Diagnosed Saturday, first vet appt today at 5...HELP

Hi all!
You guys don't understand how happy I am that a forum like this exists (well, maybe you do :mrgreen: )
Long story short I took Charlie in on Saturday becasue he has another abscessed anal gland that we needed to flush out. I dropped him off and a short time later the vet called telling me that his BG was 497!!!
** I don't know anything about anything, but have been reading none stop (and not sleeping) trying to educate myself on all of this. **
Anywho, the doc ran more tests, no keytones, no other issues other than the glucose level. She told us to come in Monday (today) so we can learn how to inject Charlie. I made the appt this morning and asked the vet tech if the doc was going to check Charlie's BG again so she can give the correct dosage. She said "probably not, She will just go off of the number she got on Saturday".
SOOOO needless to say, I am looking hrough these forums to find that cupon for the free reader when you buy the sticks (excuse my incorrect usage of terms, I'm sure i'll get the hang of it soon). I know I saw a list of items for the home testing on here...I figure if I check him before I go, I can give her an updated number, therefore a more accurate dosage???
I have JUST RECENTLY changed to all wet food...and I have no idea the carb content...Instinct by Nature's Variety. I feed them chicken and rabbit. They only eat a little (They meaning Charlie and Chispa-said Cheespa, it means "spark" in spanish). So I don't know how much of a difference that will make on Charlie, notw that his kibble is gone. Kibble has only been completely gone for about 2 days.
Iam not affraid to talk to m vet, they are so friendly and really do put the pets first...NOW
My questions are as follows:
1-Are there any insulins I should refuse?
2-Are there any questions I should be asking?
3-In general, is there a recommended dose to start at? ( I know each cat is different, but what is TOO HIGH to start at???)
I'm going to get ready and go into work for a while...I will be in contact throughout the day, and I will let everyone know how it goes after the appt...
Thank you to everyone...reading through the threads has given me hope, and the letter written by the cat was just what I needed to read, as I am checking on him every 5 minutes to see if he is still alive!!!
Thanks again everyone,
Kristina

 

Hello! Welcome to the wonderful world of sugarcats!
Hometesting may be the single best thing you can do to help your cat. It's really not that hard once you get used to it, and it can save you a lot of money compared to vet visits. A lot of people here use the ReLion brand meters from Walmart. They are inexpensive and reliable, and the strips are quite inexpensive. You'll get better numbers at home than you usually do at the vets office because the kitty is under less stress. I also believe that it's important to test before every shot, to make sure that their BG is high enough to get a shot. If their number is too low, it could be dangerous to give them insulin. If you weren't testing, how would you know?

My Chester is on Lantus, and that's a very good insulin. Other popular/effective choices are Levemir and PZI or Prozinc. You don't want any kind of Humulin, and I don't think you'd want Caninsulin, either. Those tend to be shorter acting and very harsh with steep drops and rises. The long acting insulins we prefer are much more gentle, with longer, flatter curves - much safer and easier on a kitty's system.

I'm not sure that one blood test is enough to diagnose diabetes without other symptoms...A starting dose should be low. Probably no more than 0.5 or 1 unit twice a day. How much does your cat weigh?

Welcome on. There are a lot of people here with a lot of knowledge, here to help you.

 

Thanks for the information...It really does help! I do believe his blood shuld be checked again, he gets SO STRESSED going to the vet. Today I will spray Feliway in his carrier before we go. Charlie is about 11-12 lbs. He was 11.6 when er went in Saturday.

 

Ask if the vet would do a fructosamine test first and wait for results of that. It will show average blood glucose over the last 2 weeks. A 497 at a vet with a stressed cat might very well be much lower by more than 100 points. Also, having removed his dry since being at the vet lowered the carbs he was taking in.

I would not want to see that vet start him on insulin today. Learn to hometest, buy some KetoDiastix at pharmacy that tests urine for glucose and ketones together and wait for fructosamine test results.

Please post back after you have seen the vet and tell us what insulin and what dose she wants you to eventually start him on. If you need practice drawing up insulin and shooting, the vet can show you with some safe sterile fluid from an IV bag.

 

Also, if your vet plans on giving any type of insulin without a test today just before the shot, and based on a number from two days ago.....then it's time to find a vet that knows more about safely managing feline diabetes. We call that "shooting blind". Sort of like driving down the freeway with a paper bag over your head...

 

This is all good stuff, Thanks again everyone...I'll keep ya posted :YMSIGH:

 

See my signature link for Vet Interview Topics to assess how up to date your vet is on the contemporary management of feline diabetes. Also print out, read, and then discuss with your vet the AAHA Guidelines.

Pop over to Cat Info for a printable food analysis list so you can select foods that have 10% or fewer calories from carbohydrates. That plus eliminating dry food and having no vet stress may lower that transient 1 time glucose measure by 200 points or more.

You can use a human glucometer to test him; no need for the expensive pet-specific glucometer, as there are reference numbers to use with human glucometers. The test strips are where they get you on cost. Purchase a meter like WalMart ReliOn Confirm (aka Arkray Glucocard 01, available from our shopping partner ADW - link at top of page), which only needs a tiny drop of blood.

See my signature link Secondary Monitoring Tools for some ways to assess your cat in addition to the blood glucose monitoring.

 

.

 

That is a great idea, take the cat home, and calm him down, test and then call the vet for a better dosage. I printed off all your questions, and the insulin amount. Oh and of course the insulin NOT to use. THANK YOU! o :thumbup

 

Well, I went with my gut instinct and went to Walmart to buy the meter, strips and lancets. I got the 30g because all they had were 26,30 and33g...I'm going to YouTube a bunch of videos to see how different people do it. Charlie is a pretty chill dude and he has a cone around his neck so it's not like he can run away from me!!! I don't know how much he has eaten today. They eat like 4 or 5 small meals throughout the day but always seems hungry.(no need to explain that, I get it) I'm checking it at about 4:30 right before we go and I'll have an update after the vet visit!!!
You guys are saints. I don't know what I would do without your knowledge and wisdom!!! drinking24

 

Hello there

Good luck at the vets.

Here is a food chart with the calories from carb % in it - I think you are ok cos it looks like the Natures Variety instincts are under 5% if its the grain free ones? http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

Here are some home testing tips : https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Which meter did you buy?

Wendy

 

If you have a hard time getting blood, it could be the lancets are too thin.
I used the 26 gauge at first.

 

When you first start blood glucose testing, the 26-27 gauge lancets do a better job of getting blood.

And the dose estimation is based on lean weight - ie., the lower of a) ideal weight or b) if underweight, current weight. Its very important to use the lean weight or you may give too much insulin.

 

Lets hope he is a bleeder. She might need to double poke and make use of a lot of the tips.

 

Hi Kristina. I see you have received a lot of excellent input so I'll just say welcome to Lantus Land (LL). This is where you and Charlie want to be. I hope all went well at the vet today.

Again welcome and have a great evening.

 

lOL! I guess he was a bleeder cus it went just fine. The meter read 258. I know that's high but I was so ecstatic that it wasn't higher. So, here's an overview of the visit:
She told me I should buy an animal meter as the human ones aren't as accurate.
Prescribed Purina DM. I asked if I found a similar substitute would it be ok to change, she said that's fine but let's regulate his sugars first.
She wants me to bring him in in 2 weeks for sugar check.
He was given Lantus
2 units twice a day (how much is that?)

I do feel like my vet wants what's best for Charlie and I appreciate that. I pretty much told her I would be checking his BG in like 2 days to make sure he ok. I'm not waiting 2 weeks!!

Oh and she showed us how to shoot Charlie....it was simple!!!!!
Thoughts???

 

I don't use Lantus but I sure would test him at home first before giving insulin because he may be even lower than what he was at the vet. Also, he doesn't need that expensive DM. Even if should eat it, after awhile they get bored and want other food. Also, you do not need that expensive animal meter and you can now test him yourself. Do not wait two days to do it. We have our meters so we can spot check them and always test them before shooting insulin.

Lantus people will be on to give their opinions on dose. Learning to hometest and then doing it only sporadically can put a cat at major risk.

 

Pretty much every newbie gets the same advice from the vet - buy DM, get an animal meter or don't test at all.
So, my advice is....ignore all that ;-)

You don't need DM food - I returned mine and got a refund after 1 can opened.
Too expensive and NO BETTER than Fancy Feast or Friskies.
Most cats get bored with DM food as its liver based and the taste stops being interesting.

Vet meter is expensive for strips and you can only buy them at the vet.
What happens on a Sat. night and you're out of strips and no vet is open until Monday??
Pretty much everyone uses a human meter - if its accurate enough for a human, it should be for a cat too! It runs about 30 pts different to the pet meter, but that doesn't matter as long as you stick to one.
I use Walmart's Relion Confirm - but the Prime has cheaper strips and is just as good.

Its best to check him before each shot to see if its safe to give him and if you want to get him into regulation/remission, you need to test more so you can adjust the dose when his pancreas starts to heal.
Its the only way to do it.

We usually start lantus on .5 or 1unit twice per day. His 258 isn't that terrible - did you get this number at home or the vet?
Unless he's a really big cat, 1 unit would be the max.

 

Major question....did the vet give him 2 units of Lantus at the clinic? If she did, you may want to start your testing tonight and keep an eye on him.

 

Return the Purina DM and tell her he wont eat it. Its expensive and most cats stop eating it within a week or two anyway. You can feed any low carb food - many people here feed fancy feast classic pates, friskies pates or wellness grain free but the natures variety instincts are fine too.

You dont need an animal meter - most people here use human ones, they are accurate enough and considerably cheaper. You can take in your human meter next time you go and see the difference - it tends to be more at higher blood glucose but its the low ones that matter anyway.

Lantus is a good choice but 2 units is a lot to start. Whats his weight?

Wendy

 

If he was 258 at the vet's office, under stress, his normal might be 100 points less or 150 ... which is the upper end of normal.

Lantus dose calc: 11 lbs / 2.2 * 0.25 = 1.25 units. He may have gotten too much insulin. It has been a few hours - please test him now. That dose could send him into a hypo.
Do you have supplies on hand in case he goes hypo? Karo syrup/honey? High carb food? Oral syringe? Ample test strips?

How is he behaving?

 

I got the 258 at home with Relion Micro meter. The vet didn't test him. She was talking about the discrepancy between human and vet meters but also said to test him before I take him in to make sure if there IS a discrepancy, it's consistent. She is all for me testing at home but also wants to be in the loop and involved. The poor guy is exhausted! The vet stresses him out like no other... So I should check for sure tomorrow before or after he eats?? He is kind of a grazer so he doesn't eat MEALS, just snacks throughout the day. I'll give him a spoonful tonight and then tomorrow start a stricter regimen.
I'll continue to browse the boards for more info.
I can't thank you all enough!

 

Always test before you shoot, for safety.

Just starting out, if he is below 200, we advise not shooting.

If he goes lower than 50 at +5 to +7 hours after his shot, he may be going into a hypoglycemic attack.
Also,he earns a dose reductionif he goes below 50.

Do you have high carb food? If the dose was too high for him, he could go hypo tonight. Please test him now.

 

.

 

Sorry guys, I ran and tested him. The first time he flicked his ear and I lost my blood dot so I had to poke again (sorry Charlie) he is at 100. He is wiped out from the trip to the vet and is sleeping in his cat tree. I have Karo syrup but no high carb food. If he goes under 50 ever I rub that on his gums right??

 

How long since that shot?

Yes, you can run Karo on his gums. You can mis a few drops of Karo into the food too.

Basic hypo protocol.
If test is at or under 50,
Feed 1-2 teaspoons of high carb (or food + syrup mix)
Wait 15 min.
Retest.

Repeat until in safe numbers and stable.

 

He got his shot 3 hours ago. We came home and I let him munch a little. Is this good or bad? How often should I test him now...and should I change the dosage by myself or call the vet first??? I don't want his numbers to yoyo.

 

Ok so let's see if I get this right

PMPS (preshot test) 248
3 hours later +3 100?



Wendy

 

+ 3 ~ 100

OK, that's a bit low for only 3 hours in. Still safe at present.

I'd feed 1-2 teaspoons of food if he'll eat.

General note: glucose levels cycle with the insulin (not quite as extreme as a yo yo). They go down as insulin is working and rise when insulin wears off. Some cats start with a pre-shot in the 300s and drop below 100 by 5-7 hours after the shot, then come back up.

 

Correct! But I don't know when this insulin "peaks"...

 

Depends on the cat but usually 5-7hours. Time to break out the coffee . And tomorrow you might want to go down to one unit. But for now you need to test and keep coming here for advise to get through this.

Trial by fire a little. It's not always this hard!!

Wendy

 

Kristina, My cat Jupiter was diagnosed recently with diabetes (3/14). I found this forum the same day - and I can tell you it has helped me so much. The people here are great - and will always give you good advice. I want to let you know you are in very good hands - as a lot of these people helped me with Jupiter and gave me great advice. If you have any questions, dont be afraid to ask & there will always be someone to help you. Its overwhelming at first - but things do get much better - found that out for myself. You sound like you are already doing great taking care of your kitty though. Keep up the great work! Welcome to FDMB.

Jamie

 

YOU GUYS ARE CHARLIE'S ANGELS!!!
My plan for tonight:
Test again at midnight (about 6.5 hours after shot)
Tomorrow start 1 unit twice a day and test +1 and +2
Return that Purina DM junk since I am comfortable with my Grain free Natures Instinct.
I'll communicate with my vet to let her know all this.
I will also continue to post here.
I'm so overwhelmed and have 1 last question.
Ideally, what's the range of healthy BG levels? I saw 100-300???

 

Non-diabetic: 40 - 120
Diabetic on insulin: from 50 to under the renal threshold of 240. The more time spent in lower numbers, the better.

 

You don't want to leave it to then cos it could be too low by then!!

. Get a test four hours from injection (?soon I think) and let's see how he is doing. We may need to give him syrup etc to keep him up but let's see where he is.
Let us know, we are waiting on his results...
Wendy

 

Did you feed him some more?

PMPs ~ 248
+3 ~ 100

That was about a 150 point drop in 3 hours to 100 and you've got 2 to 4 hours yet to monitor.

Can you snag another test, please?

 

iTS A 43!!! I'm sorry it took so long, we were having Internet problems!! I rubbed a tiny bit of karo on his lips/ gums and gave him some food! What now?!? 2 units is too much!!!!
I'm so upset!

 

Don't be upset. Save that for later.
Can you test again 30 minutes after that last test?

 

You're ok - experienced people are watching you and you have supplies to keep him from a hypo.
Just follow the advice you are given on feeding and testing.

 

Hi Kristina,

The 43, that was about 5 hours after the shot?

PMPs ~ 248
+3 ~ 100

+5 ~ 43??

 

do you have any high carb food - say any canned food with gravy?

if you do, then give him a couple teaspoons of gravy and test in 30 minutes

you will need to continue giving gravy and testing every 30 minutes, until you get three rising numbers - we call this rinse, lather, repeat :lol:

if you do not have gravy food, then you can use the sugar, it's better if you have the food as the sugar will not last as long as the high carb food.

and don't be freaked out when you test tomorrow and the bg is high

 

Correct. 5 hours.
You have it all correct. We just tested again. 30 mins after our reading of 48, It's now at 62.

+ 5.5 ~ 62
Now keep testing? How often. Do I even give him more insulin tomorrow?

 

Kristina,
Good that it came up a bit. You'll want to give another teaspoon of food and test in 30 minutes. We'd like it if he came up to the 70s or 80s...

PMPs ~ 248
+3 ~ 100
+5 ~ 43
+5.5 ~ 62

 

1) test again in 30 minutes

2) give some gravy if you have that - or 2 teaspoons of high carb food

3) repeat steps 1 and 2 - until you get three consistently rising bg's

without jumping ahead too much - you will most likely give insulin tomorrow - HOWEver start over by giving 1 unit or maybe even 1/2 unit. we will want to see what his bg;s look like the rest of this cycle and in the morning

if he is under 200 in the morning -you have three choices

1) skip the shot
2) wait to feed, test in 15 minutes - if the bg is above 200 then shoot either 1 unit or 1/2 unit

in the meantime, please go to the lantus forum and read the stickies (starred info)

viewtopic.php?f=9&t=147

 

Okay,
Time to play "poke the kitty"!

 

there is just something wrong with what you wrote - what I don't know, but it is wrong I know that..... :lol: :lol:

 

:lol: :lol: :lol:

That's one of my "standard lines" on 1st time new member hypo watches, Hilary! Just in case any tension needs breaking!

:lol: :lol: :lol:

 

still poke the kitty - my mind is all over the place with that one.....oh well....I am glad that I don't have to poke the kitty anymore!

 

How about "pin the lancet on the kitty" then? :lol:

How many strange looks have you gotten when you were out and you said "oh no, I have to run home and shoot the cat!" ?

 

nah - I think you need to stick with poke the kitty - get it stick it, stick with......ok, i need to go to bed, now I am getting loopy doopy

 

Ugh... Poor chawie is sick of us in his face poking his ears!!! We couldn't get a drop this time after a few attempts so we got the pad of his back foot....
It's a 77
It would have been +6 but we were 15 mins late trying to get him to cooperate... Sheesh poor kid, first day on insulin and he has holes all over. Will this be bad for his ears?
Do I test again in 30?

 

If you want, you can hold off more food, and test in an hour. Does that cut into your sleep time?

Yes, his ears will be okay. Do you have any neosporin w/ pain relief? You can rub that on the ears to help them heal faster.

 

PMPs ~ 248
+3 ~ 100
+5 ~ 43
+5.5 ~ 62
+6.25 ~ 77

 

yes get at least one maybe two more tests before you can stop for the night. that is as long as the numbers are rising or remaining steady - 77 is a good safe number

do you know the tricks for ear testing? - warming the ear with a warming sock?

take one sock -
add 1/2 cup of dried rice, beans or oatmeal
knot the top (so stuff doesn't fall out)
heat in microwave 15-20 seconds until warm to touch
place behind kitty's ear until ear is warm
then as Carl likes to say poke the kitty

also do you have neosporin to put on ears after poking? this will help with bruising

 

Kristina,

About tomorrow....

A couple of people have already suggested that "less insulin" is the way to go. It definitely looks like 2u was a bit too much today. ;-)

You might see a fairly high number in the morning. If so, don't sweat it. A lot of times, when a kitty drops in the low numbers like the 43 you saw, what follows is what we call a "bounce". It can give you an ugly high number the next day. But it's an instinctive reaction by his body to "protect itself" from hypoglycemia. It just happens.

In the morning, test him before feeding and shooting, and post the number here. Most likely people will be here to help you no matter what time of day or night it is. We have members all over the world, so this place never sleeps.

But I think, at most, you'll be shooting .5u or 1u the next time you give him a shot.

 

I'll test at +7.25.
It has been cutting into my sleep time for an hour and 45 mins. What's another hour? @-)
I'm gonna call the vet right when they open and TELL her I want to start at .5 unit twice a day.
Neosporin on ears. Check.
So after I test him again can I go to sleep?
Thank you Carl n Bob for being my knights in shining armor!!

 

If his number is steady or rising, then yes, sleep is in your immediate future! You can leave out a small snack for him when you turn out the lights. :smile:

Good plan on calling the vet. They work for you, and you shouldn't be the least bit shy about telling them what you are going to do. Hopefully they will be supportive. And numbers don't lie. Tell them what 2u did tonight and I think they'll be okay with a dose decrease.

And you're very welcome, Kristina. A big thanks to everyone else who helped too, and to Wendy for posting the "call for help" in the Lantus forum which is how I found my way over here!

 

Yes! Thank you to everyone who has been supporting me all day long!!!
You guys are rock stars and I'm thankful for you all!!!
I'll still post Charlie's numbers before I go to bed.

 

I'll keep an eye out for the next number. I'm uploading a couple hundred pics to my photobucket account, so I'll be up a while anyway!

 

confused_cat
Well +7.25~60
No sleep for me yet. I put some of his wet food down and added a teeny bit of syrup.
Test again in an hour? Poor kid. This hurts my heart. Will it eventually go up on its own???

 

Yes, it will. Lantus will start to wear off - the problem is we don't know when because we don't know his patterns yet.
For many cats 60 is a safe number but because we have no data for Charlie, we don't know what he's going to do next so everything is geared to keeping him safe.

The early days are by far the hardest due to the learning curve - it will get easier for both of you

 

You can test in 30 if you want. The food and syrup should show up by then.

 

Here's a picture to distract you from all the testing!

 

Ok people. It's at 91
PMP~248
+3~100
+5~43
+5.5~62
+6.25~77
+7.25~60
+7.75~91
...can I go to sleep? Or do I do another hour? I-) I-)

 

I looked at your photos Carl, they're beautiful!

 

I think you could leave out a snack and go to sleep, Kristina. And you did a great job with him tonight, by the way. Nothing like a trial by fire. ;-)

Thanks, I'm a novice but I'm enjoying learning how to take pictures!

 

Good Morning Kristina

Had to crash last night due to my sleep disorder; I'm glad the others were able to help you out. I had a feeling that if he was 100 @ +3 he was going diving.

When you contact your vet, you might tell her the contemporary formula for estimating the Lantus dose is:
Lean weight in kilograms * 0.25, rounding down for safety
Where lean weight = the lower of ideal weight, or if underweight, the current weight.

Glad he is OK.

And now you know how to manage a hypo.

He may be high this morning; its to be expected. If he's over 200, I'd go with 0.5 units this morning as he may be a bit more sensitive to it after going low last night.

 

Thanks for staying up with Kristina. And my o my -- beautiful picture Carl -- Wow! You're a quick learner!!! Gonna start calling you Mr. Shutterbug!!!

 

ONE LAST THANK YOU TO ALL OF CHARLI'ES ANGELS!!!!
I called the vet today and spoke with the lead vet. I asked him if it was standard practice to not test before injection and he didn't have an answer for me, just said my questions and concerns were very valid. He said to hold off on the shots for a few days. He wants to try a few days of just the food and to check his BG 2 or 3 times a day to see if the go down on their own.
He is much better than the vet we saw at the appt.
So needless to say, I am a happy guardian today.

 

Good! Glad this vet is more in touch.

Now that you have a chance to breath a bit, read the AAHA guidelines posted in a sticky at the top of Feline Health, then pop over to the Lantus Tight Regulation forum and read over how Lantus works, is stored, the dosing protocol developed by Dr Rand, and so on. Looking at some of the Lantus users spreadsheet swill also give you a feel for how it can work in various cats.