Good news about Maxx AND Mufasa

Well, I finally got the home testing down, not mastered, but we're doing it. My vet had changed insulin for my Maxx and thought it best for Mufasa as well. She has been encouraging me to home test and do their curves at home for a while now for financial reason but mostly for accuracy. I had no confidence that I could do this and put it off for that reason as well as financial. (although she kept telling me it would save me money to buy the meter and test at home) Anyway, so today my vet and I planned that I would do a 6 hour curve just to know how they were adjusting to the insulin. Well.........as she told me and some folks here mentioned, the numbers were lower just from the stress alone...Maxx's numbers dropped about 100 and Mufasa's dropped by roughly 120 at their lowest points. This may not be the greatest news you've heard today, but it is great for the 3 of us, for their accuracy...and that I have finally done it at home. Thank you to those here that gave me the additional push to home test! The three of us are getting there. Also, the concern re the possibility of Mufasa having a thyroid problem, the blood work came back negative final test. He also has gained a few ounces.....now we're just waiting for the results on his urine culture.....The three of us are having a happy night. Thanks again to all of you who have supported us.

 

That's GREAT news! Home testing becomes easier as you do it. I found treats after made Gypsy come running for her tests! I know it will help ease your financial worries too. Can I ask what numbers you got?

Which insulin are they both on?

Congrats on the home testing! I think you're going to love that you can do it since it gives you much more accurate info at any time!

 

HI Rachel...thank you for responding. They are both now on Lantus, switched from ProZinc. Maxx who when diagnosed was in the 5-600's is averaging in the low 200's, not great, but much closer to where we need him. He also has a hereditary gum disease which kicks up his numbers. Mufasa when diagnosed 3 1/2 weeks ago was in the high 500's, was averaging in the low 300's. He does have some gastro issues and has recently had some tests, so until we resolve what else is going on with him, I'm assuming this is where we'll be. Not great numbers, but much better than they both were. Mufasa has been eating well, but was losing weight, a lot of weight, but has also gained a few ounces...so I'm hopeful with him. My vet mentioned pancreatitis as one of the possibilities, he had some tests done, we now know he has no thyroid problem, waiting for his urine cultures and another test. Hoping he is ok.

Btw, I see many people mention their cat has CRF...what is that?

Thank you so much for responding. Yes I am happy with the home testing, not when I have to do Maxx so much though, he HATES anything that has to do with diabetes. Bit twice yesterday....normally he's such a sweet boy, anything to do with ears or injections, he turns in to Cujo. SMH I do a treat afterwards, so at least he does come to me, but still nuts when I have to do these things. BTW, his treats or what he thinks are "cookies" I usually give one or two pieces of his kibble that he no longer receives with his meals. Do you have any ideas for something better? What do you give as treats?

Thanks again,
Kathi, Maxx & Mufasa :smile: confused_cat

 

Hi Kathi! Lantus is a neck celebs insulin. I never used it, but plenty on here have. If you haven't read the stickies on the lantus tight regulation forum, you might make time for that when you can. Great info on how it works. It's very different from ProZinc (which isn't bad) so doing some reading on it might help you. And, of course, ask questions! Tons of lantus users here. It's good you changed since it sounds like this works better for your kitties!

Pancreatitis is fairly common in sugar cats I believe. If that's the diagnosis let us know. There's a pancreatitis primer we can link you to if you need.

CRF is chronic renal failure. I don't know much about it but we have sites for that too if needed. Did your vet say that might be a problem?

I use simply nourish freeze dried treats. The ingredients literally say just chicken (or whatever they are). I get them at petsmart. I got the pet perks rewards program there to get my friskies food even cheaper. I think I get these cheaper too. You can look for them or just search out freeze dried treats and look for ingredients. Should just be the meat.

If you'll be testing regularly, we want to get you a spreadsheet set up.
It puts all your numbers into a format everyone here uses. That way we can all look at it and help you more. You can also give your vet the link if you want. I'm going to try to find the instructions and post them here.

Let us know if you need anything else!

 

Check here: www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

That's where I went to set up my SS. Once it's set up, it's a tool we use daily to help you out!

 

Rachel, thank you so much. Yes my vet did explain to me about the difference in the insulins, but I appreciate the extra info. I will definitely read it.

I asked about the CRF, because I see many folks on here have cats that have it. I didn't realize what the initials stood for lol. I'm wondering why if it's chronic renal failure, often a result of diabetes, why feeding foods such as FF or Wellness, both with high phos would be recommended here. I don't know a lot about it either, but this makes no sense. I know many frown upon the rx diets, but they have low carbs, phos, and fat. I do realize the carbs are slightly higher than say FF or Wellness, but wouldn't it be a better balance to have a much lower phos to prevent further harm to the cat? I have been told by my vets as well as a nutritionist that the diet they are currently on will take a little longer for them to hopefully go into remission, but that it is much healthier for them overall. I am now understanding why. I am seeing much improvement in Maxx. He looks so much better lately.

I will definitely get back to you on the pancreatitis, I'm worried about that. Mufasa seems to be doing much better. I just got a call back from my vet, and the urine cultures came back all negative. He is looking much better these past couple of weeks as well....I have faith we are on a positive track.

I will get it together to get those spreadsheets done, but it's hard for me to get on everyday.

Thank you so very much for the tip on the treats...I have a Petco card as well.

I'll keep you updated and again, I very much appreciate your input. ;-)

 

Friskies special Diet pates are low phosphorus and low carb, so they may be fed to a cat with both renal impairment and diabetes.

Also, adding 20-25% plain meat or poultry to the food and portioning out a regular meal helps dilute down the phosphorus, carbs, and fat, while increasing the protein %.

 

Hi BJM

thank you for your response. According to the chart that was linked to me Friskies has much higher phos and fat than the food my guys are on. The only one I seemed to find with a lower phos had carbs at 15.... I am looking for something with a similar balance to Hill's with less carbs and have had no luck so far. Weruva is the closest I have come, but then where I am that food is more money than the food I am feeding them now. If it is better for them I will get it of course, I am looking into it.
Thanks for the tip on adding plain meat or poultry, my vet doesn't want me doing that yet, but it's a good tip for later. :smile:

 

The additional protein may be cooked or raw, depending on what you mix with it - raw with raw, cooked with canned.

 

Here's the link to information about adding up to 20% pure protein to their meals to increase the protein content and lower the overall percent of fat and carbs from calories.

No, it's not. Since they're obligate carnivores, it's better for them to have a lower carbohydrate diet. This study, for example shows normal, non-diabetic cats only need around 12% calories from carbs:

Diabetics, of course, need even less carbs. Diabetes puts a heavy toll on the the body, especially if they're over renal threshold (~220) for extended periods. By continuing to feed them an inappropriate amount of carbs, it's keeping them in higher numbers and/or from achieving remission, which is doing no good for their kidneys, their livers, or their pancreas and that is damage that is immediately calculable based on their BGs.

As to phosphorus, if he's not in CKD, then his body has no problems processing phosphorus, as stated here:

In any event, if you're really worried, you can also add phosphorus binders to the food.

To compare the food your vet and nutritionist are recommending, not sure which you're feeding (I've seen you mention both) but Hill's w/d is 37% protein, 38% fat, 25% carbs and 183mg phos and Hills m/d is 46% protein, 41% fat, 14% carbs and 171mg phos. So no, they are not low carb nor are they "healthier" for them. Not to mention, the main ingredients in both of them are pork-based (ever see a cat bring down a pig?).

Weruva Chicken Frick 'a zee, for example, is 51% protein, 47% fat, 2% carbs and 174mg phos. That's 12% less carbs than the Hills m/d and almost the same protein/fat ratio and phosphorus levels. It also contains much better, species-appropriate ingredients and it's cheaper than whatever you're paying for the prescription food.

 

Thank you for your reply....I have been looking at Weruva. Iv'e considered it. As far as cost, I don't know where you are, but it is definitely more expensive than what I am paying for Hill's Diabetic food. A case of Weruva is $48 and I currently pay $30 for their Diabetic food. While I am having financial trouble due to their expenses, I would switch to the Weruva if it were better for them. My cats are actually doing very well right now on the prescribed diet. Their numbers have dropped lower still. My cat that was diagnosed in Oct, Maxx, has been up and down a few times due to his gum disease. He has actually dropped at one point so low I almost lost him. He is finally stabilizing. My stray guy diagnosed 4 weeks ago is having a gastro issue, I cannot make any changes right now until we resolve this issue. The good thing is he has dropped considerably and is doing very well otherwise. We have also just recently changed their insulin so changing food right would not be a good move. I never fed them the W/D, only my non-diabetic cat was eating that. As far as remission being the goal, sure I want that, but not all cats go into remission regardless of their diet.
Most people were suggesting Fancy Feast, Wellness or other foods that I know are not good for them. When I looked at the list (that may not be accurate) I saw most of the foods had very high phos or fat and I would not feed them any of that. (My cats were eating FF when they were diagnosed to begin with) Never again.
I don't agree that Hill's is not a good food, it is far better than many of the others, yes they could have lower carbs, and I will change their food when appropriate.
I see differences in recommendations as well in the amount of feedings. IE: some say more small meals, other times I hear only feed twice 12 hours apart. I'm not sure about that one.
Thank you for your links, I will look further into them. Much appreciated. Again, this is all new to me and I am working very closely with my vets as well as my own research. My cats are doing much better, and look much better as well. Maxx is back to his old self again and Mufasa is getting there, less his gastro issue.
Thank you again.

 

No, not all cats go into remission; Mikey is proof-positive, but he's a fairly rare and unique case. But, 84% of newly diagnosed cats on Lantus do go into remission with the proper diet (ultra-low carb) and home-monitoring. That's a statistic heavily skewed in your favor. Diabetes is expensive to treat, time-consuming, and takes a toll on the body from the endocrine system to neuropathy to dental issues to UTIs, so if remission is possible, it's healthier overall for them to go into remission.

The reason FF, Friskies, and Wellness are the general "go-to" foods that people recommend is because they're the most inexpensive low carb food available. Just as you mentioned you have financial troubles, many people here are also in the same boat and can't afford the higher quality foods, much less the prescription foods. (Personally, I've never been a fan of the FF and stopped feeding that to Mikey over a year ago when I discovered the Chicken Feast contained fish and noticed how astronomically high the phosphorus content was.)

And they're really not all that bad when you're on a limited budget or you have cats with other issues. The Friskies Special Diet Turkey & Giblets, for example, is 37% protein, 58% fat (63.79 protein/fat ratio vs. the m/d's 97.36) with only 5% carbs and 189mg phos. I feed both of my cats that and top it off each day with the 20% pure protein mentioned above to help increase the protein/fat ratio even more. Mikey is a bit problematic because he's allergic to red meats (including the pork-based m/d), so I've had to compromise on finding a food they'll both eat and that won't increase his BGs from too many carbs (anything over 6-7% carbs and his numbers go ridiculously up from double-digits to 300s). Since your cats don't seem to have a problem with red meats (I'm assuming you've ruled out that Mufasa's IBS is related to diet), then there are even more Friskies options that are low carb, high protein, and low phosphorus.

Weruva is just one of them that I pointed out for comparison, but you might also want to check out Merrick's BG 96% Beef, Soulistic, Wellness Turkey & Duck, Eukanuba Gourmet Chicken Entree, BFF, Authority Chicken, Pinnacle Ocean Fish, Nutro Natural Choice Pates, etc.... Those are all less than 8% calories from carbs and less than 250mg phos. Yes, some of them are a little higher on the fat side than the m/d, but they're all over 50% protein/fat ratios and you can always supplement with pure protein to increase that ratio.

You might want to check out this link on feeding kitties as much as they want (within reason). Like with human diabetics, it's been shown that our sugar babies seem to do better on smaller, more frequent meals. It's up to the cat and how often the cat wants/needs to eat. As to vets promoting only two feedings 12 hours apart, that most likely goes back to the old days and the older insulins (like humulin and caninsulin) where the cat needs to eat at shot time (actually a half hour or so before the shot) because those insulins are so fast and harsh on a cat's faster metabolism. Without food on-board with those insulins, cats can easily plummet into dangerous hypoglycemia territory very quickly. With Lantus, eating at shot time isn't as important as long as they have a healthy appetite. If anything, it's more important they eat midway through the cycle in case they drop too low and need to eat to bring their numbers up.

 

For many cats (we've had a few odd ones who haven't read "How to be Feline Diabetic"!):

Long-acting insulin affects glucose with something similar to a U shape. It is not exact - the glucose may go up a bit around +2 from food, especially if it is a big meal.

When the cat is meal fed, there tends to be a larger food-caused glucose spike in the first part of the shot cycle, typically around +2 hours post shot. This is particularly true of the cat who gobbles up the food in just a few minutes. Slowing that down can reduce "scarf 'n' barf" where the cat has eaten so fast, that it then vomits. One technique is to spread the food thinly across a large plate.

When the food is spread out in 2-3 mini-meals in the first half of the shot cycle, the incoming glucose better balances the incoming insulin. This can result in a smoother curve with fewer and generally less extreme food spikes.

 

Thank you so much for that info....I'm seeing what you mean on that. it actually does make sense to me as I initially thought I should feed them that way..Right now my Maxx keeps dropping, I am worrying as he is down to 50...I'm going to check him again in a few minutes but it looks like we may be hitting the ER again....so upsetting. yesterday he dropped to 36, I ran him to his vet, no problem....haven't given any insulin.. and cookies and a tsp of that molasses-like stuff ..( I can't thin right now)....I'm mindblown. :cry:

 

Has he had any insulin today? If no insulin, he can't hypo, barring some other medical condition being present.

See the link below for instructions for managing or to head off a hypo.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

* * * * * * * * * * * * * * *​

Examples of using the chart:

Ex. You are a new insulin user and you test your cat before giving insulin. The test is 300. It probably is safe to give insulin.

Ex. You are an established user of Lantus, following the Tight Regulation protocol. You've tested around +5 to +7 hours after the shot to spot the nadir. It is 200 mg/dL. You probably need to increase the dose, following the instructions for the protocol.

Ex. Your cat is acting funny. The eyes are a bit dilated. You are concerned and test the glucose. The number is 35 mg/dL. ACK! The cat may be in a hypoglycemic state. You quickly follow the HYPO protocol linked in the glucose reference values chart. (which we really, really, suggest you print out and post on your refrigerator.)

 

How is Maxx doing now? What are his numbers at and when was his last shot?

 

Nutri-cal

 

He hasn't had insulin since yesterday, he was crashing yesterday....ran him to vet at 36....he stayed for a few hours, he was able to come home at 210....I wouldn't give insulin....this morning he was the same....he hasn't had insulin, we went from 118 2 hours ago to 50 last check...he has had cookies (diabetic treats) a can of food and Nutri-cal 1tsp.....going to check again...

 

If he is not on insulin, he may normally run low, or something else is going on.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. [Glucose reference ranges are unsubstantiated and have been removed by Moderator]


When we deal with low numbers on insulin, we want something that will enter the blood stream quickly to bring up the glucose. That is why we use Karo, honey, molasses, sugar syrup, or high carb gravy/food - they are mainly quick carbohydrates to boost the glucose level quickly.

Once you get the glucose up, you start adding in some protein, but until then, it is test, feed 1-2 teaspoons of high carb, wait 20-30 minutes and repeat as needed.

 

If he hasn't had any insulin since yesterday, I wouldn't worry too much. Lantus does have a depot that can take 3-5 days to clear out after stopping insulin, however, it most likely won't cause him to drop into hypo territory after 24 hours. It sounds like his pancreas has kicked in and is helping bring the numbers naturally down. Let us know what he's testing at now and if over 50, he's probably fine for the night, although you might want to grab another test in an hour to see where he's at and how much the food might have increased his BGs.

What are the diabetic treats? I've never heard of those before. Around here, we use freeze-dried meat treats (like PureBites) because they contain nothing but protein so we don't have to worry about them affecting BGs too severely or any of the additives and other bad stuff that many of the treats are crammed full with.

What dose had you been giving him? At this point, I might recommend holding off on the insulin altogether for a day or so and see how he does. He might have elevated numbers tonight and/or tomorrow from the food you've given him, but if his pancreas is working, his numbers should start to come down again on their own.

 

thank you, but I have no idea what your numbers mean. yes I am giving him food and he has had a tsp of Nutri-cal (instead of Karo syrup, )...I am trying to rechck now
I have an AlphaTrak I'm not sure what you are converting up there

 

Correction to my earlier post then: you want him above 80 on the AlphaTrak before calling it a night. Is he showing any hypo symptoms?

 

sorry Kpasa...I didn't see your msg...he is hiding now...great...he is stressed though... not sure what he is at..last was 50...being he dropped so rapidly yesterday, I would rather be more cautious. I was writing quickly before...his "cookies" are the diabetic dry kibble that he no longer eats....thanks for the advice of treats...I will try to get them....sorry still trying to get him from under furniture...we may have to head to ER...not sure..anything as low as this and given yesterday...I really don't know what else to do...

 

yes and spot on that's my cut off number with vet..

 

The carbs should have kicked in now to at least off-set the drop if it's still the Lantus depot causing these low numbers. Can you entice him back out with his "cookies" to test again to make sure? I used to leave a little trail for Mikey and then wait for him to start creeping out as he vacuumed up the treats.

 

The first chart of numbers did explain how to use them.
Let's try again.

[Glucose reference ranges are unsubstantiated and have been removed by Moderator]

If not on insulin, this can be safe.

 

Kpasa

sorry I never got back...I greatly appreciate your attempts to help me. It was hard trying to be on here and try and get him as well. Sorry I am only responding now. He is very very hard to do the ears with, fighting, biting etc (which in itself is a good sign)...the highest number I got was 71...still not a safe number to leave him unattended. My vet also said anything under 80. I'm not sure at all what is going on with him and why his numbers remain this low. I opted to sit with him all night, and continue to check him if possible until my vet office opens. I prefer he work with her over unknown ER vets. Yes of course I would have taken him if he went lower than the 71. I continue to give him "cookies", more canned food (but all I have is his diabetic) and his Nutri-cal (which just in case you don't know, is a tube of molasses like substance made for this purpose for cats).....NO INSULIN.....he was on 1 u of Lantus....none since Thursday. His vet will be in in about an hour and a half....I'l be bringing him over there regardless of his numbers...obviously something is up with him.
I totally appreciate you hanging in there with me and trying to help, I really do.

I'll keep you posted.

Thank you again
confused_cat

 

BJM

I thank you for trying to help...unfortunately I was distraught over my Maxx and not able to check the links you posted. These numbers you posted still confuse me, but when I am not in a emergency situation I will look these things over more closely. I have never used a meter other than the AlphaTrak and am in the US...

Thank you for your help.

 

Keeping fingers and paws crossed for you here that all goes well with Maxx.

Eliz

 

BJM...sorry, by numbers I mean like " +5 or +7" I have no idea what this means...also what is nadir? I appreciate your trying to help me last night, I just am not familiar with this method or codes. I don't know when you say " tight regulation protocol" are you meaning as far as strictly adhering to my cats treatment plan or are you referencing a method used here? I haven't been able to make a spread sheet here, so am not familiar with how things are managed here.

Thank you again for trying to help me last night it is greatly appreciated..(even though it seemed foreign to me ;-) )

 

Thank you so very much.....this is a crazy road...scary and never a dull moment....your thoughts are definitely appreciated. I am currently trying to get him from under my bed (can't be moved)...I want to get another reading of course....last we are still at 71....I'm not comfortable with that at all, he hasn't had insulin in what will be in 2 more hours, 2 full days....not getting this. I will ge taking him to his vet shortly no matter what his readings are, something isn't right here.

Thanks again all for your efforts and support...even though we may not agree on some things, this definitely means a lot. Thank you! :smile:

Maxx and I will keep you posted confused_cat

 

Hi,

The terms "+5 or +7" mean 5 or 7 hours after the insulin shot.
So, typically, a shot might be given at '+ 12' (12 hours after the previous shot). Then, you count from there and an hour later will be '+1'; 2 hours later is '+2', etc.

The 'nadir' is the cat's lowest glucose number during the insulin cycle (a 'cycle' is the period between two insulin shots). The time of the cat's blood glucose nadir is also the 'peak' of the insulins activity.

There's a lot of jargon here, sorry about that. But you will very soon get the hang of it.

Good luck at the vets!

 

Thank you so very much...I am totally drained. I don't know how you all do this....for me it's only been since October. Something is definitely wrong here...Maxx was crashing all night, then maintained at 71....I continued to give him small amounts of the Nutri-cal and little nibbles here and there of his kibble. Now he just read 371! Highest in a long time. I am mindblown..... I still will not give him insulin as he drops sooo fast and unexpected. I would rather err in the not enough insulin than too much. Waiting for vet. Something is definitely wrong here, I almost wanted to believe my brand new meter is broken....tested the meter with the test fluid, it is 100% accurate. I am too new to this and losing my mind.

Thank you so much for all...despite our previous issue....I totally appreciate every ounce of help and support.

just so totally discouraged and upset here...I can't even stop crying, I feel I am losing him. Sorry, I don't mean to be dramatic...I will update later today....thank you all so very much.

Kathi & Maxx

 

What you are describing may be a delayed reaction to all the carbs you were feeding last night. Better too high for a day than too low for a moment.

What was the insulin dose you were giving? In chemistry, they have a saying "the dose makes the poison". It very likely needs reduction. And we do have some kitties on literally drops of insulin because they've found that is what works for the cat. If you're already down to shooting 0.25 units (we eyeball these on the syringes) you may need to figure out how many drops are in 0.5 units, then dose with drops. That is doable; it just takes some practice.

Since he was not given any insulin yesterday, it is possible he has something else happening. We've had a few folks come through whose kitties were very unpredictable in response to insulin. There is a very rare condition called an insulinoma. It is a small insulin secreting tumor. The excess insulin triggers compensatory hormones to release any and all stored carbs, thus raising the glucose immensely. Then, when you give external insulin, it crashes the cat.

 

Yes, I think he's much higher today from all the carbs you were feeding overnight to bring his numbers up. Let us know how it goes at the vet. If you do decide to give insulin again, I'd suggest at the very least you cut his dose in half to .5u.

 

BJM....
Thank you so very much for that piece of information. I will ask my vet about that. But in the meantime, yes you and Kpasa are right. The high number my vet agrees was from my giving him the Nutri-cal and food all night. She is looking at the number, but doing nothing with it as she stands with both of you. She believes there may be a possibility of him going into remission?????? This would be wonderful...but we are not assuming this is the case yet. He seems to have maintained the higher number, but on a continuous decline throughout the day as he was there. We gave him NO insulin tonight either. I was able to bring him home, but will have to watch him like a hawk. He is going back to the vet for the day on Monday. I could do it at home, but sometimes i can't get him on time with the testing as he becomes a cat I have never seen in my life and comes close to attack. So it is better he is there where they are experienced with all of this. I am ok with this because I am shooken up over the last few days, and feel better when he is there for now. I will be nervous all day tomorrow for sure. Thank God I am home testing now, I would have missed this altogether and probably have given him his dose that night and he would have been in much worse shape or even dead. Home testing is sooo important and i am so glad you all stress that repeatedly. you all had given me the push on that I needed.

I will keep updates as we go along.....depending on his number in the morning, I MAY give him 1 unit of insulin...I am terrified of this, but will be with him the entire day. He was on 1 2X a day...now will be just in the morning and only IF the number his still high.

Again thank you all so much for the info and support....

Kathi & Maxx

 

Just wanted to make sure you saw this:

Remember, once you put the insulin in, you can't take it back out again. "It's better too high for a day than too low for a moment."

I also thought I might share this document I wrote up with you. It's about creating a conducive ear-testing environment and you might find it helpful.

 

How about 0.5 or even 0.25 units of insulin? No insulin lasts longer than 12 hours in the cat. Ideally, you want a dose you can shoot safely every 12 hours.
In some cases, folks here even dose in drops of insulin. They'll practice by measuring up some colored water, then squeeze out equal sized drops until then can do the same number of equal sized drops consistently.

 

HI Kpasa & BJM

K thank you so much for those tips... I will definitely look at that...and yes, I def know about the insulin dose. thank you

BJM....yes, with the insulin that is why I wrote "if" and it depends on the numbers. The reason my vet and I are going with the 1 dose in the a.m. is because when looking at his curves and all of the home testing, including a full day curve I did Sunday (last) it is clear that he doesn't really come back up in the evening. ( I don't know how to explain this properly) Two nights in a row he crashed at night...the numbers dropping rapidly even after food and no insulin, the numbers continued to drop! This is the mindblow....so we do not want to give any insulin at night. I know this is not the norm and my vet has explained it all....but for the next few days, this is the game plan. We wouldn't give him insulin at all in the morning either, but if he has a high reading again, we will, ( I probably would be afraid to do a whole unit anyway, so I more than likely would go with the 1/2 like you suggest ) So all this depends on his number in the morning.....which it just occurred to me, I have a question. I think I should test him as soon as I wake up, BEFORE his breakfast, then I would test him again after, before his shot or what would be his shot.....does this make sense to you? I just think it may be better given how odd his readings have been.
I know there is a protocol here you all have for when to inject and at what number...my thing is, he drops soooo fast, that our "safety" number is 100....I will not give him any insulin at all if he is not over 100.....

Again thank you both so much for being here....Maxx just walked in and walked right across my laptop...think he wanted to say hello...lol He seems to be ok, I'm going to test him in afew minutes just to see where we are at...

 

We usually don't give ProZinc when the cat is below 150 mg/dL on a human glucometer or 180 mg/dL with a pet-specific glucometer.

 

He is on Lantus...he used to be on ProZinc, that was changed a little over a week ago. Did i accidently write ProZinc up there? I apologize, Lantus...

 

Sorry - thought you were on ProZinc.

We suggest new folk, especially without a spreadsheet for peer review, not shoot under 150 mg/dL regardless of insulin.

Spreadsheet instructions here.

With Lantus or Levemir, folks test, feed ,and shoot within 10-15 minutes. If you get a test an hour before then, you'll know if the number is rising and safe to shoot.

 

ok great thank you...I have to admit, the other night he read 118...I did NOT give insulin...good thing, he continued to crash....I like the 150 number better...maybe I am remembering wrong now...I seriously need to sleep....

Thank you so so much for all your help, and you patience with answering....

 

No problem.

When you're ready for some more reading on Lantus, the Tight Regulation forum is here. There are several sticky posts on Lantus you'll find helpful, and you can take a look at what other Lantus users are doing.

 

Thank you....btw, my two boys are the same color and look very much like the kitty in your profile pic.

 

That was my first diabetic cat, Spitzer.

 

Hey there! I think it might help a lot if you edited your signature with some info. Your name, cats names and dates of diagnosis, type of insulin, meter you are using, other medical issues, food you use, and anything else you feel is relevant. If you set up spreadsheets, they can go here also. That way, we have info on your cat that we may need every time. It's especially helpful in emergencies so we don't make wrong recommendations or have to ask for the same info over and over.

To do this, go to user control panel, profile, edit signature. Then that info will appear after every post! :smile:

 

How are things going with Maxx and Mufasa?

 

Hi Kpasa

Well I don't want to jump the gun here, but Maxx has not had any insulin since our last event...he is staying in the upper 100's....he hasn't dipped too low again so we are happy here. I am still watching him very closely though. He may have to spend the day at the vet tomorrow as I ran out of strips and the ones I ordered(one day delivery mind you) did not come yet... :sad: Right now with all the crashing he's done, I feel it's the safest option.

Thank you so much for asking.

 

Rachel

thank you, I will attempt to do that today. Good point!

 

That's great to hear! :thumbup We usually don't recommend for new members to shoot under 200 anyway, so that's good that you're holding off on the insulin. We prefer to see them in lower numbers, however, between ~70-160 on an AlphaTrak with the majority of the time spent in lower ranges. One thing you might want to look into (dare I say it? :lol: ;-) ) is a lower carb food to nudge those numbers further down and make this remission a strong one that will stick.

 

Hi Kpasa

LOL I hear you and understand the concern about carbs....right now I am leaving him on his Hill's...his vet is on vaca and we will talk further when she returns in a couple of days. He may stay at her office tomorrow with her fill in doc. He has dropped drastically a few times in this past week alone that I feel more comfortable leaving everything as is.(less the insulin) I found a food that I may like with lower carbs, Weruva, but I don't want to make too many changes on him right now. (and don't you know, it's more expensive!!! ugh) If it's better for him, I'll do it though. It's been really shaky with him. Like I said, I don't want to jump the gun that this is remission.... but that would be amazing! I am hopeful.

Mufasa is still on his insulin and his numbers have gone down a bit more. I am now getting his low at 188...that's a plus and ok for now. If he continues to go down that will be awesome. I'm not looking at his records right now, and sometimes confuse the two's charts, but if I remember correctly, when diagnosed Mufasa was in the 500's so we're getting there. ( I hope)

Thank you so much!

 

If he isn't getting insulin you don't need to worry about a hypo. Some cats, like mine, seem to naturally run in the 40's when not on insulin and do just fine.

 

Hi Nikki's Mom

Thank you for the tip. I'm just too new to this to make any changes without discussing with my vet first. I know you are right, but feel a little more comfortable with not making the change yet. This may not be remission, so we're just waiting to see. I'm still watching him like a hawk because two days of "crashing" has traumatized me.
Thank you again.

 

You might have mis-read my post. I'm not recommending any changes. Just noting that you don't have to worry about "crashing" if you aren't giving insulin.

 

oh ok lol gottcha...I'm so used to being told to switch foods, that I did mistake it to mean there was no problem switching...ooops sorry. Thank you again for the heads up! I guess I can sleep tonight.

 

Still NO insulin for Maxx!!!! He is doing very well. Playing a lot...and much happier since he HATES injections...I am hoping we stay this way.

Mufasa is doing ok too, but still needs his insulin.

Thank you again so much everyone.

 

That's great news, Kathi. :mrgreen:

How long since insulin?
And what sort of blood glucose numbers are you getting for Maxx at the moment?

 

Yay for Maxx! :mrgreen: Hopefully Mufasa starts copying Maxx soon. :lol:

 

HI ....thank you so much...Maxx is reading in the lower to mid 100's...he's been off of insulin for a little over a week now....he's maintaining well so far....praying we stay here.

Kpasa...thank you, LOL Mufasa copies everything else of Maxx...this would be nice too!

thank you all again

 

Go Maxx!

I'm keeping my bits crossed for him.

juliet

cat_pet_icon

 

The reference range for normal glucose used by IDEXX labs is 70-150. Since you are using the Alphatrak, your readings should be in the same range. If all of Maxx's BG readings are within those limits, then great! If some of the readings are over the 150, that shows that there is still room for improvement and lower BG levels.

Cats are unique in that they can heal the pancreas and start to produce insulin on their own. Stopping the insulin too soon puts stress on the healing pancreas and can lead to further destruction of the beta cells. He still may need a tiny dose, maybe 0.1U to 0.25U to give his pancreas more time to heal and produce sufficient insulin on it's own.

There are two ways you could check to see how well Maxx is doing.
1. Take him to the vet and have a fructosamine test done. This checks the glucose levels over the last 2-3 weeks and should be <350.
2. Do a food test. When he is over 100 with your first test in the morning, hopefully before you have fed him, go ahead and feed normally but then test him again somewhere in the +3 to +4 hour time frame. The BG levels should have gone down, below 100, from you first reading if Maxx is producing enough insulin on his own to counteract the BG rise from the food.

The Veterinary Clinics of North America: Small Animal Practice had a special edition on Feline Diabetes last year (Volume 43, Issue 2, Pages 221-446 (March 2013)), that said BG levels over 117 were a cause for concern. Perhaps your vet has access to this article and can find that reference.

We'd like to see a strong remission for Maxx so you do not need to put him back on insulin. A tiny dose of insulin now may help him to achieve that strong remission.

 

Dr. Shrodinger

Thank you so much. Maxx is doing very well....he is still off of insulin and his readings remain the same, 100 - mid 100's...
Mufasa is still on insulin, but doing very well. I just had him neutered the other day, so he is healing well. I haven't done a BG curve on him as it would be out of wack right now anyway, but Weds. I will be curving him all day. I don't think this guy wants to come off of insulin any time soon. He is happy and doing very well though.

Thank you :smile:

 

Deb & Wink

Are you a licensed veterinarian? I'm not sure why you would be telling me to give my cat insulin when his vet has him off. His vet who has thoroughly examined him, monitored him for months, and knows HIS history and needs. If you have been reading my updates you would realize Maxx has a history of crashing frequently and rapidly. If I took your advice I would be putting him in great danger and possibly causing his death. You really shouldn't be advising others or deciding what units of insulin their cat needs when you are not an educated, licensed veterinarian and have NEVER even seen the particular pet. My cat is not a statistic, he is an individual little diabetic in treatment.
I also am not understanding why you would even comment on my post at all when you harassed me personally in a pm, because you did not approve of the treatment my cat and another members cat were in or the food our vets rightfully have prescribed to our cats. And then attempt to report me for supporting that member and sharing my experience and what I have learned with her.
Sorry but this makes me furious and it's pretty dangerous that you are attempting to tell others what is best for their cat, when actually your advice would be extremely harmful to mine in this situation.

 

I do believe you may have mis-read what Deb wrote.

Not once did she say put him back on insulin. She indicated there was a veterinary test which could be done - fructosamine - or a food trial to observe the glucose response (an empirical approach) - both things a vet might consider reasonable, if asked.

I know you want to believe in your vet. You might also consider that your vet is merely human and that it is prudent to ask about things just as you would with a human doctor. Veternary articles in peer-reviewed journals are an excellant source of information to discuss with your vet - to ask questions and get interpretation of the information and see how it might apply to your cat.

 

The newest standards for management of feline diabetes are to control clinical symptoms and achieve remission. Those standards have been published in articles in various vet journals since at least 2008. One of my goals here is to provide you with the resources to help your cat achieve remission.

The BG numbers you are telling us range into the "mid-100's" which could mean anything from BG levels of 130 to 180. Those higher ranges are not euglycemia.

I pointed out to you that BG numbers outside of normal ranges can result in further destruction of the insulin producing cells of the pancreas.

I pointed out to you 2 methods you could use to verify if Maxx was producing enough insulin on his own.

My statements were taken from this article in Vet Clinic Small Animal volume 43,(2013) "Management of Diabetic Cats", the AAHA Diabetes Management Guidelines for Dogs and Catsand various other vet journal published articles and I stand by them.

I pointed you to some current, vet journal published, educational references on Feline Diabetes that you could share with your vet. Your choice to read them and share with your vet or not.

From Vet Clinic Small Animal 43(2013) 251-266, "Management of Diabetic Cats"

 

BJM

I not only want to believe in my vet, but I have the upmost confidence in her as she is highly versed in the treatment of diabetics. Again, my vet has examined my cat, is fully aware of his needs and he is in the proper treatment. I am not sure why many continue to assume my vet is not qualified or up to date with her knowledge....I did not misread what she said. Nor did I misread the nasty msgs she left in my inbox.
As far as the test you mention, we have already been there.
My only purpose of posting was to update those supporting my choices as to the progress my cats have made. I did not ask for any advice or opinions.
I do appreciate input, but I addressed that particular person and she knows why.

 

We've just had experiences here that have resulted in problems when the vet acts confident ... and wasn't quite as expert as the confidence would lead you to believe. At least my vet recognizes she doesn't know about managing feline diabetes with Lantus.

So, what was the fructosamine?

(And since I've not read much about it, I just looked it up at Cornell University. I'm going to have to remember that if serum protein is low, fructosamine may be off.)

 

Well said, BJM... as is the information posted by Deb/Wink.
Thank you, ladies!



Donning my Moderator hat...

This thread has once again been brought to the attention of the Team of Moderators. There's some obvious friction between certain members apparent in this thread and others. The FDMB prides itself on being an open board subject to peer review. We don't have to agree with each other. We don't even have to like each other. Going forward, let's not allow personal feelings to take away from thoughts, ideas, and opinions expressed nor the sharing of experience and/or well documented information. Please be aware: In some cases, remarks are made for the benefit of all who are reading the thread. OTOH, if anyone's comments drive you crazy or are obviously unwanted... move on to someone who is receptive to your help. I'd also like to suggest everyone remove all chips from their shoulders to focus energy and attention on the reason we're all here... our cats.

BTW, there's a handy dandy little feature available in the board's software program. It's called "Friends & Foes". Find it in your User Control Panel. If you choose to make another member a "Foe" you'll never have to read anything else they have to say anywhere on the board.

Questions? Please send me a PM.

Thank you and have a good day!
~ Jill

 

Donning my mod hat as well, as it is the only hat I own nowadays...

I'd like to talk about "unsolicited advice". Almost three years ago, when I was a newbie, I posted on a thread in Health that was about "where do you shoot your cat". A couple of people didn't like my answer. And the thread was hijacked by well-meaning members who told me that "I was doing it wrong and it can't be done that way". I was following my vet's advice to the letter. I trusted my vet completely. The advice was "unsolicited". It caused me to question my vet's advice. I came within one click of leaving the FDMB. And I ignored the advice of those who had offered it.

I didn't leave, obviously. But not once after that did I ever ask for advice about insulin shot location or dosage for Bob. In time, after reading posts for endless hours, I came to understand that my vet was too aggressive on dosage, and I "went rogue" and started reducing his dose. But I also felt like I was "alone" in doing so. I wasn't going to ask for help here, because I didn't want to hear again that I was "doing it wrong".

Somehow, Bob and I made it, and he went into remission for over two years.

Since the day I got advice that wasn't asked for, or welcome, I've posted over 12,000 times. More than any other member who has joined since May, 2011. Yeah, I talk a lot. But I would hope that at least a few dozen of those posts have been helpful to people.

The point? I almost quit back then. And anything I have said since that day might never have been said just because a couple of well-meaning people decided to offer advice where it wasn't asked for. Ironically, one of those advisors eventually became one of my dearest and most trusted friends here.

My advice? There are scores, hundreds, of well-meaning people here who give advice to new members. I hope you continue to do so. But pick your battles. And answer the questions asked, and know when to "not" say something. When people ask, they want to be told what to do and how best to proceed. But when they are told, without asking, they aren't going to be open to hearing it no matter how long you've been here or how good your advice is.

The last time some of the people in this thread locked horns, it was in the thread of a new member. The thread was hijacked and we had to close it. That member? She is gone. She hasn't visited the site at all for three weeks.
We will probably never know how she or her kitty are doing. And that makes me sad.

That's all I got...

 

Carl & Polly,

While I hear what you are trying to say, I don't find sending someone a message telling them how horrible they are, being accused of having an agenda to promote a particular food, or being told the harm they have caused another new member, or demanding they make a public apology for their wrong-doing (especially when I was not wrong in my statements) in any way well-meaning. Then having the nerve to continue to post on posts regarding my cats. Since I came on here I have repeatedly been "advised" about the food I feed my cats and how they should be switched. I looked into it and found it would not benefit my cats in any way. While remission is the ultimate goal, I choose to concern myself with my cats' overall health.

While one member may not know the entire situation and see no harm in what was said to me, the fact remains, it was not appreciated. After my Maxx crashed almost every day for weeks,( some days down to a reading of 30) the fact that he maintains numbers from 100 - to mid 100's is a God-send...so why anyone would concern themselves with suggesting I give him insulin or that my vet may not be aware of this, is beyond me. Not all situations are normal or statistical. And I was letting the folks here know that he was no longer crashing. Do I think he is in remission? No, but he is safe now and hasn't crashed since. he remains in treatment and is doing much better than he was.

The new member that hasn't been on left for the same reasons I almost did, and for the reasons I still have not done spread sheets. The over bearing of those against our choice of treatment for our cats. She writes me still so we can see how each other's cats are doing. It's a struggle for everyone, but being told you are doing it wrong, when it is simply a different approach than most on here is, not well meaning. Being repeatedly told your cats' food is not good, simple because others don't like it, or being told it is not a low carb food is ridiculous. Trying to convince a new member that a food is not designed for their cat or that it is a marketing strategy is absurd.
I chose to stay, as many on here HAVE helped, (ie; home testing). I have considered trying different approaches, but for now my cats are in the best treatment for them.

I do appreciate pointers, or advice, but NOT when it is being done in a condescending manner or a manner in which the person feels they are superior or more knowledgeable than others, including the number of highly qualified veterinarians I am working with.

NONE of us here have the absolute answer, including myself, because if we did, there would be no such thing as Feline Diabetes.....

 

There's an old saying "If you don't really want advice, don't post on the internet".

 

Funny I never heard of that one but

there's also an old saying: "If you have nothing nice to say, don't say anything at all"

 

Perhaps the moderators could close out this thread as I am realizing it isn't about the cats or concern for them, but really a "my way or no way" game. I am not interested.

 

Ever heard of the one, "People who live in glass houses shouldn't throw stones." :lol:

I imagine many could go on... "tit for tat" all day long, but what a huge waste of time, energy, and productivity.
Let's get back to the business of helping cats, please.

My thoughts exactly.

Done.