Doodles diagnosed 9/13 & we are so confused

Hello everyone!


Doodles, male, 10 years old was diagnosed on 9/13/2016 at St. Francis Animal Hospital, GA. He came to our home as a sickly stray, but has had no illnesses since we got him healthy his first month with us. His sugar was 723mg/dl and spent the night on an insulin drip. I initially took Doodles to the vet because he was lethargic, lost weight and had groomed the under portion of his body bare. The opinion was he may have food sensitivity or other household sensitivities & the Hills z/d would help, but our main focus should be his sugar.

He was discharged the following day with Lantus 2u twice a day and Hills z/d wet & dry food. He eats 4T dry and 1/4 can wet twice a day at 7am/7pm and then he gets his insulin.

Returned 2 weeks later (9/27) for a curve and Lantus was increased to 3u twice daily.

Returned 1 week later (10/4) for a curve and Lantus increased to 4u twice a day. Level: 500's

I have no idea where to start to help him become healthier & happier. He HATES to go to the vet and would rather stay at home than take a ride in the car. I don't blame him one bit!

He has cooperated fully with diet change and accepts insulin injections without a fuss.

I am reading a lot information within the forums, but am still 'lost'. Ask me a million questions & I will answer...I want him better!

Any help would be greatly appreciated.

Please & thank you,

Tina & Doodles

 

First, take a big deep breath. We were all terrified at first. We found that, the more you learn about diabetes, the more empowered you feel and the better you can help your cat.

First, we'd encourage you to test at home. Most cats are stressed at the vet (sounds like Doodles is) and stress raises blood glucose levels. The doses based on those levels can be too high once he gets home and relaxes. Here is info on testing: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

As you have probably read, we suggest wet low carb food in the 8-10% range. When you post on the Health forum, you can ask for and get some other alternatives to the Hills which is high carb.

Lantus is a good insulin and we have a separate forum for it. Maybe start by reading the stickies at the top: http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

Now that you've introduced yourself, maybe check out the Lantus forum, hometesting
links and post on the Health forum for food suggestions, questions on testing and specific Lantus questions.

Welcome!

 

Thank you! I purchased a glucose monitoring device today and plan to test him at 1pm since that is mid-point between am & pm dose. I am interested to see if the reading is close to what the vet hospital obtained. I just bought a case of canned food, but if I need to change it to something that would better suit a diabetic cat then I will. So much to learn & I am willing to do the work to get him healthy. Thank you for the welcome & vote of confidence.

Hey! We're in GA too!

 

Welcome, Tina and Doodles.

Following on from Sue's comment above, DO NOT change Doodles' food to a lower carb one until you have learned how to home test and have gathered some data on how he's responding to insulin, especially on a dose as high as 4IU Lantus BID. (A change from a higher to lower carb food can drop BG levels very significantly and very quickly and usually requires a reduction in insulin dose because less carbs are being consumed.)

Please can you post details of the brand/variety of food(s) Doodles was eating when he was grooming his tummy bare.


Mogs
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I am very frightened.

I have seen more than one person indicate that the dose he is on is SO HIGH.

The vet acted like it was no big deal...just keep giving insulin...see you in a week for another curve.

 

Yes you are understandably frightened. Home testing will help you determine if it's to high. The people here will help you with the insulin your using. And your ready to start.

FYI- GA after the name refers to a kitty that has "gone ahead" or guardian angel.

 

Thank you. My apologizes for being insensitive.

 

No apologies needed. At first I thought it meant general advice.

 

(((Tina)))

A lot of us arrive here feeling very frightened indeed.

Some vets give very little information about treatment and a lot aren't very progressive when it comes to home testing cats' blood glucose (BG) levels at home. When Saoirse was first diagnosed the vets she was registered with at the time gave me no support whatsoever for my wish to home monitor Saoirse's BG. I had to dose her 'blind' for several weeks at the start of her treatment and they were some of the most terrifying weeks of my life (and a lot of things have scared me before and since). I moved Saoirse to another practice who had a much more positive attitude to home testing (and they are generally more feline-diabetic-friendly than a lot of practices).

The relief I felt when I got Saoirse's meter and started home testing was e-normous! To be able to check BG in real time gives a caregiver so much more peace of mind. It's the best thing you can do to keep a diabetic cat safe and well during insulin treatment.

Now that you've got your meter we can help you learn to home test. We can give you a spreadsheet for you to record Doodles' BG results and that will help you to check that he is on a safe, effective dose. Here are the links to get you started:

FDMB spreadsheet setup instructions

Understanding the spreadsheet grid

If you'd like help setting up Doodles' spreadsheet, just holler.

Most members put a spreadsheet link into their signature. The spreadsheet will enable you to learn how Doodles is responding to his insulin and because other members will also be able to view his results they'll be able to give you better information when replying to your posts.

Here's another helpful forum sticky with a really clear diagram of the 'sweet spot' on the ear - typically the easiest place to get a sample:

Testing and injecting tips

In the early days of testing it really makes a huge difference to your success rate if you warm the ear well. As you continue to test you'll find it easier and easier to get a blood sample so if it's a bit fiddly at first don't lose heart!

Before every dose of insulin you need to test BG to make sure it's safe to give insulin (the morning and evening preshot tests - AMPS and PMPS on the spreadsheet), feed Doodles and then inject the insulin dose. Then you need to do daily BG spot checks between doses (mid-cycle tests). Ideally one mid-cycle should be during the AM and one during the PM (the 'before bed' test is a great safety precaution as often cats may run a little lower at night). The sooner you start testing and filling in your spreadsheet the better members will be able to help you understand how Doodles is responding to his insulin treatment. It will give you much more of a feeling of being in control of things and help you to keep Doodles safe.

The other advantage of home testing is that you will be getting results that are in the home environment and therefore have a more realistic picture of how Doodles is doing. (Vet/travel stress can influence readings when curves are done at the vet clinic.)

You are not alone with this, Tina. There are many very experienced caregivers of diabetic cats here and there's a very active support group for Lantus users. We'll do everything we can to help you learn and to support you both every step of the way.

Your vet is correct in saying that you need to get Doodles blood sugars better regulated first as it is very much time critical - without insulin the body can't use food properly. Comments have been made about the dose Doodles has been prescribed because his dose has been stepped up quickly. A lot of vets increase insulin dose in jumps that are too big (e.g. by 1IU at a time) and sometimes this can mean skipping over a dose that works better for a given cat. FDMB follows recommendations from a world-renowned, highly respected feline diabetes specialist and advocates adjusting doses in small steps - typically 0.25IU - as it decreases the likelihood of skipping over a 'good' dose. After an adjustment is made the dose is then held for several days until its effect can be properly assessed (unless daily home testing shows the dose to be too high, in which case a dose reduction is given on the very next cycle). Preshot tests and mid-cycle tests are done every day plus periodic curves to build up a pattern of how a kitty is responding to the insulin and the dose. As you start gathering data you'll be able to see better how well Doodles is doing on a given dose.

Start by doing a preshot test before each dose is due. Assuming the cat is clear of ketones the FDMB guideline for members with little or no BG data is that no insulin is given if the preshot BG is 200 or lower (as measured on a human glucometer) - the "no-shoot" number. I recommend you discuss no-shoot numbers with your vet. If you do measure Doodles' BG at 200 or lower at preshot post for help here and let your vet know straight away.

Which meter do you have?


Mogs
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