Diagnosed 5/13 and struggling with data

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Robyn, Jun 1, 2015.

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  1. Robyn

    Robyn New Member

    Joined:
    May 30, 2015
    Hello, my name is Robyn. My cat Lincoln was diagnosed with diabetes on May 13th. This has been a very confusing time for me. I feel so lost. I'm very thankful for the information I have read here. It helps so much to know there is a community of knowledgeable and friendly people. :bighug:

    My husband and I adopted Lincoln as a FIV+ adult cat of unknown age about 5 years ago. The whole time we've known him, he's never been very active. He's always has hind-leg issues (that we were told was simply arthritis and would get worse with age), drank a lot (and we were told it was good he drank his water), and had quite an appetite. He weighed about 16 pounds when we adopted him, and I believe we got him down to 14 pounds at one point, but he tended to hover around 15 pounds. He also has a history of gingivitis and tooth disease.

    I realize his inability to lose weight is directly our fault for overfeeding him. We had tried to limit his food intake in the past, but he always seemed abnormally hungry and demanding about his food. Lincoln is not our first cat, and we have helped other cats lose weight, but somehow Lincoln always seemed a bit different. Perhaps he was exhibiting pre-diabetic signs the whole time we've had him.

    His BG readings have been all over the place. I don't know if that's typical when first beginning insulin or if we're seeing the Somogyi effect. Through all this, he has been showing improvement and is in good spirits. I think the biggest thing I am struggling with right now is how to organize all the information I have collected on him in a useful way.

    I have started a spreadsheet for him (linked in my signature) where I've taken some BG readings at home. I have also posted him lab work from 5/13 where he was diagnosed with diabetes. Here is some of his recent history...

    July 21, 2014
    Regular wellness visit, vaccines
    15.13 pounds
    normal blood tests prior to dental cleaning (data not available currently)
    high-carb dry food diet

    May 12, 2015
    Wellness visit, having a "bump" on his jaw checked out, intended to schedule dental cleaning
    11.00 pounds (We had no idea he had lost weight :()
    vet suspected diabetes due to weightloss, pu/pd, hind leg weakness, and plantigrade stance
    likely not well enough for dental cleaning
    Blood test and urinalysis taken to look for disease, most likely diabetes
    Prescribed antibiotics for "bump" on jaw, but they forgot to give them to us
    high-carb dry food diet

    May 13
    Received call from vet about blood test results. Told he had 553 BG and diabetes, and that we need to come in to get insulin prescription.

    May 14
    Began transitioning from dry food to canned food

    May 17
    On an exclusively canned food diet. Primarily Friskies pates with some Fancy Feast pate.

    May 20
    Brought Lincoln to the vet to pick up Lantus prescription and syringe prescription. They showed us how to give injections. Clarified about the antibiotics and received ZydaClin. Told to come back once a week for a glucose curve until he's regulated.

    May 21
    Began 1 unit of Lantus twice daily and 1.25mL of ZydaClin twice daily.

    May 22 - 27
    Fed him about 11-12oz canned food daily, concerned about overfeeding but he often whines for more food. He is good about taking his injections and antibiotics. Still showing signs of pu/pd, but is noticeably drinking/peeing less. Hind legs showing a little improvement. He is experiencing soft stools (about a score 5 on the Nestle Purina Fecal Score Chart) probably due to antibiotics, but checking his scruff shows he's doing alright on hydration. Only took about 1 BG test a day.

    May 28
    Weighed 11.63 pounds (so he gained ~10oz in his first week on insulin)
    Brought him in for glucose curve. We do not have the data from this, but we spoke briefly with the vet who said he went from 124 to 400-something and they only wanted him for 6 hours. She didn't want us coming back for glucose curves anymore. Told to bring in a urine sample in 2 weeks for urinalysis, and to bring back Lincoln for a fructosamine check in 4 weeks. Continue with 1 unit Lantus twice daily. Still on 1.25mL ZydaClin twice daily as well. Vet says the "bump" on his jaw is likely an abscessed tooth, and it is responding well to the antibiotic treatment.

    May 29
    Caught my first midstream urine sample from him for practice! He was good for it. I did test it with a urinalysis strip. Glucose +++ but no ketones. He seems to be adjusting to timed feedings better and not begging for food as often, and the "new deliciousness" of the wet food seems to be wearing off, so I am attempting to feed him less to avoid weight gain. Introduced homemade chicken stock (just chicken simmered in water with the fat skimmed off) to help keep his hydration up.

    May 31
    His soft stool has firmed up a bit, seemed midway between a score 2 and a score 3. He seemed much more energetic today.


    I'm sorry, I realize I'm all over the place with his information. Thank you for making it through this wall of text to learn about my handsome little Lincoln. :smuggrin: I must get a picture up soon.
     
  2. Chris & China (GA)

    Chris & China (GA) Well-Known Member

    Joined:
    May 10, 2013
    I think it's time to increase him to 1.5U....he's been on 1U long enough to build the depot and it's still not getting him anywhere good and with nadirs that high, you can increase by .5

    When testing, it's not necessary to test every hour (unless the cat is in a hypoglycemic crisis)....every 2 hours for 12 hours or every 3 hours for 18 hours is a perfect "curve", but most of us don't really do curves. We get the Pre-shot tests in, and a couple other tests sprinkled into the AM cycle and then at least a "before bed" test at night so we know they're going to be safe overnight or if we should plan on setting an alarm to wake up to get a test in later in the night

    I'd increase to 1.5 in the morning and get a +2 , +5 or +6 and maybe a +9 for the AM cycle and then see how his numbers were before making a plan for tomorrow night
     
  3. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Robyn,
    Welcome to the forum. It is normal to feel overwhelmed by it all in the beginning but it sounds like you have made a really good start with things. It is great you are home testing him. It is normal for the blood sugars to be a bit all over the place when you start. The depot has to fill and that takes a few days.
    I don't give dosing advice.
    Several things you can do though.
    Have you transitioned him over to low carb canned fully yet? Just be aware when you do that , it will probably lower the blood sugars.
    It is great you are giving him extra fluids to combat dehydration. You can also add warm water to his food and make it a bit soupy to add water. I give my cat chicken broth every day but I make it with chicken bones which I cook for several hours. It is nutritious, jelly like and cats usually love it. I freeze it in ice cube trays and get out as needed.
    If you haven't done so, I would read all the sticky notes at the top of the lantus and levemir forum. They will give you lots of info.
    Do you have an auto feeder. We find they are great to have especially if you have to work or go out. You can find them online.
    Lincoln is probably hungry because until the diabetes is under control, his body is not able to properly process all the food. So he will need more than a healthy cat would to eat until his blood sugars lower.
    His peripheral neuropathy in his legs will probably not improve much until his blood sugars get down more towards normal. My cat had it badly but is back to normal now so don't lose heart. You can buy Zobaline for cats from a company in the U.S. called lifelink I think it is called. Google zobaline for cats and you will find it. I highly recommend it for the peripheral neuropathy.

    Ask lots of questions. Everyone here is happy to help. When you feel comfortable to do so, You may like to post over on the Lantus and Levemir board if you would like ongoing advice about dosing.
    Good luck with it all. You have made a good start:)
     
  4. Dyana

    Dyana Well-Known Member

    Joined:
    Dec 28, 2009
    With the 124 at the vet's on the 28th, and the 145 and maybe lower on the 30th, I would stay with the same 1 unit dose for a couple more cycles. Do you have any test numbers for the 1st and 2nd?
    We base Lantus dosing on how low the cat goes in a cycle.
     
  5. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    There isn't much use in a fructosamine test when you are blood glucose and urine ketone and glucose testing at home routinely. If you always test pre-shot, plus get spot checks between shots +5 to +7 hours post-shot, or run a curve every week of two, you have better data than a fructosamine is going to give you.
     
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