Hello. New member/newly diagnosed cat

Hello,

We are a family with a 3 older cats. Our 12 year old boy, Smokey, had been losing a LOT of weight, and in the last week had been vomiting, and sleeping more than usual. After a long trip to the vet, he was diagnosed as being diabetic. As I'm sure you all know, trying to figure out what information is CORRECT is a little difficult.. I found this message board while trying to do some research on what is the best diet and treatments for our cat. I welcome any information and support that can be gained from this board, I've read some great things about the site..

Smokey has been overweight most of his adult life, A few months ago, I had found a sore, possibly a bite from one of our other cats, that was infected. He weighed about 20.5 lbs at that point. This week we took him into the vet, he was a little over 15 lbs. This process has been scary and confusing, and I obviously want to do what is best for Smokey. I hope to find some information on diet, insulin regulation, etc..

Smokey tends to eat dry food more than canned, so for the first couple days we have been forcefeeding A/D canned food, he would not eat it on his own. Today, at the direction of our vet, we purchased Royal Canin Diabetic feline vet diet dry food. It is quite expensive ($25 for a 4lb bag) and, from what I have read online, NO dry diet is good for a diabetic cat, even if it is specifically labeled as a diabetic food. He is also prescribed 2 units of NPH insulin 2x a day. While he has stopped vomiting, and today (2nd full day after diagnosis) he seems a little more like his usual self, which I am of course greatful for.

I am wondering what is the best diet for him now, and possibly if it is safe to put our two other cats on the same diet, before we have to give them insulin as well. Our other cats are Gizmo, female 13 yrs old who is not overweight, and Anton, male, who is overweight (around 20 lbs.)

I look forward to reading others experiences, and having a place to come to when I need to voice concerns, or ask a question. As a family we have dealt with diabetes, but never in a family pet, so it is a learning experience we are just starting.

 

Welcome to the Board!

Do you know what insulin he has ordered? Also, you can probably google vets around your area and call them and see if they have any FD patients, what insulin they use, are they for (or against) home testing, what is the best diet for a FD cat, ect...

A few things are needed to combat FD:
The correct and better insulins are Levemir (get the pens), Lantus (get the pens), and ProZinc- they cost more but they are worth it and have excellent track records. Not so good (and vet favs) are Humulin and Canisilun (made for DOGS) so if the vet prescribes ask for the first three instead and refuse to pay for the other two.

The correct FOOD- and all three cats would benefit from the same diet. keeping them on dry could lead to more FD in the 'family'
https://docs.google.com/spreadsheet/ccc ... hYXc#gid=0 (called Hobo's List)
http://binkyspage.tripod.com/canfood.html (called binky's list)
http://www.catinfo.org/docs/Food%20Char ... -22-12.pdf (new list from CatInfo.org)

You want to look for canned food that is low carb. The two lists above are ones that we use- look for the %kcal/carbs- under 10 (5 is better) in both lists. Feed the best you can afford. Most do Fancy Feast, Friskies, 9-lives. This will also help with the UTI- dry food is, well, dry. Canned food has more moisture and when you add water to it the water content is increased- all the better to pee a lot. You do NOT need vet prescription food- it is overpriced, high carbs, and contains high quantities of liver- which most cats won't eat day in and day out. If you bought some just take it back and say your kitty stopped eating it. They should refund even if it is opened. You also should consider feeding several small meals throughout the day. Not only is a diabetic cat losing weight- the reason is because they are literally starving, unable to get the nutrients out of the food they are eating. Give more food in small meals and your cat will slow down once they start getting the nutrients out.

Home testing-
You need to get a glucometer to test your cat- a human one is fine and reliable to use. It reads different than the pet ones but all you really need is the consistency of the levels day in and day out. You might be able to get a free one- there is a spot just at the top of every page that says home testing kits. Here is a link to what's inside:
http://felinediabetes.com/FDMB/viewtopi ... 28&t=60261

If you purchase one here is a list from Consumer Reports:
http://felinediabetes.com/FDMB/viewtopi ... 28&t=70140

You need to look at the ones that have the cheapest strips- not the cheapest meter. The meter you will buy once, the strips you will continue to purchase over and over again. A lot of people on the board use the Relion micro/confirm meters from Wal-mart because the strips are the cheapest around- $.36 each and usually easy to get (and you can get the strips even cheaper online through the ADW site). Bayer is another popular one. Be wary of the generic kinds that have the word TRUE in the name- those have been inaccurate in the past for higher #'s or don't go above 299- and another bad one is the Freestyle Light with the butterfly on the strips- both of these have led many pet owners to believe their cats were okay when they were really in trouble. And you can do your own curves at home when you hometest- that is cheaper than doing it at the vet.

To keep up with the BG #'s there is a spread sheet (SS) that we link to our signature line. Here is the link to set up:
http://felinediabetes.com/FDMB/viewtopi ... =6&t=18207

Incidentals-
- I would suggest getting ketosticks (found in the diabetic supply aisle) to test your kitty for ketones that lead to DKA- this is a very serious and deadly (and EXPENSIVE) illness. For $7 you get 50 strips- the best insurance against ketones possible. If you catch it early the easier it is to treat.
- Lancets- for your first box go for the lowest gauge you can find- 26 or 28. His ears won't bleed that much at the start. There are so many u-tube videos out there that can show you how to test the ear. You can either use the lancet pen or free-hand. I free-hand as I feel like I have more control over the pointy end. After the first box is used up you can switch to 31 gauge.
- TREATS! In the videos you see the cats eager to be tested. That is because they are shamelessly bribed into sitting still because of a yummy treat that is given after testing. Freeze-dried chicken, beef, shrimp are no carb treats and there are others out there that get used as well. Give this treat ONLY a poke time- tests or shots. Your cat might not care for treats, mine never did. She just knows it comes before her food

Good luck on the sugar dance!

 

As hmjohnston said you want to feed canned, low-carb canned is best. However, the cat does have to eat so dry is better than nothing. You can try slowly increasing the canned and decreasing the dry.
N insulin is not really a acceptable insulin for most cats. The Human Lantus or Levemir and the pet-only insulin ProZinc are very good.

 

welcome to FDMB - lots and lots of info and so much that can help Smokey.

Looks like the vet prescribed 2 units of NPH insulin 2x a day which unfortunately is one of the bad ones Heather listed.
Its a short-duration one - that causes the cat's bg to fall quickly and then rise pretty quick and then they are without insulin in their bodies for generally 4 hours twice per day.
Less chance of regulation and remission because of this.
Has he had any insulin yet?

Also on catinfo.org is advice on helping cats to lose weight. It seems like Smokey has lost weight fast - which is typical with an unregulated diabetic - but there's a danger of losing muscle mass with a big drop.
Dr Lisa advocates a gradual weight loss- just like for a human. feline obesity - the case studies have a couple of cats over 20lbs.

I moved my 3 onto wet low-carb food after my Honey was dx with diabeties - trying to keep them all healthy with a species-appropriate diet now.

Keep asking questions - you've made a great start with your first post

 

Thank you for the reply!

The vet currently has him on NPH insulin, which I have heard confusing things about.. Thank you for all the information. I am going to look over it a little more carefully, and also show it to my parents so that they have more information as well. Again, thank you!! There is so much to learn, and so much conflicting information out there!

 

Please try and convince the vet to use either Prozince or even better, Lantus(Glargine) or Levemir. N is old school and a lousy insulin for cats. He needs to eat a good 1/2hr. before shooting N. Fast acting and short duration. Others will also respond to give you a lot more info to give to your vet. Glad you found us though :razz:

 

Yes, he has had the NPH, I do believe that the vet may have given that to us because of the cost. Cost is an issue, but we do want to do what is best for Smokey. We are going back on Monday, I plan on discussing the insulin with the vet then.

 

If you are not yet giving insulin, change the diet to lo carb asap. This may drop the glucose as much as 100 points. Cat Info has a printable list of foods and their nutrient composition. you want 10% of calories from carbohydrates or less. Low carb wet food is preferred for all of your cats; classic Friskies pates in the 13 0z are pretty economical. If, after reading the Cat info site you still wish to feed dry, there are very few that are low carb - Wellness Core and Evo Cat and Kitten are 2 of them that maybe found locally.

If you ARE giving insulin already, focus on home testing with a human glucometer such as the Walmart ReliOn Confirm (aka the Arkray Glucocard 01 from our shopping partner ADW - link at top of page). you'll need a decent meter, ample test strips, lancets (26-27 gauge at first), and possibly a magnifier (my eyes are cr*p!)

My signature link Secondary Monitoring Tools identifies some supplemental methods to monitor your cat.

 

yes, cost is important but..you are going to save lots of money by home testing - there is no need for expensive 'curves' done at the vets ( I was quoted $200 per time) as you can do just the same at home and have Smokey much more relaxed.

Also, there is a reasonable chance of remission on the better insulins - I only bought 1 vial for Honey (approx. $125) which lasted for the whole 4 months that she was on insulin.

 

Primer on Humulin covers N type insulins.
(Lente and ultralente are no longer available.)

These last roughly 6-8 hours in most cats.

Lantus, Levemir, ProZinc, and PZI insulins are preferred for their longer durations.

 

Yes, what's best for Smokey is best. I am going to research the cost of the glucometers and test strips, I do plan on checking the one from Walmart that I've heard about on here a couple of times already. I could no way afford, nor would I want to have to stress Smokey out by taking him back to the vet so often to do a curve, but seeing as he was just diagnosed I will be taking him back in for a check after the weekend. I also have some fancy feast classic (which is what I have read would be better than the flaked kind) on the way home tonight for kitty "dinner".

 

It just amazes me the things I have learned here and elsewhere online that were not brought up on the day of diagnosis. I suppose maybe the vet was just trying to ease us into the transition, but I do plan on speaking to a different vet on Monday, whom I have dealt with before and liked. Not that anything was wrong with the one who gave the diagnosis, I've just had better experiences in the past with Dr. McNeal. Our vet that we had used for years passed away a couple of years ago, so we are trying to learn to trust and build a new relationship with McNeal whom took over our old Vet's practice.

 

Can you tell me how many units Honey was taking a day? Thanks!

 

.

 

Just making sure with your question on how many units Honey was taking....her kitty, Honey, was started on Lantus, not N insulin.

 

Doses for Lantus may start as low as 0.5 to 1.0 units every 12 hours.

A lantus pen has 3mL at 100 units per mL for a total of 300 units.

Ex. 2 units per day - 1 unit am and pm, 1 pen would last 150 days (kept refrigerated and an a stable fridge shelf, not the door)

Ex. 4 units per day - 2 units am and pm, 1 pen would last 75 days.

 

According to our vet, Smokey was spilling ketones. nailbite_smile I don't know anything about what ketones are or what they do to my poor boys body. I am so confused and stressed, I really want to get this right for him. I am going to get him a glucometer tonight or tomorrow and start testing him. Now, as far as doing the test, how does that work? Do I test before or after food/insulin?

Also the vet I wanted to see is on vacation next week. I'm not sure exactly what they wanted to do, but I wasn't going to question the vet. I figured she would know more than I would about what was best, but I am starting to question alot of that..

 

Ketones are by-products of fat breakdown.
Excessive fat breakdown occurs because there is insufficient insulin to use the carbohydrates for calories.

Too many ketones result in diabetic ketoacidosis, a potentially fatal, expensive to treat, complication of diabetes.

Pick up urine ketone test strips at the pharmacy.

In my signature link Secondary Monitoring tools are some tactics for using them to check for ketones.

 

Testing - When and Why

1) We test before giving insulin (pre-shot) to make sure it is safe to give

2) We may test at +2 hours after giving insulin to see how fast the glucose is dropping. If the numbers suggest the drop may be too big, we'll continue testing every 2 hours (or sooner if it looks like it'll get below 50) to identify if we need to intervene.

3) We test around the expected low point to see how low the glucose goes. For Novolin, this is around +3 to +4 hours after the shot. For Prozinc, this is about +5 to +6 hours after the shot. For Lantus, this is +5 to +7 hours after the shot. For Levemir, this is around +6 to +8 hours after the shot.

4) If the glucose goes below 50, we'll start a testing/feeding/15 minute wait and repeat process until the numbers come up to a safe level.

5) When we have stable dose management, we'll do a curve - testing from pre-shot to pre-shot, every 2 hours.

 

With Lantus, I've discovered a few effective cost-cutting methods.

• Request a prescription for the Solostar Pens from the vet. Lantus can start losing its potency after 4-6 months (make sure you keep it refrigerated and there is no need to roll it!). Since the vial contains quite a lot more insulin, you end up losing quite a lot more insulin in comparison to the pen.
• Sign up for the Lantus Savings Card online and print it out to take with you to the pharmacy.
• Call around and find a pharmacy that will sell the Lantus pens individually (instead of in the box of 5). I had luck with my local Walmart, others have had luck with Mom&Pop pharmacies.
• Make sure they also take the Solostar Savings Card (most all places, including my local Walmart, should since it's a manufacturer's discount).
• Finally, pay only $25 a pen, which will last you quite a few months (usually to the last drop).

 

Pleae pick up either Ketodiastix(tests for ketones/glucose) or Ketostix(tests for ketones)...in pharmacy..used for testing urine for ketones. If your vet said Smokey was spilling ketones, then your vet should have explained them to you and maybe given you fluids at least to help flush them out. Ketones are nothing to mess with or to wait on to treat. Ketones can quickly escalate into DKA which needs vet intervention and hospital stay. A cat's breath will have an nail polish remover smell to it.

So far this vet is scoring ZERO for helping you or being up to date to Feline Diabetes. Please at least get the Ketostix and try for a urine test on Smokey tonight and let us know.

 

The vet did give Smokey fluids at the vet, just to clarify. It's been a long couple of days, it slipped my mind to mention in my earlier posts. He wouldn't eat or stay awake for more than a few minutes at a time before the vet visit, so I am seeing improvements.

About my vet, I agree, I do not care for her either or how much information was given to us upon diagnosis, which is why I am going to try to get in to see the vet that I liked from previous appointments, or possibly call around and see if I can find a vet who deals with FD. We are doing the best we can with what we have right now. We have one car and someone who works full time in the home as well, so we will do what we can as soon as we can. I appreciate everyones concern and information. I have alot to look over and alot to learn about FD. He means alot to me, I've had him since he was a kitten, so I plan on doing the best by him that I can, which was my reason for coming here. I didn't feel like I got alot of information from my vet, but I didn't realize that until I came home and started looking online and saw how much information was out there, and how much there is to FD. She didn't mention testing his BG, nothing. So I am not happy with her at all either, and will not go back to her if at all possible. IF I HAVE TO, I will be going loaded with information and asking many more questions. It is up to my parents who also may be on this board under this name from time to time, because at this point they are the ones who are paying the bill.

I am breathing a (exhausted) sigh of relief to a point, only because I have seen a huge turnaround in the last 48 hours. I didn't know if all this was caused by an obstruction, or what we were dealing with. If it would have been an obstruction and we would have needed surgery, that wouldn't have been an option due to finances. So, all considered, I am greatful that this is something that can at least be dealt with. Tomorrow before my dad goes to work I do plan on going to walmart to get the BG meter, and check into the ketone test strips as well. Thanks to everyone who has posted so far with info!
-Kim

 

Kim, just post back tomorrow and let us know how Smokey is doing. All kinds of help for testing too.

FWIW, this board is covered 24/7 by people all over the world. When we are asleep there is usually someone up and on from the UK at least and the difference in time zones also help us.

 

I sure will. Thank you again.

 

Good day everyone,

Just came to touch base, when I fell asleep last night I FELL ASLEEP..lol. It had been a long couple of days.

Anyhow,
I am going to be off to Wal Mart to get Smokey his meter and testing strips here in a few minutes, as far as the ketone strips,.. can anyone tell me where those can be purchased, other than online? Also, how DO you collect urine to test on a cat?? I am going to look up a guide to see what his numbers are, and check into how to do a curve at home.

I am really appreciating the support I am getting here, as who I am dealing with at home, the support is so so. My mom is trying her best to do what's right (what SHE thinks is right) but it seems like any time I say anything (including wanting to test his BG, switch him completely to wet canned food, etc) is a huge arguement. I can't deal with it anymore, so I'm just not going to bother to make it a conversation. I am just going to do it. Luckily, (not really, but as far as giving care to smokey) I am unemployed atm. So I am home all day with him and can monitor him.

Does anyone have tips on trying to switch him to a wet food diet? He seemed to be a dry food (more so treat) addict, and he licked the gravy off the fancy feast last night, but didn't eat the flakes. I am going to pick up some fancy feast classic today at wal mart as well.

Hope everyones having a good day!
-Kim

 

Kim!
welcome to the board

You can get Relion Ketone strips at Walmart. Heres how to test urine: https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

Also tips on transitioning to canned:
http://www.catinfo.org/docs/TipsForTransitioning1-14-11.pdf
Wendy

 

Thank you Wendy! This board and the people here.. WHAT A BLESSING!!

 

You may have to ask pharmacist for the Ketostix.......may be behind counter.

 

Awesome, I absolutley will. Thank you!

 

Does any one have any experience or knowledge about the Relion PRIME BG meter? I see the strips are $9 for 50 compared to almost $20 for 50 for the confirm. Just trying to save where I can.

 

Prime is great and cheap but it needs a little more blood than the Micro and the Confirm.

So it depends on how patient you are - once you are used to testing then the Prime will be fine but at first you might find it a little more challenging if kitty isnt a good bleeder. We have lots of tips for this though so as long as you dont panic and be prepared for possible testing issues at first, the prime is fine.

 

Ok, thanks wendy. Im going to just go with the confirm I think, as I don't know how he bleeds.

Also, have a vet check on Monday for him to get his BG tested there. I plan on taking the readings from over the weekend and any questions I have to compare. I am going to Wal-Mart in a few, I'll check back in later.

 

When you go to the vet, test him before you leave for the vet, then test him again when you arrive at the vet, and if it's a long visit, test just before you leave. Once you get home, wait about 30min or more and test him one more time. You want to know on your own meter, if his numbers are greatly affected by the vet visits.
One of my cats went quite high when at the vet but came back down once she got home again.

You also may want to compare the numbers you get on your meter with the meter your vet is using, just as a comparison. You do not need to get any fancy pet meter, but do want to show the vet that are you doing fine with your own meter.

Once you have your numbers in a spreadsheet, you can email the link to your vet to see your numbers anytime.

 

Later on, you can always switch to the prime and keep the confirm as a back up.

 

.

 

Hi guys,

I am having a really hard time getting blood out of his ear. I bought the 26g lancets. I watched many tutorials on youtube, tried warming the ear with a warm washcloth, and rubbing the ear between my fingers. When my dad get's home from work, I can find out what kind of lancet pen he has, other than using the pen, I'm open to any suggestions/feedback. I apologize if this is in the wrong forum.

 

Everyone has problems at first - its partly not knowing what you're doing and partly because Smokey's ears have to learn to bleed (develop more capillaries) as time goes on.

More testing tips: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Do you want to see if someone will come out and help ? You're in the Detroit area, right ?

 

I find a few things are key

1. if you are using the pen, dont. The lancets along give you more control of angle and depth. Go in at a 45 degree angle.
2. Make sure the ear is really warm. Give it a massage for a good minute.
3. Look to see the vein with a small flashlight. Try poking the vein itself (not ideal long term but good to get you started at least)
4. Do two small pokes in the same area
5. Have something hard behind the ear to press against.. a pill bottle or something. Many new people are so scared of hurting their cat they dont press hard enough

Give a treat even when not successful!
let us know how you get on!
Wendy

 

Hi everyone,

Still not having any success with getting blood. I noticed a small bruise today too I feel bad, I dont want him going through more pain than he already has or than is necessary. Denise, I sent you a PM. I would love to have someone come out and help me, but this isn't my house, so I'll have to see if it's okay. Just because it's someone that we don't know, I don't know how comfortable my family would be with it. No offense as I would be SO GREATFUL to anyone who was willing to take time out of their day. I'll see what I can do, god knows I could use some help. When I saw that bruise, it broke my heart. I don't want to keep poking him when in the end it's for nothing, because I'm getting no blood. My poor lil guy.

 

You do get a few bruises at first. Make sure you apply some neosporin and it will be fine

Wendy

 

Thank you Wendy, I will do that now.

 

Just remember to apply pressure,,,,even putting two fingers on top and underneath ear where you poked, to stop bleeding and it helps minimize the bruising. New ears, need to "learn" to bleed and eventually you won't see any bruising. It DOES NOT hurt them but their people think it does. Mishka alone has been poked for close to 9 1/2 years, always her right ear ( at least to me because her back is to me and sitting on my lap) and always from the tip to maybe 1/2 way down and no vet would be able to tell what ear. She also gets more than her 2 ps tests because I do spot checks also and before I leave the house for any reason.

 

Kim, FWI, many of us have gone to homes to help and I understand your feelings also. We also take a chance, especially with the cat who doesn't know us at all. I remember one gorgeous Maine Coon when I walked in coming up towards me growling and swishing that tail nailbite_smile I explained everything to the owner, showed her all the stuff, had her sit him on her lap with his back to me and stuck him. No problem, don't think he even knew I did anything and by showing her she saw how easy it was and how to do it and he lived anothe wonderful 4 years because of hometesting helping her to help him.

 

Hi Everyone,

I just registered today because I am getting absolutely no information from my Vet on how to deal with managing my cat Simba's diabetes. When I took Simba to the Vet on the 12th of this month, his glucose level was 557 - a diabetic for sure. I started his insulin injections of 1 unit twice a day on the 15th of this month. The vet prescribed Novolin which I got at Walmart. He also gave me a bag of Purina Diatetic Maintenance dry and wet food to feed him instead of what I was feeding him before. I was sent on my way with no instructions and no follow up appointments for further blood work or monitoring to see if the insulin dosage was working or not.

Well, that is why I am here. I am at my wits end because Simba does not seem to be getting any better. He used to be so energetic and playful and now he just wants to eat and drink all the time and then go hide under the bed to sleep. I want the old Simba back!

I found out on line that I should be checking his blood sugar level myself so I immediately went to Walmart and got all of the supplies that I needed and tested his blood and his glucose level was still a whopping 391. The testing was much easier than I thought it would be and he really didn't seem to mind it at all.

Since I cannot get any information from my Vet, I am turning to you nice people on here. Should I take the initiative and slowly increase Simba's insulin dosage my self to see if I can get his number down or try to find another Vet and work with him on it? I was thinking of just increasing the insulin one unit at a time, test him and see if it is working. Good idea or not? I give him his shot of 1 unit at 5:30 every morning and 1 unit at 5:30 every evening.

Any help or advice would be greatly appreciated.

 

Clay, I responded in your other post which you started and I believe that is where most people will post to so keep an eye on it.

 

Just following up to see how the testing is going.. if at first you dont succeed...

 

Hi everyone,

I'm still having an impossible time testing Smokey. He's been so stressed out, which is no good. I have been trying to take it easy on him the last couple of days. Trying to convince my parents to allow me to have someone come over to help me. I totally understand it's a risk for someone to come over and take time out of their day to help Smokey and I. (Which if I end up getting the OK, if anyone is awesome enough to come over and show me, he's the SWEETEST most CHILL cat I have ;-) ) If it were up to me, and me alone, I would have done it already. I did get a little blood out of his back paw, because I was not going to continue to poke his ears over and over and over for nothing. But I did not get enough blood out of his paw to test. I don't believe he is dehydrated, he hasn't been drinking as much as he was, but he is drinking water, I just think he's a bad bleeder.

I'm doing the best I can. I want him to be happy and healthy though. If he's miserable because I'm constantly coming at him with needles, that's not good either. I understand he needs to be tested.. and I'm faithful we'll get there. I plan on trying before nighttime feeding again tonight. If I can talk them into allowing me to have some help come over, I will let everyone know. I'd really appreciate the help. I feel like I've been obsessing about everything that needs to be done, and I'm trying to keep my stress level down, so that I can keep his down as well. I did test his urine this morning with the ketone sticks, and it seemed to be negative, so that was a plus for sure..

 

Let us know if you need hands on help and we'll see if anyone is nearby.

The secret for us was to warm the ear thoroughly - with a very warm rice sack for a minute or more. And have big enough lancets. The 31 gauge used by humans is usually too small at first. 25-27 gauge works better.

 

VICTORY!!

Ok, I spoke to my dad, and he's totally fine with someone coming by to help Smokey and I. If anyone is in the area, I could definatley use some hands on help. I would owe you big time. This has been quite a stressful journey, any help would be a god send. Please let me know if anyone in the Metro Detroit area is willing to come by and show me what to do! I am about 20 miles west of Detroit. Close to 275 and Michigan Ave. Also the meter I have is the Relion Prime, which uses more blood.. I think .05 and the confirm was .03. Next week when I get paid, I am considering taking the Prime back to get the confirm, but I can't afford to buy the strips for the confirm until then. Whew. So glad I got the ok. Please let me know!

 

oh i totally know someone in that area, long time member of fdmb too. unless she's moved she is in the metro detroit area. i'll message her and point her here. her name is Phoebe

 

Just heard from Kim and she was able to get a little blood this time - still not enough for the test though. I told her if she can to try tonight or tomorrow again.

Kim, you are doing great! Just keep trying and I know you will soon be able to test!

 

Hi Kim,
I live up in Novi area and work in Plymouth. Last fall, my hubby and I also helped another gal in Westland with testing her kitty, O'Malley.

I will send you a PM with my cell phone (text messages are fine). If it works out, I would love to connect you with Sarah, who lives in Westland and has been doing very well with O'Malley for the last 6+ months. (i will need to text Sarah, as she doesn't post here every day).

gotta get to work now --
phoebe

edited to add - I see that you're near 275 and MI Ave - I might be able to come during my lunch break today or tomorrow -- check your Private Messages (PM) for my message with cell phone number.
Another possibility is my husband might be able to come on Friday. I just checked with Sarah / O'Malley - she is working double shifts, so she can't come over this week.

 

Oh, wow. Thank you Phoebe! That would be awesome. I got the OK to switch to Lantus, so were going to start that this evening too. If I can get enough blood out to test this evening, I'll post later. I will be lurking on and off this afternoon as usual! THANK YOU to everyone for your help!

 

Sometimes that tiny difference between a drop of blood and a drop of blood is the difference between success and failure when first starting out. The Micro/Confirm does require half the amount of blood, but you're right; the strips are much more expensive. My suggestion would be to still keep the Prime for future use once Smokey's ears learn to bleed better and you guys have both gotten more used to testing. It's also great to have a backup meter anyway. Mikey once managed to knock his glucometer into his water bowl (they were nowhere near each other and I think it might have been purposeful...) and I had to wait a couple of days for it to dry out before I could use it again. It wasn't a big deal because I had a backup meter, but imagine if I didn't have a backup meter and he'd done it one of the numerous times he was running low numbers at 2 am! :?

Also, you can't return diabetic ("blood") supplies to the store, but have to contact the manufacturer directly for a refund, so it might be more trouble than it's worth.

 

I simply use Wikipedia's link to Blood Sugar Guidelines in cats for help in determining what numbers are "good."

ETA: The numbers on the Wikipedia table are what you see with human meters. (A 70 on an AlphaTrak, a pet meter, is hypo territory vs. a 40 on human meters.)

Another handy "numbers" list, since you're going to be using Lantus, is the "typical" curve:

When I was first starting out, I printed both of those off and made little laminated (well, scotch-taped :lol: ) reference cards that I kept in Michelangelo's glucometer bag. They're also useful for surrogate testers (like family members who don't test as frequently).

As for keeping track of numbers, here are the instructions to our amazing spreadsheets and also how to create a profile and update your signature.

 

A quick run-down of common terms:

• Fur shot: when the syringe needle pokes through almost like a sewing needle through fabric and it is unknown how much, if any, insulin actually made it inside the cat. Usually detected by wet fur or the smell of insulin (it smells like band-aids or scotch or antiseptic). IT IS ALWAYS ASSUMED THAT THE CAT GOT THE INSULIN AND YOU NEVER GIVE ANOTHER SHOT. It is always better to miss a shot than to give too much insulin.
• AMS/PMS: morning (AM)/evening (PM) shot
• AMPS/PMPS: morning pre-shot test/evening pre-shot test (it's assumed the shot is given within 15 minutes or less of this test).
• +1, +2, +3...: How many hours after a shot, i.e. +1 would be one hour after their last PS (pre-shot) test
• BG/BS: Blood Glucose or Blood Sugar (numbers). Usually used in relation to testing and dosing and what "level" or "point" the cat is at. Used in a sentence: "Michelangelo's BGs have been high so I've been increasing his dose."
• AMBG/PMBG: morning/evening Blood Glucose. Used when no shot has been given at the regular shot time.
• Condo: In Lantus Land, this is your daily post about your cat. My suggestion is to browse through a few condos to see how people post on a daily basis there and start posting yourself. You do not have to be following Tight Regulation to post here; you simply need to be home testing with some frequency (at minimum 3 to 4 times a day) and have your spreadsheet set up for others to view.

And, as always, when in doubt, ask! Around here, the only bad question is the one that goes unasked. ;-)

 

I can't say thank you enough to everyone! I've learned so much from this board over the last week, can't imagine not having the access to the information I've gotten here. I give Smokey his insulin as close to 8 AM/PM as possible. With him being so used to free feeding, it's been a little trying to get him to eat enough food to give him insulin, so I usually give him about a 30-45 minutes to eat, and will give him insulin about 20-30 minutes after he started eating. I'm hoping that over time, he will get used to having meal times, and he will eat a bit more. During the times where I have to coax him, I will try talking him into eating more, (which actually has been working, most of the time!) if that doesn't work, I try putting on his paw/nose/side of face. As a last resort, I will use the syringe. Don't want to do that unless I have to, the last thing we need is him to develop food aversion!

 

Actually, once you switch to Lantus, you don't have to make sure they eat at shot time. As long as they're eating throughout the day (most specifically around peak/nadir/+5 to +7), you should be fine. You can go back to free-feeding if that is what Smokey prefers (yes, you can free-feed with wet by adding water to it, freezing it, and/or using timed compartments). The only thing recommended is for the food to be picked up ~2 hours prior to shot time so as to not affect the PS BG number with an artificial spike from food.

Another secret to getting them to eat is sprinkling their food with Parmesan. This works like a charm EVERY time I use it on my cats (usually to get them to eat cold food I took straight out of the fridge).

 

I will try the parm tonight if he's being his usual picky self! :lol: My dad was a sucker, and spoiled him with treats (too often for my taste) so, he's getting used to eating food more often now. I am going to get to petsmart this weekend and grab some freezedried treats for him. I hope he likes them!

 

Having them eat before the shot is most important for NPH insulin because it hits pretty fast.

Lantus and Levemir are gentle and free feeding during all day / all night is ok.

 

Yet another upside to the Lantus! lol I'm so happy I convinced my vet to switch. She told me the NPH"is what they use" at her office. It makes me sad to think about the kitty's whos owners don't have a computer or don't take time to do the research.. If my printer was working correctly, I'd print out some of the information I found online about FD and NPH insulin, and take it to her next time we go in..

Oh, and I was finally able to make an avatar! Everyone.. please allow me to introduce you to Smokey on left, (aka Mokey Monster or Mokey Moo), and his son, Anton (aka TT or Mr.T) on the right. ;-) Smokey says thank you as well!

 

Well,.. good news is, I got enough blood to test...
Bad news is, his BG was 497... I fed him, and as he was eating gave 2.5 U of Lantus.

I will be checking it again in a few hours, and will post results if still extremely high.
I really hope the Lantus works, the NPH obviously wasn't working well at all.

 

What cutie pies! cat_pet_icon

Congratulations on getting blood! :thumbup Remember, Lantus should be given as close to every 12 hours as possible, so if you gave him a shot now, the next shot will have to be 12 hours later from now. Also, be patient. You might see higher numbers the first few days as the Lantus depot fills and this is normal. Don't change the dose over the next few days unless at any time he drops below 50, then immediately drop the dose at the next shot time.

 

Kim

I am going to ask some of the Lantus users to look in on you. I think you might have dosed him a little to high. But they have been doing this a long time and can help you with the dosing.

Terri

 

Thank you. I was giving 3u of nph after giving him 2u at the beginning. Both at the direction of my vet. Just for a little backstory. I will test again, at +2, +4, etc... I switched ears this evening. Should i keep switching ears? I just don't want them getting sore.

 

Kim

I have asked for help, NPH is a totally different kind of insulin and you need to test many times with it, its old school and no one uses it anymore.
Lantus dosing is usually based on cats body weight and just dosed twice a day at twelve hour intervals. I am trying to get someone over here for dosing help. You are doing a great job. You got him a great insulin, I just don`t want you to give him to much to start.

Terri

 

Oh boy - Did you give him the same amount of Lantus as you were of N? That may be too much.

The initial recommended dose for Lantus = (the lower of ideal weight or current weight in pounds) / 2.2 * 0.25

Lets figure out if that might be too much:

What are his ideal and current weights?

OK - someone told me he currently weights 15 lbs
divided by 2.2 = 6.8 kg
times 0.25 = 1.7 units

He might be OK, but!
just in case - do you have Karo syrup, some high carb gravied foods, an oral syringe and lots of test strips (like 50)? You've got a couple of hours before it starts really kicking in if you need to get any of that.

 

Kim

His ideal starting dose of Lantus should be NO higher that really 1.5 units based on body weight every twelve hours.

Terri

 

Oh god.... Karo.. No... Syringe and wet food yes. Now im freaking out. His ideal weight? Im not sure. Right now hes 15.5

 

Im looking for karo now. Just in case..

 

Thanks for checking, Terri! I was also a little worried about Kim starting him at 2.5u (depending on size, most cats don't need more than around 1 to 2u if they're being feed wet, low carb food). I just don't know enough about starting dose recommendations to help with this so the best advice I can give at the moment is test frequently to make sure he doesn't drop too low and have your hypo kit ready in case he does. Again, because Lantus utilizes a depot, you might not even know it's too high a dose until 3 days later!

Do whatever you feel comfortable. I mainly test Mikey on his right ear because it bleeds better than his left and is easier for me to get to in the position he prefers to sit in when I test him. Smokey's ears may be a little sore the first few days/weeks (and will probably look terrible, too), but it will all clear up with a little bit of time, so don't worry.

ETA: Thanks, BJM! I knew there was a formula for initial Lantus dose somewhere and couldn't find it fast enough. :lol:

 

OK

Don't panic - this is manageable.

You need gravied foods, Karo syrup/honey, lots of test strips, and an oral syringe.
Have you got them? If not, go get them NOW or send someone.

Do NOT feed dry food - it expands and the cat vomits.

The basic hypo protocol is:
test for low levels/large drop
Feed 1 -2 teaspoons of gravy if he's going low
wait 15 minutes
test again
repeat until he is safe

 

Found karo. Gave lantus at 6pm. Its almost 7. When should i test again?

 

Test now.

Is it OK if I round up a few troops - I've got something scheduled shortly.

 

I'd test every hour until you either see a sharp drop (i.e. from 497 to 230) or he tests under ~150 (or maybe 200?). Then switch to half-hour testing till he starts to rise again for at least 2 tests in a row that are not food-induced rises. If he goes under 100, I'd be testing probably every 15 minutes and have the high carb food and karo syrup close at hand in case it's needed.

 

Its actually Kroger light corn syrup.. If it matters.

Being 15 lbs, and eating diabetic dry at this point. He's a dry food addict, trying to slowly switch atm. Im hoping he will be okay. Esp with numbers this high. He was over 500 at the vet monday. I know not the best, but the only # i have to compare to right now.

 

A question worth asking is what syringes were you using to give the NPH (I think this is dosed with u40 syringes??? :?: ) And what syringe did you use to give the Lantus (they should be u100).

 

OK. The diabetic dry isn't great as it will swell if as it gets wet in the stomach.

If he starts getting down under 100, you may need to syringe feed a mix of the corn syrup and some wet food - about a teaspoon worth at a time, or put a blob on your finger to give it to him and maybe rub corn syrup on his gums.



I'm a "be prepared" kind of person, so just in case, (and we are nowhere near that) have you a carrier, transportation or friend who can transport, and know the nearest 24 hour vet services? If you stay on top of this, you likely won't need it.

 

I know of a 24 hr vet. But i have 40 bucks to my name, so hopefully it won't get to that point.

 

hi Kim

did you manage to get a test?
The dose may be a little too high but he'll probably be fine - his depot is empty so that won't be affecting anything.

Obviously the blood tests will show exactly how he's doing so as soon as you get a number, post it and we can take it from there.

Don't worry - there are lots of very experienced people around!

Denise

 

Kim

which syringe did you use to give him his shot the U40 that you used for the NPH or the a U100 that should be used for Lantus?

Terri

 

I understand

I've contacted a few folks who've been through this to come monitor.

And as I noted - he may be OK, but being prepared is a good thing!

Take some time to read over this hypo protocol as it is possible you will need to do this.

And please keep a running list of the tests in your posts here, so switching to the spreadsheet isn't necessary to track how it is going. It'll be faster.

I've got to head out; I'll check back as soon as I'm able. Several folks will be helping you.

 

1.5 hrs after shot... 581... Ill check the syringes..

 

NPH is a U100 insulin just like Lantus but that is where the similarities ends....How much Lantus was given and when?

Sorry trying to play catch up here and figured it was easier to ask than scroll through the posts

Mel, Maxwell, Autumn & The Fur Gang

 

Mel

She gave 2.5 units at 6pm but trying to figure out what syringe she used if it was u40 or u100 she used. He was on NPH previously.

Terri

 

A quick Summary:

PMPS 497
2.5u Lantus given U100
+1.5 581

ETA: Had some weird board flukiness with this post. :?

 

The U100. I checked the boxes, they are both U100 insulins.

 

NPH should also be a U100 like Lantus. U40 will have a red cap ....U100 an orange cap

Mel, Maxwell, Autumn & The Fur Gang

 

Hi, his BG was 497 at 6pm, gave 2.5u lantus. Now its 730..bg 581

 

Okay so we know it truly was 2.5u of Lantus...<gulp> Well guess you are going to learn to home test with a trial by fire, but it will be okay...done this many many times.

Mel, Maxwell, Autumn & The Fur Gang

 

On set for Lantus will be right around +3ish so its normal he would be still rising at this point, problem is Lantus lasts much longer in the system than NPH...so you could be in for a long night. Hope you have plenty of strips, coffee, corn syrup, HC food etc. BTW the coffee is for you.

Mel, Maxwell, Autumn & The Fur Gang

 

For future.. I called my vet again, she says because his numbers have been running high, to go with 2u of Lantus.

We started with the NPH... were doing 2U for about 6 days, no improvements in BG according to readings at the vet. I couldn't test at home, but based on the #'s I'm getting now, I'm going to assume they were close to accurate. After there were no improvements, she upped him to 3u of the NPH.

Now, I know that according to his weight, it should be 1.5 to 1.75 of Lantus. So, for the next shot, assuming his numbers don't DROP low tonight, should I do 1.75 or 2U? I'm so confused, and stressed out. I know it will be okay, and this is going to be an ongoing battle, I just feel like I'm getting nowhere. Trying to stay positive and as stress free as I can, but it's hard. I want what is best for him.

 

Thank you Mel. I will test again around 9pm.

 

Kim

Dose based on weight is 15.5 lbs which is 6.8kg times .25 = 1.7 units of Lantus. That is the formula for dosing.
I would give him no higher than 1.5

Terri

 

Well there are two different protocols for Lantus ...either start low, go slow where you would start him out no higher than 1u, or the Tight Regulation where the starting dose would be based on weight...my preference with my diabetics ( I have two) is the Start Low Go Slow. I would rather them be high a little longer than go too low for a minute.

So going forward would depend on which protocol you are going to follow.

My personal recommendation would be to start at 1u, hold for a week if not enough increase based on the nadir readings...You can always add insulin you can't get it back out once it is shot.

Mel, Maxwell, Autumn & The Fur Gang

 

And then if his sugars don't come down after a week go up from there by .25? Am I correct (or close lol) on that?

 

Yep you will either go up by .25 or .5 depending on where his lowest point it...generally if his nadir is still above 200 you go up by .5 if below then by .25

I need to step out briefly to go test feed and shoot my girl and the rest of the Fur Gang then grab a very quick bath, but you will be in good hands with Terri until I can get back on.

Mel, Maxwell, Autumn & The Fur Gang

 

KIm

Mel has much more experience than I do follow what she says. Please do whatever she recommends. Mel has a couple of diabetic cats at the present time.
I am only giving the you the basic calculation for dosing.
What I am giving you is the Tight Regulation dosing.

Terri

 

Well, first try getting him fully off the dry. ;-) But yes, according to the "General" Guidelines, you would most likely increase by .25u. If you've already started posting in Lantus Land by that point, you'll be assisted with when to increase the dose and by how much.

 

Thanks to you both!