Help with my newly diagnosed cat

My cat Charlie was recently diagnosed and I'm concerned about his continued weight loss. We will just be getting started with Lantus this week when the syringes I ordered arrive. Have had some bumps in the road from diagnosis to today. The vet prescribed 1 unit 2 times a day. Does not seem to think its important to monitor his BG levels, but I do it anyway and after his first dose I am glad I did. One dose sent his BG to 31. I called the vet and they didn't seem to think that was possible so I brought him in to check our meter against theirs, and yes it was accurate. Vet couldn't figure out what to do next with Charlie and suggested 1 unit a day, but I would need to watch him for 4-6 hours after each shot! He didn't think there were syringes to dose 1/2 units, but I found some online so he has now advised we give him 1/2 unit shot a day and bring him in at 3 weeks for a fructosamine test. I plan to monitor his BG daily even though vet does not think it's necessary. Charlie is still losing weight which concerns me. Will this improve after he starts insulin? I have 4 cats who free feed so even though I think it will be difficult so switch all of them over to wet food, I don't think I have a choice. Any advice on doing this and helping Charlie gain weight is greatly appreciated.

 

He should begin to gain back weight once his glucose is under control. Did they check to make sure he does not have hyperthyroidism? I would make sure he is getting enough calories. A common formula is 20 calories per pound of healthy body weight, and if he is underweight, he could need a little extra right now. Wet food is better for all of your cats, so switching them all is a good choice. If you haven't been there yet, you may want to visit catinfo.org where you can get all the info you could need on feline nutrition. There is also a chart to help you find appropriate low carb foods (there's a link to it in my signature).

You are smart for testing, regardless of what the vet says, and for getting syringes with 1/2 unit markings. I am confused about the insulin though - you said you will be starting with Lantus this week, but you then mentioned one dose sending his BG to 31. Was/is he on a different insulin and you are switching to Lantus? Insulin dosing in cats should be twice daily rather than once. So, for example, 1/4 twice a day rather than 1/2 unit once a day (for 1/4 you have to estimate between the 0 and 1/2 marks). Have you been to the Lantus forum yet? There are 'sticky' posts at the top where you can get a lot of helpful info (including about the two dosing methods normally used, TR and SLGS), and that is the best place to post insulin-specific questions such as about dosing. http://www.felinediabetes.com/FDMB/forums/lantus-basaglar-glargine-and-levemir-detemir.9/

It would be very helpful (to you and us) if you could go ahead and set up one of the spreadsheets we use to track BG and insulin doses given:
http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
http://www.felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/
You can add a link to it in your signature.

 

I brought Charlie in for weight loss which seemed rapid to me and also he was constantly drinking water. Vet did bloodwork and told me it showed he was diabetic. Last visit I asked for his BG level just to know for myself and it was 381. The first shot we gave him was Lantus so sorry for the confusion. The problem was we gave him that shot that dropped his level too low 2 days before our weeks vacation. At that point vet said to stop shots during vacation (cats watched at home by pet sitter) and call him when we got back which was this past Monday. He did have me bring Charlie back in the day we left for vacation to do a fructosamine test to see what his levels had been. He called me to tell me his levels were high and he definitely had diabetes. Once I told him I found 1/2 unit syringes he said to dose him once a day at 1/2 unit which I also thought was odd. I asked about doing a glucose curve in a few weeks and he said no just bring him in in 3 weeks for another fructosamine. I would think me taking daily readings and doing a curve would be much better data on how Charlie is doing. When we got home this past sunday I checked his BG and in the morning it was 331 and evening 289. I have started Fancy Feast pate this week and he seems to like that, but I haven't removed all of the free feed dry food they all have been eating. He just looks so skinny and lost weight while we were gone on vacation. With 4 cats its hard to monitor exactly how much he is eating but I don't feel like its a lot. I will check out the links you provided on nutrition, thanks for that. Also thanks for the spreadsheet link, I will get working on that as well.

It's strange because the vet tech believes in changing his diet and doing curves but the vet does not seem to think it's necessary. My goal is to get him in remission if possible.

 

Good for you for testing, it's the best way to keep Charlie safe and know how the insulin is working for him.
Please read these links and get a Hypo toolkit prepared in advance. That BG test of 31 was too low and you need to know what to do and be able to intervene if this happens again. Testing before every injection is essential and at least once during the 12 hour cycle between shots, or more, so you can see how low the insulin takes him. The change to a low carb wet diet is going to affect his blood sugar levels and you need to know what they are.

• How to treat HYPOS - THEY CAN KILL! Print this Out!!
• jojo and bunny's HYPO TOOL BOX

This information is found in the FAQs forum, which has an Index you can go through for more information since you and Charlie are just starting this journey. http://www.felinediabetes.com/FDMB/threads/index-health-links-faqs.194624/

The information in the Lantus forum is invaluable and you can learn about how it works, the protocols used here and get experienced, knowledgeable help and support. The members of the Lantus forum supported us, instructed us and helped Idjit to a very surprising and fast remission. Our vet also provided some inaccurate information about dosing (once a day like yours) and also was not aware that there were 1/2 Unit marked syringes. We found some at Walmart, the ReliOn brand, but it sounds like you have some on the way.

The spreadsheet is going to provide very valuable information that will be used to help you determine what dose Charlie needs, a dose of Lantus is based on the lowest number in the cycle, the nadir, not the pre-shot test.

Best of luck going forward and hopefully to remission. Idjit would love to have Charlie join him at The Falls!

 

Thank you for your reply. I have a lot of reading to do! Did you ignore your vets once a day dosing advice and break it up into 2 shots a day?

 

Charliesmom, I was a dumb bunny. Plain and simple, and honestly. I was trying to get the right syringes and my hubby got the wrong kind, first try. Then I ordered some..wrong kind again. I was so afraid of messing up and trying to eyeball a half unit, and then with the diet change and insulin..he started going a bit too low. They helped me through that and I was getting differing opinions as to giving half unit, or a 1/4 unit or just ceasing insulin. I chickened out and stopped insulin. I know now..oh hindsight!..that I should have continued at least a token dose when we finally did get the right syringes, but I didn't. Idjit, thank goodness, is still in remission, but I have been so fearful that it wouldn't be a good strong remission because of my method.

So, my advice to you, is learn as much as you can, test him faithfully, get the testing information and gradually ease him off the "juice" if and when it's appropriate. Until then, get that testing data into the spreadsheet so they can look at it, give the shots twice a day and get educated. We will help!!!! I know it seems like a lot, and it is at first, but I have faith that you will persevere because it's the best thing for Charlie.

Lantus is best twice a day, because a cat's metabolism is faster than a human's, so what works for a human in this one way is not appropriate for a cat. My vet was applying human values (one shot a day) to Idjit and although she is probably a good vet in some areas, this was not her expertise.

I watch Idjit like a hawk, to see if diabetes symptoms are rearing heads, and hold my breath when we test, but so far, so good. Hoping it continues. And I vow that if he needs insulin again, I am going to listen to the wise men and women here with the experience of 24/7 and years of feline diabetic care.

 

Insulin usually needs to be given twice a day. What is important is to test before every shot to make sure it is safe to give the dose.

What are you feeding him? A change to a low carb canned food diet is one of the best ways to also lower the glucose levels. Getting all of your cats on the same diet not only will help Charlie, but also reduce the chance any of the other cats developing FD. Plus it will help keep Charlie from cheating.

We realize that it will take time to get them all off dry food, but it can be done We can help you by giving you suggestions that worked for us.

 

So he went into remission without insulin and diet change alone?

 

Right now I still have the Iams dry food out all day for all the cats. The past few days I have been feeding Fancy Feast watered down once a day to all of them and 3 of them including Charlie like it! I have seen some low carb dry food options as well. Is it ok to use a combo of low carb wet and dry? Any advice on how to transition all of the cats over is appreciated! Mostly concerned that Charlie is eating enough. Only one of the other cats is slightly overweight.

 

If you can go to all wet, that is best. You will find information about that on catinfo.org. Also, here is a related post (by the same vet that has the catinfo.org site): http://www.felinediabetes.com/FDMB/...r-more-than-just-carbohydrate-content.175004/ Transitioning can be very hard, but is possible. If you need a dry food for the transition, I suggest Dr Elsey's Clean Protein Chicken which has 4-5% carbs. Here is a link to the info on catinfo.org about transitioning a dry food 'addict': https://catinfo.org/docs/TipsForTransitioning1-14-11.pdf

 

By the way, leaving out wet food instead of dry is an option. Some people use automatic feeders to feed additional wet food when they are away or freeze portions to leave out for the cats to eat as they thaw.

 

He had about 11 days of insulin, along with the diet change. We had to replace the dry food that he had out all the time, and the high carb gravy varieties of canned food he got twice a day, with the low carb Fancy Feast and Friskies pates. It was not difficult with Idjit because he loves to eat, and we provided more frequent, smaller meals. He still gets 4 meals a day, and because he's incredibly spoiled, he gets raw gizzards (hopefully for dental health) and some cooked chicken breast now and then. Depends on how pitiful he is and how long the begging has gone on.

We were advised about how many calories he needed, and I used the food chart from www.catinfo.org to determine how many calories he was getting as well as the carbohydrate values.

Dry food is not good for diabetic cats, even the so called prescription varieties. In fact, dry food is not ideal for any of our cats and it's my opinion that's why we are seeing so many diabetic cats, lots of stuff in it they just can't use or need. But I am not an expert on this subject at all. Some of our members do use the low carb dry food, but it's expensive and many cats either do not like it or have gastric upsets from one of the brands.

Here are a couple of links on transitioning, about dry food and to the most excellent feline nutrition site I have found:
http://www.felinediabetes.com/FDMB/threads/transitioning-your-cat-from-dry-to-wet-food.956/

http://www.felinediabetes.com/FDMB/...r-more-than-just-carbohydrate-content.175004/

www.catinfo.org