Help No Idea What to do....

I just found out that my beloved Babygirl, 14 years old, has a sever Diabetes problem. I took her to the vet, and her labs was 400. Was told by the vet normal is 65 to 150. She has lost weight, drinks always, pees like she has a river inside her. The vet has told me she needs insulin twice a day, a prescribed diet, and 4 checks at his office, once each week, to check her gluclouse level. I don't know what to do. She is very sick, and I love her with all my heart. However, I am limited on my income, only social security and some part time work. I have estimated over $500.00 in the first month between vet checks, medicine, food, and that does not include the complete panel he wants to do on her again, in a month after he gets her insulin right, to see if she has other problems because it is sever. I am truly at my wits end! I have cried until I can't cry anymore. I have a very supportive son, but my husband thinks we should put her down. She IS a member of the family as far as I am concerned. Any help, guidance, anything is so very appreciated. I am trying to educate myself, but it is so much to take in. I pray there is a way I can help my Babygirl, that is within my means. I feel asthough I have to try, try to save her life. I have read that my cats just like her, get regulated and live great lives. I want so much to believe this can happen with my cat too. Thank you all in advance, and God Bless! :sad:

 

We can help! The first thing is that your sweet Babygirl does not need to go to the vet for monitoring. Diabetes is a disease managed at home. You can buy a ReliOn meter at Walmart and keep track of her levels. We can teach you how. That will save you lots of money. The other thing you can do at home is give her a better diet, that can dramatically reduce the blood glucose levels. If she is not on insulin yet, you can start feeding her a low carb diet. A vet explains why here: www.catinfo.org. Lots of us feed Friskies pates which are inexpensive and low carb. Then keep track of whether her levels are reducing with the meter.

So breathe! Start doing research on this site - the more you learn, the more confident you will feel. Ask questions. Everyone who answers your post is paying it forward for help they received when they are new and terrified

 

Hi and welcome to FDMB

A diagnosis of feline diabetes can be scary and overwhelming. However, it is a disease that can be easily managed. Unfortunately your vet did not give you the best information. We can help you learn how to care for Babygirl and you can have many more years with her. Here is some info that will help you.

1) Diet - Your vet is wrong, she does not need to be on a prescription diet. Most are high in carbs and cats don't like the taste. Instead you do need to switch to a low carb/high protein canned or raw food diet. Dry food is high in carbs and you want to remove it from her diet. If you have more than one cat, the best thing to do is switch all of their diets. This could prevent any other cat from developing FD. Many of us feed our cats either Fancy Feast or Friskies canned foods. Pate flavors are lower in carbs, avoid any of the flavors with gravy. By just removing dry food and changing to canned food can significantly reduce your cats glucose levels and it may be possible that you will not need insulin or only need to give it for a short time.

2) Testing - you do not need to take her to the vet just to be tested. Instead we recommend learning to hometest. This means that you will test a small drop of blood from her ear before every shot. Even if you are not giving insulin yet, hometesting will also let you know how well a diet change is working to control her glucose levels. You can use any human glucose meter to test. Many of us use the Walmart Relion brand meters. The Confirm and Micro use the smallest amount of blood. There are pet meters available, but they are expensive to buy and use. Hometesting will also eliminate unnecessary trips to the vet just to be tested. Also, don't be surprised if your vet tries to discourage hometesting. Unfortunately that is a common response but often once what happens is that when your vet sees how well you manage her diabetes, it may change their opinion. Many of us have trained our vets. :mrgreen:

3) Insulin - If you do need to give her insulin, there are several that work well in cats. Lantus and Levemir are human insulins you will buy at your pharmacy. If your vet prescribes either one of these, ask for the script for the pens instead of vials. With the vials, the insulin will become ineffective long before you can use all of it. So you will end up throwing a lot of it away. The pens are packaged in smaller containers and you get 5 pens per package. There are also coupons on the manufacturer's website that will save you a lot of money on the pens. Prozinc and PZI are pet insulins. These you will purchase through your vet's office. All of these are good insulins and cats respond well to them. Avoid short acting insulins such as Novolin, Humulog, and Caninsulin. These have steep drops and do not last as long in the system.

With any insulin, you want to "start low and go slow". What this means is you start at a low dose, preferably 1/2 to 1 unit twice a day. You will stay at this dose at least one week before determining if you need to increase it. This is also where hometesting is valuable. Hometesting will also help you avoid giving insulin if her glucose levels are too low. This could be dangerous and cause hypoglycemia. Don't worry, we can help you learn all of this. If after a week, you (with our help) determine the dose needs to be increased, it is only increased by 1/2 unit and you will wait at least another week before another dose increase. By following this method, you will be able to find the optimal dose to keep her glucose levels under control.

Begin reading the information on this site and ask any questions you may have. There is a lot of experience people on this board and we are here to help guide you through the process which we call the sugar dance.

 

Friskies pates are one of the lowest cost over the counter canned foods under 10% calories (not weight) from carbohydrate.

 

Thank you so much for all of the advise. The more I read on this site, the more hope I have. I have decided to buy a Relion meter from Walmart, get rid of the dry food, and as my cat already likes Friskies pate I will switch her to that exclusively. I am wondering how many cans of food should I feed her. She has always been free feeding with dry food, and one can of Friskies, usually gravy, everyday for what seems like forever. Also wondering if I change her diet before I get her insulin, should I wait to give insulin or not. I will find out tomorrow what the vet is recommending for her insulin and how well he responds to me home monitoring. But regardless of what he says, I know I am a great caregiver, been doing it a long time. If I can I would much rather care for my Babygirl at home, than stress her with the vet. She hates the ride, the office, and the is scared of anyone there. Thank you again for your help, it is so greatly appreciated! I will post tomorrow and let everyone know what the vet says, as I value what all of you have to say. God Bless All of You, and Babygirl says thanks too!

 

A food change to low carb canned may drop the glucose 100 mg/dL within a day, so I'd change that first and work on home testing.

Vet stress may raise the glucose 100 to 180 mg/dL, so the home tests are more useful in determining how your cat is doing.

Those 2 factors combined may drop the glucose 200 to 280 mg/dL from that 400 found at the vet, taking it down to 120 to 200 mg/dL. That range is just a tad over normal, so some insulin may be required for a bit to help the pancreas recover. (Yes, it can do that in the cat!)

Start low with the insulin - maybe 0.5 to 1.0 units - so you don't overshoot the best dose for your cat. If your vet wants you to give more, say you are concerned about hypoglycemia while away from home.

While you work on testing, check out my signature link Secondary Monitoring Tools for additional assessments you may wish to make to evaluate your cat. In particular, you need to check the urine for ketones (or both ketones and glucose). Ketones form as a by-product of fat breakdown for calories. Too many ketones (more than a trace) may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat complication of diabetes.

 

If your vet is going to do blood tests, ask him to check Babygirl's B12 and folate levels (important for diabetic kitties).

 

hi, I know how scary at can be at first.

I'm not sure what the 'best' insulin is the US, but try not to go for the caninsulin (I think it's called huminsulin over there) That's what we all get started on in the uk and although my cat was doing ok when he was on it, it's not really recommended for cats. Since finding this board when my Angel was diagnosed at the end of May, I've found out that diabetes in cats is NOT a death sentence and if properly managed your cat can have a good quality of life. Angel is possibly in remission, he is on a trial of Prozinc which is not used in Uk at the moment, so he is helping future generations of diabetic cats in the UK.

Don't be afraid to ask questions here, everyone is so lovely and supportive x

 

Just waving Hi as you have already got tons of great info from the other folks that beat me here.

Also wanted to give you a little encouragement because you sound like a fantastic kitty mom so you'll catch on quick.

I have 3 diabetic kitties...yep 3 but guess what I also have 13 non-diabetics and the 3 extra sweet ones well I adopted them after they were already extra sweet. Now if you look down at all those names in my signature, you will see only 1 has a spreadsheet attached. Because out of 3 she is the only one still on insulin. If this was tough I most certainly wouldn't have adopted 3 with all the healthy happy kitties already here.

Maxwell will celebrate 4 years insulin free next month. Cassanova was up to 11u twice a day because his previous owners were following vet advice and just taking him in for tests and feeding him prescription dry. He was also a walking watermelon with legs at 37lbs. Yep he could have been a float in a parade.

I adopted him, took what I had learned from here, started testing him at home, started him on a nice diet of Friskies pate like everyone else eats here and his dose started dropping and dropping and dropping. Until September 8th of this year when he never budged out of the double digits and he also went into remission.

In the US the insulins you want your vet to prescribe are Lantus, Levemir, or one of the various flavors of PZI the most common one being ProZinc currently. The ones to avoid are Humulin N, NPH or vetsulin. Those onset very hard causing a steep drop and don't last a full 12 hours normally in a cat which causes them to shoot right back up again before the next shot time.

You are now in the best place you never wanted to be, but are blessed to have found. Keep asking questions and we'll keep answering. We are here to hold your hand and paw all along the way. And the best part, no office hours. Someone is always around to answer questions, lend a shoulder to cry on, and ear to vent to and hand out lots and lots of hugs and high fives when needed.

Welcome to the FDMB world of sugarcats and the folks that love them.

Mel and The Fur Gang

 

Thanks Mel for getting the Caninsulin US names right! xx

 

Ok, went to the vet to pick up the prescription for insulin, it's Novilin. He wants her on 2-4 units twice a day, along with a dry and wet combination of prescribed food. Then into the vet for gluclose readings every week for the next month at $30 a pop, just for the reading. I did not get to talk to the vet only the tech, she is also training me Wednesday how to administer the insulin. I got 31 gauge needles and a Relion Micro Meter and strips. However, the vet tech informed me it was a waste of money and time. She said you cannot use a human meter on an animal. Also told me that no sense in checking for keytone in a cat under a 800 reading. Also said she appreciated that I was trying to educate myself, but seemed to her that I need to take what you good people tell me with a grain of salt, that I will get overwhelmed with information and lose site of getting my cat better. Also said there was no place better for that then the vet's office. She said the dr. would not give me a prescription for the cat for a meter, so coupons are useless. Also said that the insulin is a 12 hour drug that peaks between 4-6 hours after taking, but it is the standard of treatment. Also noted that I said I was on a budget, so that's what they gave me. @-) I am so upset at this point. She, and the vet, seem to be dead set against doing home testing, and feel that I am over stepping my bounds and stepping on their toes. I feel like it is more about the money with them than my Babygirl. :evil: I do have a few questions, before I see the tech. Does this dose with the low carb diet of Friskies too much to start with? Also, I am unsure how much to feed my cat, as the vet tech was no help when I explained I was trying this diet instead of their prescribed diet. I am going to watch videos and read more articles so I can try to do a reading on Babygirl tomorrow. I would like to be able to do a reading on her at the vet when they do their first reading, if do nothing more than prove to my vet that homecare IS a possibility. ;-) I have one more question, how much is the insulin that others here use and recommend? Also, how do get a vet to prescribe it? I realize I may need a new vet, but really want to be educated if I have to walk into a new vet's office. I appreciate all your help, and Babygirl, because of all of you here, has so much hope now, as do I. I feel like she can and will get better. Even if she never comes off insulin, she can live a good long life, which is all I really care about anyway! God Bless and thank you again! :!:

 

Hi, and welcome! I just want to say that I think your 'gut' reaction to the things the vet is saying is spot on... it is sad to think it, but reality is that for so many (animal and human alike) doctors, it is far more lucrative to treat the symptoms and preserve the disease. This is your child, you KNOW inside when something isn't right, follow your instincts. You can learn ALOT just by reading the stickies here in the forum, go slow, its pretty overwhelming at first. I found myself reading the same articles 3-4 times each before they really sank in. (not that I'm a pro, lol, but comfortable at least)

Also, personally I would definitely NOT give that much insulin with only the wet food, until you have numbers to back it up and show how safe it is. As they say here so often, better high for a day (or even a week imo) than hypo, which can kill very quickly.

 

Hi there!

Babygirl's blood glucose may be elevated by stress during vet visits. Home testing gives more reliable BG readings upon which to base insulin dosing requirements. I got stung for a 3-day hospitalisation for glucose curves when Saoirse was first diagnosed. They must have seen me coming for miles ... :roll:

Follow the link below and then download a copy of the Managing Diabetic Cats PDF. The Tight Regulation protocol described in the document (used extensively by FDMB members) is based on a published, peer-reviewed study and it defines home testing as a fundamental requirement. The document also discusses the best insulin choices for feline diabetic patients. Hardly something one should "take ... with a grain of salt."

http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

It might not be a bad idea to have a read of it to familiarise yourself with its contents. Perhaps you could print a copy out and then use it as a basis for discussion with your vets? ;-)

Not only is home care a possiblity; with home testing you will get better data and you'll be helping to keep Babygirl safe. It will also give you more peace of mind through knowing more about her levels. For that alone, the cost of the meter and testing supplies are an absolute bargain. (worth immeasurably more than gold).

Blue meanie. :evil:

 

If the Vet does not support Home testing and will not give you a prescription for the meter??? That is Black Mail to a degree with your kitties life. cat(2)_steam

IMO, Time to find another Vet.

Meanwhile, read all you can here and ask questions. We are more than happy to help you out.

I have one kitty in remission after only 7 weeks. My other, is trying hard to do the same. She is just now coming up on 7 weeks.

This would NOT have been possible without the information that I learned here and from the people who care and help. And my vet supported at home testing.

All the best!

 

Do you need a prescription for the meter? I don't think it is required in the states I know about…..

N is a hard insulin to regulate with because it has a shorter, harsher cycle in most cats. It is cheapest but doesn't work as well. I would get the meter, figure out the hometesting and see where his numbers are with wet low carb food and then decide what to do.

If you decide you need a new vet, start a new topic with your city and state. Maybe we have a member who knows a FD friendly pet nearby.

 

If your vet is discouraging home testing, it might be worth considering finding a new vet.

Hang in there.... it seems overwhelming at first but you can do this.

 

You don't need a prescription for a meter! Just go to Walmart's diabetic section and get the Relion brand 'Confirm' or 'Micro'. Those take a smaller drop of blood which is important when you're just starting. I like the micro because it fits my hand better. You'll also need to get a pkg of test strips that fit that meter - it will say it right on the front of the box. They are $9 for 20, $19 for 50 or $36 for 100. It is NOT the one that's $9 for 50. You'll also need a box of lancets, NOT the 'Ultra thin' ones.

You CAN do this all by yourself!

 

Your vet is blatantly out of date.

Print out a copy of the American Animal Hospital Association Guidelines for Diabetic Dogs and Cats

It supports home-testing and using a long-actin insulin - ProZinc and BCP PZI both last roughly 12 hours in the cat, and work similarly to Novolin/Humulin NPH other than duration.

You may find you need to dose about every 8 hours to get good control with Novolin/Humulin N insulin as they generally last 6-8 hours in the cat.

 

Ok, got another question. Babygirl is 7 lbs, I am feeding only Friskies wet pate twice a day and am going to do a BG test before I feed her tonight. However I am unsure when I should test her after eating? Also how many cans should she get a day. She has a ravenous appetite, she has lost a lot of weight, so I am unsure what to do. Also not too clear on how to read the meter yet. I have a Relion Micro. I also bought her purebites treats. She is kind of ok with them after being rehydrated, but I am also unclear how much to give her. Also, can I feed her chicken breast or other cooked food as a treat if I don't add anything to it and only cook it without adding fat? Finally, for now, can I still give her catnip? confused_cat I hope so because she loves it, especially fresh picked off her plant! :lol: So many questions that I can't think of now. Also I am going to the vet for subq training tomorrow, any advise as I am very fearful of giving her shots? I will post her BG read after dinner, thank you all so very much!

 

Testing around the nadir, or lowest glucose level between shots, can be done +5 to +7 hours after a shot so you can see how low the cat goes. The lowest it should get is 50 mg/dL on a human meter.

A normal cat might eat 1/2 of a 5.5-6 oz can AM and PM. You may feed up to 50% more food right now because she isn't regulated. Add 1-2 tablespoons of water to increase the volume, plus spread it out in to 2-3 meals AM and PM. Spreading it thinly on the plate will slow down the eating a smidge. A timed feeder such as the Pet Safe 5 can do this if you aren't home. Go through our SHOP link above to check Amazon for it; any purchases made that way will help support this message board.

Yes, you may supplement her diet with up to 20-25% plain meat or poultry, raw, cooked, dehydrated, or freeze-dried. Just figure that as part of the total daily consumption.

Catnip is fine.

 

Ok, first test did not produce the blood I had hoped for. I realize now my lancets are too small gauge. However, Babygirl was a trooper about it. She laid quietly in my husband's arms and did not seems to mind the poke or noise at all. No treats eaten, as she does not really like the purebits. But that's ok, will try again tomorrow after getting bigger lancets. Hopefully I will have a reading to post tomorrow. However, my husband is being really stubborn about it. He read that human meter are just like animal ones and require no conversion, the read is the sme for humans and animals. I read however that the human meters are a different regarding animals, that you basically have to add 30 to it. Argh, I hate to argue with know it all! Anyways, she seems to already be doing better with just the wet food. At this point I have been feeding her 1 can of Friskies twice day, which seems to suffice for her. Now I am going to try to make some treats for her myself. Going to boil chicken tender for her, or bake it, and give that to her as a treat, of course not all at once. Does this sound right to everyone? I hope so. I knew this was a challenge going in, but my sweet Babygirl is worth it all and more!

 

Report the numbers as you get them; no adjustment.
We have pet-specific reference ranges using human glucometers; see my signature link Secondary Monitoring Tools.

1) All meters can read within +/- 20%.
2) The human meter estimate is 0.6 to 0.7 times the pet meter value; the human meter/0.6 or 0.7 estimates the pet meter.

 

i simmered chicken breasts for punkin, diced them small (1/2"), froze most of it and kept a couple of tablespoons out in the fridge for pokey treats.

just fyi, even with perfect lancets it will take about 2 weeks for more capillaries to grow in her ears. When that happens you will get a blood drop each time you poke. In the meantime, your poking will stimulate capillaries to grow - so even though it's frustrating to not get blood, you're helping the process. in a couple of weeks you'll get blood every time.

you want to give her enough food that she regains weight to a healthy weight. I don't know much about Novolin, except that it's not one of the best for cats. Sounds like you've got an issue with the vet -it's too bad they gave you Novolin, though. The pdf that was mentioned by Critter Mom above is the most recent document on the treatment of diabetic cats. In a study they showed that the longest lasting insulins have the best chance at getting a cat into remission, meaning that the cat becomes diet-controlled and not needing shots. That's about as good as it gets.

What we know (and that study shows) is that the sooner a newly diagnosed cat gets their blood sugar controlled and back into normal range (your vet said 65-150, which is on a pet glucometer, or 50-120 on your relion) the greater the chances the cat will go off of insulin. Time is of the essence in this. Being newly diagnosed is an advantage - make the most of it.

The 3 best for cats are Levemir (detemir), Lantus (glargine) and ProZinc. I'd choose in that order, although all are good. Lev is slightly cheaper than Lantus, and sometimes cats need an even smaller dose on Lev. Those 2 last about 12 hours in a cat's body. Prozinc is next best, in my opinion - it lasts about 10 ish hours. That document is very good - i'd spend some time plodding through it - it's worth the time. Another good document is on this page, especially the link on that page explaining the differences between Lantus and Levemir.

Hang in there! Everything gets easier as you learn more!

 

Ok, I have good news to report. I was able to do two bg tests on Babygirl tonight. The first read, before eating was 289, this is the actual read from the Relion Micro I got. Then she ate and I waited until about 35-40 minutes after she had eaten. The reading at that time was 348, actual read. I don't know if it's me, but it seems that the diet is working. The vet said her read was at 448 with her test when I first took her in. Now, after feeding only wet Friskies Pate twice a day since Tuesday, and no treats yet that she likes, just water to drink, she is already beginning to be herself again. She is moving around all the time, talking to people, jumping up onto her favorite perches, and really wanting to be social again. I almost forgot to mention, she has also began drinking less water and therefore having less urine. I have not checked her for Keytones yet, but that is the next step. I need to know what the reading I took mean. I have the Novilin, but have not given it to her as of yet. I thought I would take readings until next Monday, which is a full week on her food, and then decide if she really needs insulin at all. I know I will need all your help and encouragement to do so, but I pray she does not have to be given this bad insulin. I have already begun calling vets in the area and so far no luck, but I am not giving up yet!
I just really wanted to show my appreciation and graditude to everyone here! If not for all your help and guidance I would never have made it to this point. Honestly, I am very overjoyed at Babygirl's readings tonight. I thought it would be sky high, and no it is high, but not like the vet tried to say when he scared me to death!
Thank you again everyone, you have been a major blessing to me and little sugarbaby..Babygirl! God Bless everyone and all the sugarbabies out here! :mrgreen:

 

Those glucose numbers are sufficiently high that I would suggest at least a token dose of 0.5 units. You really don't want to risk ketones and high glucose may suppress her appetite enough that she'll break down fat for calories ... which generates ketones. Also, insulin will let her pancreas rest a bit which may enable it to heal.

Test, feed, wait 30 minutes, then give the Novolin if she was over 200 mg/dL on a human meter.

 

Thank you for the advise. I still have not had subq training from the vet tech, not until Monday. How hard is it to give an insulin shot and where do you do it? I have experience with giving shots, never directly into blood stream, with people but not an animal. If this is something I can learn to do myself, so I can give her a does tomorrow before her dinner, I would definitely like to try. Any advise on the subject is very appreciated. I am going to watch some videos on youtube in the morning, and hopefully wake up to more helpful advise here! Thank you again, and I feel I have to say that I do realize that Babygirl is going to need insulin, I am just unsure how to give it. However BJM already let me know how much to try at first. I can't begin to imagine not having this message board to talk to everyone. I would be lost without it, and at the mercy of my vet. Thanks, Goodnight, and God Bless! :YMHUG:

 

Hi Angiebabie,

I'm new to the board but boy all the apprehension and worry w/ giving a shot without hurting my cat is so fresh in my mind.

http://youtu.be/OL17BkgdQ0o This is where I learned a better technique from. It's nice b/c the demo is on a hairless cat so you can see exactly where and how to pinch the skin. I read somewhere else that the hip area is another good region which is what I do since Tyler loves to lay belly up and stretch out. Since then, Tyler doesn't even know or wince at all! It is so much easier, quicker, and he's stopped running away when I prep the syringe. It's also good to alternate areas where the shots are given.

Wish I had saved the links to the websites where I got this info but I'm sure someone here will give you really great, expert advice/add'l links.

 

hi Angie,

Not sure if you saw my post about vets in your other thread? As I said, I don't know if any are in your area. Good luck finding a better one x

 

the scruff is fine to shoot in. I shot punkin there every single shot for the 2.5 years he lived after his diagnosis. It may be something in how you did it, tyler's person. Basically you pull up a hunk of skin and hair, put the syringe pretty much parallel to the spine, and inject into the tent that is formed by pulling up.

You are NOT shooting into the bloodstream. You are NOT shooting into muscle.

The skin will separate from the muscle underneath - that area of fat between the fur and the muscle is where you want the syringe needle to go into.

Those are high enough numbers you need to start giving insulin asap. I wouldn't delay. Carbs from a diet-switch are typically gone by the next day, at the most 2 days. You don't need a week to see what's happening. As a cat's body becomes accustomed to high numbers it will accept that as normal, then it can become difficult to get them to accept normal blood sugar numbers as normal. If you're using a human glucometer, normal for a non-diabetic is under 100. For a cat getting insulin, we call normal 50-120 and try to get them into that range.

Cats that are newly diagnosed who become tightly regulated (blood sugar kept between 50-120) as soon as possible upon diagnosis have the best chance of becoming diet-controlled and going off of insulin. Time is of the essence - unfortunately this diagnosis overwhelms every one, but for your kitty's sake, bite the bullet and learn how to give the insulin asap. Even a less than ideal insulin is better than no insulin.

I can't speak to the dose that BJM mentioned because I don't have experience with that insulin, but i would trust her suggestion. Follow her directions exactly - test, feed, wait 30 minutes and then give the shot. With a quick acting insulin like Novolin, you want to make sure she's eaten before you give the shot. Then get tests every 2 hours or so after the shot so you know what that dose is doing. You're going to repeat the process again 12 hours later.

 

Here is a post on Testing & Shooting Tips that Marje put together. You do want to rotate where you inject, but that means rotating even by 1/8". Many people switch sides when they shoot.

Neosporin ointment with pain relief will heal ears overnight and take the owie out. That is worth it's weight in gold - just wipe off the excess every morning before you start testing again.

This is an excellent video on Injecting Insulin into a Diabetic Cat.
[youtube]XeZgKLfIJn4[/youtube]

Most people use Relion meters and strips, or you can buy generic strips to fit the relion meters from American Diabetes Wholesale (link in the "shop" button at hte top of the page benefits this site and helps pay expenses to keep it online.)

Move methodically and don't freak out - the needle is fine and tiny, so it's not going to hurt as much as you're worried about.

Always give a treat after you test or shoot - i used simmered chicken breasts. Simmer in water for 10 minutes, dice in 1/2" pieces, freeze most and keep a couple of tablespoons in the fridge to dole out. A treat is tiny - not a meal. you'll be amazed at how she'll accept this if you give a treat every time. Some people buy freeze dried meats - those work too. whatever is just meat (ie, minimal carbs) that she like is ok.

 

Ok, during her bg I gave her four 1/4 inch pieces of boiled chicken breast, she was at 365 on the Relion meter, let her eat her dinner 3/4 of a can of Friskies, waited 30 minutes and gave her .5 unit shoot of the Novilin. Now when do I check her BG again? Also she hasn't eaten all her food yet, do I take the rest away, it's only about 1/4 left. The shoot was easier than I thought, and she is tolerating me poking her for both shots and bg tests. I love the fact that it doesn't seem to bother her. :mrgreen:

If someone can let me know when to test again. I read that I should test her when the insulin it at it's peak, about 4-6 hrs after giving her the insulin, but I am unsure. Any help would be great! Thanks again in advance! God Bless!

 

It isn't necessary to take the food away. Yes, if you can get a test around +4 and +6 and see if you can catch the lowest point.

Great that she is being so coperative. Keep those treats coming.

 

The nadir, or lowest glucose, is likely to be around +3 to +4 hours after the shot. You want that to stay above 50 mg/dL on a human glucometer.

 

Thank you for the fast reply! I am going to leave her food for now. She is resting comfortably as she always does after food. I am staying up tonight to check her at the 3 hour mark, and the 4 hour mark tonight as I am the only one taking care of her. I do need some sleep before we start again at 7:00am tomorrow. However, tomorrow I will check her at the 3 and 4 hours marks also to find the drop off. I am so thankful to God that I found this site. Honestly, with all of you I almost don't need a vet, at least the one I've got now!! :lol:

 

What do I do if at any of these bg tests she is below 50? Very nervous about this, don't want a Hypo sugarbaby! Also what is the advice about increasing her now that I have started her on .5 units 2x daily? Do I wait a week to increase if she needs it? One more thing before I go, I have heard that I could feed her 1/2 can of Friskies 3 times a day, 8 hours apart, and dose her with Novilin after each feeding. Is this doable, or should I only be injecting twice a day. Seems to be a lot of contradiction when using Novilin, I just want to get it right for my Too Sweet Babygirl.

 

Novilin can be given every 8 hours but I would get a few cycles of data before I consider that. Once you have some numbers, then you can decide whether that is a good option. If the cycle consistently only lasts 8 hours , then it may be a good idea.

Yes, generally you get data for at least 3 cycles and increase by .25 or .5 if the numbers are too high. The problem with N is that in some cats, increases only sharpen the drops and make the bounces worse. You'll just have to see how it works for her.

If she would goes down to 50, you first give a little of the gravy off the higher carb food. A few tablespoons so she doesn't get filled up. Then another test in 20 minutes. Still going down? A little honey mixed with the gravy and retest. You should be able to guide the numbers up with a little higher carbs and keep her safe.

 

Rinse and repeat the feed, wait, test, evaluate process as needed.

 

Here we go. First read at 10:40pm, three hours after insulin given is 188. Still high, also thought I might have hit the blood vessel and not a capillarie due to the high amount of blood. Does this make a big difference? I am retesting again at 11:40pm and will post results. I also would like to start a chart for her bg tests, is there one associated with this site that everyone uses? Wish us luck and say a prayer for Babygirl and myself! Thanks!

 

Yes, we have a great color coded spreadsheet. Here are the directions

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

It's a little tricky. If you need help, just ask.

A 50% drop. Be interesting to see if that is the lowest point or if she drops lower.

 

Another test done at 11:40pm and it's at 279. Seems like quite a jump for just an hour. However, she did have about .5 ounces of wet food in her dish she ate about 10-15 minutes before the test, I am unsure if that may have had an affect on the test number. I am trying out the spreadsheet now. I am not sure if I need to retest her again tonight or if I should wait until her test in the morning? I am worried about it getting really high again.

 

Low carb food takes roughly 2 hours to spike the glucose much. High carb gravy or Karo syrup takes about 20-30 minutes, which is why you want to have some of both on hand, just in case of low numbers.

As far as high numbers go -better too high for a day than too low for a moment. Cats can often tolerate high numbers for quite a while, barring infection or ketones . Low numbers can kill quickly.

When over about 240 mg/dL, it is a good idea to test the urine for ketones. These form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis (DKA), a potentialy fatal, expensive to treat, complication of diabetes. See my signature link Secondary Monitoring Tools for some tips on doing this, as well as other assessments you may wish to make.

 

Do I need to do anymore readings on her tonight or wait until her 7am feeding? confused_cat

 

Just did a midpoint read, it is 340. This is 6 hours since the insulin dose. So for tonight it is as follows:

Pretest @ 7:00pm was 365, fed her, gave .5 Novilin Insulin at 7:30pm.
Test @ 10:40pm, 3 hours after insulin, was 188
Test @ 11:40pm, 4 hours after insulin, was 279
MidPoint Test @ 2:00am, 6 hours after insulin, was 340. :sad:

Well I am not sure what all this means yet, but I know I need some sleep before her am pretest and feeding at 7:00am.

Thank you all for the information and have a Blessed Night.

 

Another update:

AMPS 307 at 7:30am
Feeding 1 can Friskies Pate
Giving her .5 insulin at 8am
Then a bg at 11am and again at 12pm

Overall her number is 60 lower this morning than it was last night when I did her initial read. I was really amazed because I did not get blood the first or second time I tried and she got a bit upset. I was expecting a higher number due to nerves. Happily that was not the case, third time with a small amount of food did the trick. Not sure what it means yet, but I am learning and have so much hope.

Additionally, I have not updated her spreadsheet because I can't figure out how to get back to it to edit it! :lol:

Not enough in the world to keep me up and going today! :YMSIGH:

 

You'll need to log in to Google Drive to be able to edit your spreadsheet. The link is for the shared, public version which no one else may edit without getting permission to do so.

And when you get to the log-in page, save the shortcut so you can get back to it quickly!

 

I urge people to save the spreadsheet in favorites or to bookmark it. Then, if you're signed onto Goggle, it's always there on your computer. (the one you shared in your signature is a read only). Good job getting it set up.

First cycle with N looks pretty standard. Doesn't last very long...that's the biggest complaint with it. The 3 favored insulins give most cats 6-8 hours before the numbers slowly rise. Numbers today will be good to have. It's possible that she bounced back up earlier because she hadn't seen a lower number in a while, but more likely it's just the N. If the pattern looks the same today, then you can try increasing to one unit (if you can test the first cycle to make sure she doesn't drop too low) and see if it lasts any longer.. N is usually a hard insulin to regulate with. We like the milder, longer lasting ones.

What do the possibilities look like for getting a better insulin from your vet?

 

Ok Freaking out right now. If you look at BabyGirl's BG SS, you can see her AMPS was 307, then at 3 hours 345, now at 4 hours after insulin she's at 438. I can't imagine what is going on. The only difference was that my husband did her bg test. It was his first time. He thinks he contaminated it somehow. He said he washed his hands, so I don't understand what is going on. I am very concerned about these numbers with the dose of insulin. Any advise? What should I do? Do I wait until PMPS to do a bg, or should I check again before then. Please help, any advise is very welcome right now! :cry:

 

It could be that the tests were off, or that the N is just not working well. You are on a very small dose. If she continues to rise, you could give the pm dose a little early and raise it to one unit. Just be sure you can test at the pm nadir because the N could take her low.

 

Ok, so should I test again before her pm feeding at 8:30 EST, it's 12:31pm right now. I am very unclear on this subject of testing. I already feel like I am over testing or stressing her about it. confused_cat

 

If she is rising, she is not likely to go any lower, so I don't think you need to do anymore testing till pm, unless you want to.

 

Back again. Did PMPS, it was 360. Gave her 0.5 insulin at 9:10, after waiting 1/2 hour after feeding her. She is actively cleaning herself now. Took her injection very well, better then the bg tests. She seems to be happy and content, so I am going to get some very needed sleep and let my son do her bg at 3 and 4 hours into the insulin. I will post in the morning.

I do have one question though, do I need to always check her bg at 3 and 4 hours in until I get her under control. It just seems very excessive to me. confused_cat I will be up and checking the board for an hour or so, so if you have any advice on this one I would LOVE to hear from you! :smile:

God Bless everyone, and especially the sugarbabies, on this site. I still do not have enough words to describe how help you all have been!

 

i'm not familiar with Novolin, but looking at the test results you do have, i wanted to make a couple of observations.

It looks like the Novolin lasts about 3-4 hours max in her body. That leaves her 8-9 hrs with her blood sugar back up. that's the downside of a short-acting insulin.

The dose you gave got her into the 180's yesterday. If your goal is remission, you want everything under 120. You can't get it there faster than is safe, and I'll defer to others who have more experience with this insulin on the dosing.

It looks to me like she bounced from the 188. Notice how she didn't have a curve in the day cycle today? She was high at amps and basically stayed that way all day? That's a bounce. Here's a description of that phenomenon:

My comments about dosing in the quote above are regarding using Lantus - not Novolin. Because it's short-acting, as Sue suggested, you may be able to adjust the dose during this bounce time. Again, I'll defer to her on dosing. But the bouncing itself happens to all kitties. The more they've gotten used to high numbers, the harder it is to get them to re-accept normal numbers as normal again. If your goal is remission, you want her to get into normal numbers (50-120) and stay in that range as long as possible for her pancreas to heal.

I'd push the vet again on Lantus or Levemir for the best-long-lasting control of her blood sugar. If you haven't looked at it yet, the latest research about Management of Diabetic Cats Using Long-Lasting Insulins is in the PDF about 5 paragraphs down from the top of that link. It's worth reading and worth printing out for your vet. It supports getting cats onto longer-lasting insulin as soon as possible so they can go into remission before their pancreas is damaged beyond recovery.

Promise - i don't get a commission for encouraging you to go to Lantus or Levemir! I have seen so many cats go off of insulin on them - i would just like to see your sweet Baby Girl have a chance too. If we don't tell you, how will you know?

 

and yes, i would always check her about 3 hrs after the shot.

if her preshot is lower than you've shot so far, check her sooner.

if you increase the dose, check her sooner.

your goal is to catch her if she goes below 50, and if she does, give her a little bit of high carbs to pull her back up over 50.

 

If you're not changing the dose and no other health conditions have altered, getting it when you can is OK. You just don't want to be surprised by coming home to a cat in hypoglycemic crisis.

You may find our Humulin/Novolin primer helpful.

If there is any way you could shoot 3 times a day, roughly 8 hours apart, that may help lower the wide swings. Otherwise, getting a longer acting insulin such as ProZinc or BCP PZI as soon as possible will help immensely. As those are both in and out insulins, your vets experience won't be totally contrary to how these 2 insulins work.

 

Getting ready to begin work life again, now that I have some sort of routine. I did manage to find a vet that prescribes PZI, but no one will do any of the human insulin besides the Novilin. So I am taking her in to see a new vet here in town that uses PZI. They do condone home testing, however, they said that a human monitor is useless. I want to be prepared to talk to this vet intelligently and get it across the right way that you can indeed use a human monitor effectively. Does anyone have any ideas on how to accomplish this. I am fresh out of ideas and honestly exhausted at this point. I need to find way to do this for my kitty. I cannot stop now, love her too much to just not do all that I can. Thanks again everyone & God Bless!

 

I'd keep looking for a vet that will prescribe Lantus (glargine) or Levemir (detemir). They are the 2 that are recommended with the only dosing protocol for diabetic cats that has been published in a professional veterinary journal. I can't believe in all of Battle Creek there isn't a veterinary clinic that has the latest information on treating diabetic cats.

Here is the original protocol: http://www.felinediabetes.com/Roomp_Rand_2008 dosing_testing protocol.pdf They recommend human glucometers because they are accurate enough and in order to follow the protocol you have to test a minimum of 3-4 times per day. Alpha Trak strips cost $1 each. Human meter strips cost about 10 cents. The AT cost is prohibitive for most people.

That PDF is the most recent update to the above protocol. They do use an alpha trak in this update - but we've had thousands of people come through FDMB and we always encourage the human glucometers because of the cost.

Here is the study as published in a professional veterinary journal - also using home monitoring with a human glucometer. http://www.ncbi.nlm.nih.gov/pubmed/19592286

All of these links are in the first part of the Tight Regulation Protocol page for using Lantus and Levemir. All of them support home-testing and the documents above should be enough to support using a home glucometer.

Seriously, if remission is your goal, I'd make an appt at the Veterinary School at Michigan State University. Looks like it's just a one hour drive for you, and you don't need to make that trip regularly, just to get the prescription. We can help you with dosing by following the published dosing protocols. It would probably be one time to get a prescription for insulin and then you can use your regular vet that you're currently with for ordinary care. Prozinc is a world better than Novolin, but Lantus & Lev are proven to be more successful for remission. The comparison data for these are all in the PDF that you can download on managing diabetic cats using long-lasting insulins. Also on the TR Protocol page - about 5 paragraphs down from the top.

Good luck! It sounds like you've got a challenging situation!

 

See my signature link Glucometer Notes for reference ranges using human glucometers.

These are based on articles written by feline diabetes expert Dr Janice Rand of the University of Queensland.

The human glucometers read about 60% to 70% lower than AlphaTrak meters.
Thus:
Human glucometer / 0.6 to 0.7 = AlphaTrak estimate
AlphaTrak * 0.6 to 0.7 = human glucometer estimate

 

If you like this new vet, ProZinc should be fine. I know you are mentally and emotionally exhausted and can appreciate that trying to look for another vet might be too much. It's true that Lantus has published studies but we have had many cats go into remission here with ProZinc. There just haven't been any studies done. It's very encouraging that he'll prescribe a better insulin and does encourage home testing.

As far as the meter, there are the studies Julie cited. You can also just say to the vet " I know the readings will be lower than the pet meter, but I will take that into account. I can't afford the pet meter or the strips. I am doing the best I can for my cat and hope you will accept that."

 

Well looks like her bounce may have rebounded. I hope so. My son is going to try to do her bg in an hour just to make sure her peak doesn't go down too low. I am encouraged though. She seems to be a happier cat already. I have read about the difference in meter, but am still confused. I got a 159 on the Relion at 3 hours after insulin. Does that number become 129 if I account for the difference in human to pet meters? Or is it that I take the 159 and divide it by 0.7 to get 227? Just want to make sure I have it right. I appreciate all your advice so much.

I also decided not to try and take my cat to State of MI Vet Clinic because she freaks out on a ten minute ride let alone a hour there, then a hour back. Also, the vets in town did say they would not work with me if I used another vet for insulin. It's all or nothing with them. I am praying that PZI will make a bigger and better difference than the Novilin. After all it can't get much worse than Novilin. lol.

Thank you for the articles to take to the vet and the advice! Good night and God Bless!

 

Report the numbers you actually get, no math.

Use the reference ranges in my signature link Glucometer Notes for approximate interpretation.

See the link Secondary Monitoring Tools fro additional assessments you may wish to make, especially urine testing for ketones or ketones and glucose. Ketones form as a by-product of fat breakdown for calories. Too many ketones may indicate diabetic ketoacidosis (DKA), a potentially fatal, expensive to treat, complication of diabetes.

 

then definitely go with ProZinc - it's a good insulin too and it lasts much longer in a cat's body than Novolin.

i agree - just put the numbers in the ss as you get them from the meter. Make a note on the ss as to which meter you are using - experienced people will know what they mean.

hang in there! it gets infinitely easier - really. :YMHUG:

 

hi everyone i am new to this whole thing but i just discovered by cat is diabetic. I brought him to the vet in the summer because he lost tons of weight all of a sudden. she gave him some worm pills and nothing happening and we got a huge vet bill. So i started to research and took a reading of his blood today and it came out to be 24.3 mmol/L! Now what do i do? i really want to limit going to the vet because it seems to never work for my family.

 

Beensl, you'll get lost at the end of this thread. I'll copy your post and start a new thread for you. It'll be Beensl, New Diabetic.