for reading.

 

Hi Lizwardia-
And Welcome. I am still rather new myself, and was scared, overwhelmed and confused when I first got on the board like i'm sure most everyone here. We really had no relationship with a vet and this forum became invaluable. My suggestion, since I am NOT the expert, is to read and gain as much knowledge as you can on these boards. But also to please post your story on the Lantus forum (lantus Land- LL for short) There are some amazingly knowledgeable people there that can help guide you with dosing and all getting your other questions answered. My Hank was diagnosed in late february. We got on Lantus at the beginning of March, and I am now (anti-jinx) excited to say have begun a trial period OTJ (off the juice) which began just a few days ago. We were able to reduce his dose fairly quickly. He was in high 300's-low 400's at the beginning. I got very little helpful advice from the vet.

Please post over to the Lantus board...and best of luck getting your little guy settled in.

Betty

 

hi there and welcome!

i can actually see a couple areas that could use some work and would probably help in how he is reacting to the insulin.

first, some questions though

are you hometesting his glucose levels or you just take him to the vet occasionally and have it checked?

if you aren't hometesting, i strongly encourage you to look into it. it will tell you so much about what is going on. and you will get more accurate information from it then a random spot check here or there obtained at the vet's office. one number doesn't mean much yet so many people adjust doses based on them, leading to cats that are being overdosed until you end up with a middle of the night trip to the emergency room with a cat having seizures.

here's some info for you on hometesting
viewtopic.php?f=14&t=287

then, did you guys start at 1 unit twice a day? and how large were the increases? a full unit at a time or less? lantus is kind of a quirky insulin. it needs to "build up" in their systems for a few days for it to truly start working yet it is quirky enough that the slightest difference in doses can make a huge difference. lantus requires a lot of patience as with each dose change, you have to give it a few days to "build up" before you see what that doses is gonna do. and dose changes need to be done in very small increments because of that, like 1/4 to 1/2 a unit at a time.

here's some info for you about lantus
viewtopic.php?f=9&t=151
viewtopic.php?f=9&t=150
viewtopic.php?f=9&t=147

mind you, you cannot get all this in one reading or overnight. print out stuff, start a notebook to keep stuff in, and read and re-read things over the next several weeks.

next, food. check out http://www.catinfo.org about proper nutrition for our furry felines. contrary to what we've grown up thinking, what most of us have fed our animals in the past has now played a part in their developing diabetes, kidney problems, obesity, etc..... now. sooooooooooooo, the food you are feeding is not really the best for a diabetic in all honesty and in fact is probably playing a big role in why the insulin doesn't seem to be doing too much.

BUT, AND THIS IS VERY VERY IMPORTANT HERE: you CANNOT change what you are feeding without hometesting and lowering your insulin dose. It is not uncommon when taking carbs away from kitty for their glucose levels to drop 100 or even more points. So if let's say you suddenly take away the higher carb dry food and put in low carb canned food, yet shoot that high dose of insulin still, you could end up overdosing kitty and making a quick trip to the emergency room with a cat having seizures. Dr. Lisa addresses on her catinfo.org site so pay close attention to that part.

soooooooooooooooo, that's probably enough info from me for now so i'll leave you with that to ingest. go over it, read, take notes, and ask questions. anything that comes to mind. that's what this board is here for. to help other diabetic kitty owners take care of their extra sweet kitties.

 

Wow, thanks for the fast replies. I did post on the lantus area also and it looks like the next step is to buy a meter and follow the "5 steps to regulating". The vet did start us at 1 unit and has been slowly adding another for 5 weeks. We only go in once a week for the test, I wondered how accurate that could be since the levels fluxuate throughout the day. I also thought that I was giving him the best food possible, Royal Canin Diabetic DS???, sounds like the right stuff to someone who is clueless, like me! I'll read all the links you sent and hope for the best. What's the difference between the Life Scan 17$ and 60$ meter?

 

by Life Scan $17 meter and the $60 meter i'm betting you're talking about the Ultra Mini and the Ultra2 meters?

if so, either one will work fine. a lot of people use the ultra mini as a matter of fact. the Ultra2 has some users too. the biggest difference i see between them is that the Ultra2 has ALOT of bells and whistles. if i remember correctly you can for instance, get a cable and upload your BG (blood glucose) data to your personal computer so you can analyze, etc..... type of stuff.

to be honest, we don't need all the bells and whistles to obtain readings from our cats so there is no need to get the $60 meter. and for that matter, sometimes you'll even find that $60 meter for the same price as the $17 meter depending on what store you go to and who's got it on sale.

as far as meters go, the important things to remember when purchasing one is :

1. the less blood required, the happier you will be believe me as most kitties don't like to sit still long enough to give big blood samples so you want ideally to get one that takes 0.3uL. Meters that take that that I can think of off the top of my head are the Freestyle meters and Walmart's Relion Micro and Confirm. Most other meters take 0.6uL which still isn't that large. you definitely don't want to get one that requires 1.0uL

2. look not at the price of the meter as most come with mail in rebates for the amount you paid for the meter, but instead look at the price of their test strips. Most name brand test strips in a store will cost you about $1.00 a strip and you can and will use a lot of them, especially in the beginning. Walmart's meters are about half that price so alot of people use the Walmart meters due to their economical value.

if you prefer namebrand, buy a small box of strips to get started, then shop online for more as you can get them online for about half the price a local store charges. sites to check out and/or use would be

http://www.hocks.com
http://www.ebay.com
http://www.store4diabetics.com
http://www.americandiabeteswholesale.com

just to name a few

 

Hi Liz and welcome.

I saw your note and Cindy's link over in the Lantus forum so I thought I'd post over here since you already have a thread going with lots of good information.

I'm not familiar with either of the meters your mentioned. I use a Bayer Contour. Lots (really, LOTS) of people use the Walmart Relion brand meter. The meter itself is inexpensive and the strips are probably the least expensive available. Once you start testing, you will appreciate that having affordable strips is a big consideration. You will go through lots and lots of strips. If you let people on the Health Board know what city and state you live in, there's a good chance there is a member in the vicinity that can help you learn how to home test.

In addition to the site that's written by Lisa Pierson, DVM on feline nutrition that Cindy gave you the link to, there is another site that will give you the carbohydrate counts for most of the available foods. We are strong proponents of feeding canned food. Once you look at Dr. Lisa's site, this will make a great deal of sense. You might want to take a look at Janet & Binky's food charts. On the dry food table, you'll see that the Royal Canin is 24% carbs. A low carb (LC) diet should be under 10% carbs. What you are currently feeding is a high carb food and will keep Boots blood glucose (BG) numbers elevated. If you consider yourself clueless about the food issues, join the club! Before finding FDMB, many of us free fed dry food thinking it was the right thing to do. In fact, many vets will be very happy to sell you prescription dry food or prescription canned food that is, on the basis of ingredients, at the bottom of the barrel. Many of us feed Fancy Feast or Friskies or, if you budget will allow, Wellness or other premium brands like EVO 95%. If Boots is a dry food addict, Dr. Lisa's site will guide you through how to transition your cat to a LC, canned food diet. Given the number of mouths you feed, you might want to consider feeding a raw diet. However, as Cindy suggested, learn to home test before you change food since there is a VERY good chance that Boot's numbers will drop once the dry food is eliminated.

I'd also suggest you take a look at the Tight Regulation Protocol for Lantus and Levemir which is the dosing protocol that we use on the Lantus Board. It will also help to explain some of the questions about where your dose started and how quickly you increased the dose. Typically, doses are increased in increments of 0.25 or 0.50 (depending on where the BG numbers are) in a at least a 3 day period. It may be that Boot's dose was increased too quickly. If you could provide more information, that would help. As the protocol suggests and as you will no doubt see on the Lantus Board, we are very numbers oriented and we all do a fair amount of testing.

There is a huge amount to absorb at this point in yours and Boot's journey. If you are feeling overwhelmed, we've all been there. The front end of the learning curve is huge. Hang in there. Get your feet underneath you with home testing, get a spreadsheet and a profile set up (the instructions are on the Tech Board), join us on the Lantus Board. And most of all, keep asking questions.

 

Morning!

Just wanted to welcome you to the wonderful world of SugarCats and the SugarDance. It's kinda like Riverdance, only without the music and fun stuff. LOL. I've got a pair of Lantus kitties, and it's been such a wonderful (really) and amazing experience. It's not easy, but it's so completely worth it. I have 10 cats, so I understand the whole "I got a lotta cats" thing, too. Nothing like it, is there?

I am going to bet a nickel that Boots got a lot of anti-inflammatories when he was at the vets - lots of corticosteroids. That may have induced his diabetes (it's not uncommon for steroids to do that).

There are three keys for diabetic kitties. One is the correct diet; sometimes, cats can be diet regulated just on diet alone. Second is the correct insulin dose. I think that 5 units 2x a day is really high...there was one point where I took Esse off everything, and started over, because of rebounds. And the third - and likely most important - is home testing.

My vet hates - HATES - that I home test. Too bad for her. LOL. She deals with it...because I won't stop. It is really important to know how the insulin works in their bodies. The high numbers at meal times is NOT the way Lantus works...the important numbers come in the middle of the cycle. That's the "nadir", or low spot, and that's what we base our dosage on with Lantus. If the vet is basing their dosage instructions on a single number, they're missing a lot of the picture. So home testing is really, really important...

As a student nurse, I will not give my human patients insulin (whatever kind) without knowing what the number is before the med is given. I just won't. (And honestly, in human medicine, if you do inject without knowing the number, you're at risk for losing your license...it's that important).

The very first thing to do is start testing at home. And once you do, you might just find that Lantus is working really well, and that the high numbers are a rebound issue and that a dose decrease is warrented.

We're all here to help; I don't give dosing suggestions because I haven't been at this too long, but others can. And there is a wealth of information here for you to start learning with, and for Boots to get better with...so jump on in, and welcome again!

Hope to see you around the boards!!

Best-
Michele

 

Two things will help Boots. First, a species appropriate diet that is diabetic friendly. Dry food and tuna won't cut it. The best nutrition information is at www.catinfo.org . Less insulin. You need to start home testing so you can safely do a rebound check. Read about rebound in our FAQs, I'll make a bet that rebound is going on.

Go to the Lantus support group for information on the proper way to use Lantus and give them your history.

 

Hi and welcome

Not slowly enough I'd say -- it's not at all unusual for a dose of, say, 1.5 units, to be passed on the way from 1 to 2. Since overdosing leads to high blood sugar too (often), it's easy to miss if you add dose too fast. That's what originally happened to Jock. 1.5 units turned out to be what he wanted and we kept raising, with the vet's encouragement, up to 11 units before he seized.

You're absolutely right. Not at all accurate or useful. In addition, stressing a cat out by bringing him to the vet's gives a higher blood sugar reading than he'd get at home.

The word "diabetic" on the label doesn't seem to help the cats nearly as much as actually checking the 'as fed' carbohydrate level. Janet and Binky's list is the best source I know of, and scanning down the %calories from carbohydrates column in those lists will change your life.

http://binkyspage.tripod.com/

Meters -- the initial price of the meter isn't really a big deal, and you can get many of them free for asking. Instead look for a meter recommended by people here, preferably one with cheap strips and very small (0.3 microlitres) blood drop requirement. Walmart's brand seems to be good.

You'll get there! Lantus is a good insulin for cats. One more link to read -- lots of useful info:
http://tillydiabetes.net/en_6_protocol2.htm

 

Hi. I haven't been on this site too long myself, but all the information on this site has been invaluable, I've learned so much in a short time and my Conner is back to being himself. I just recommend that any advice you are given, take it to heart and follow through, because they know what they are talking about.

 

Hi, I see on your other post (Lantus Land) that you are in Palm Bay. I'm in West Melbourne.

I have no advice about Lantus, but if you have general concerns, or need some local vet info, or just to chat, drop me a private message and I will give you my phone number.

Lisa & Spooky (GA)