Hi from Simone and her Stressed dad

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Zipdrive, Feb 18, 2017.

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  1. Zipdrive

    Zipdrive Member

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    Feb 18, 2017
    Hi All, I'm Scott from Canada.

    My little girl Simone (13yr old Siamese) was diagnosed with diabetes the beginning of February this year, though it probably started sometime in January, maybe earlier. I thought I'd vent a little as it seems that my little one is not really responding well to the insulin (in my opinion) and the cost of all the testing and supplies has been a bit of a financial burden at this point and time, but I'm not the only one and you do for your little ones what you can.

    It all started a week before Christmas last year when she was diagnosed with Pancreatitis (or so the vet said) which was causing her to have loose stools and losing weight. The blood panel and fecal smear all pointed to Pancreatitis. Her Thyroid, Glucose, and other levels were all normal for a cat her age and the smear was negative for any and all bacteria and what not. Multiple antibiotics, both vet injected and oral at home, were given for 2 weeks which seemed to help. Around the 16th of January the loose stools returned and she was given another course of antibiotics on the 23rd. This again helped a little with the stool issue though I noticed her urinating and drinking more. Thinking it could be a side effect of the medication I kept an eye on it but that's all.

    It wasn't until I was getting a slight sweet smell from the litter box that I knew something was still wrong, so back to the vet she went for more blood work and urine testing. The blood work and urine test showed really high glucose levels, though the good news was that her kidney levels were good. At least at that time, who knows now.

    Simone has been on Lantus insulin (SoloSTAR pen) and Royal Canin diabetic dry since February 6th. She has also been getting 2ml of Potassium every day too. The vet started her at 1 dose twice a day and 2/3 cup of food in the AM and PM. Nothing at noon. The reason for the dry food is that this little thing down right refuses to eat any canned food or any of my cooking (tells you something right there), but she does love her chicken and roast beef deli, LOL. Just this past week she was at the vet for her 1 week glucose curve test and that didn't show any promise. She refused to eat any food while at the vet, the blood samples were hard to get through her ear and the results of the curve were like she was never on any insulin. The vet has since increased her dose to 2 in both the AM and PM but the little thing is still drinking a lot of water and urinating a dozen times or more a day and I'm worried for her.

    I bought a glucose monitor, strips, etc today in the hopes of trying to see what her BS levels are at various times throughout the day here at home. After reading and testing the supplies on myself I tried to get a blood sample from her ear but that was a total disaster and she bit me, the poor thing. With the insulin not seeming to be working and the botched blood test it stressed me right out to the point that I almost took her outside in the hopes that she would take off scared and I wouldn't have to deal with the hassle of her or the cost anymore. I hit a real low as she is my only family and I was ready to give up on her, which is why I came to the forum for help and guidance.

    I've been reading various threads on the forum to try and educate myself and tomorrow I am going to try and get some blood from one of her back paws. Hopefully that will go a little smoother.

    Thanks for reading.

    Simone.jpg
     
  2. Salem

    Salem New Member

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    Feb 18, 2017
    Dealing with diabetes in a cat is tough and it's Ben a while since I was back at the beginning with what felt like endless trips to the vet, checking number, and changing doesages find that magic number. One suggest, is if your kitty will allow it, get a friend to help you. I was likely in the fact at the time I was getting, two ladies were starting a new business and provide vet tech services at home. It's no longer operating, but maybe you can find something similar. They would come in an run the curve. It's best to do itmin comfortable surrounds, as if he cat is stressed, it can throw the numbers off.
     
  3. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    We have certainly all been where you are. Don't give up on her. It is certainly frustrating and costly (esp initially) but we can help with cost cutting suggestions as well.


    I'm so glad you are willing to try home testing. Since she's resistant, try desensitizing her to having her ears played with first. Any time you pet her, stroke her ears.

    When you are going to try a test have a low carb treat ready as a reward. Many find it helpful to warm the ear first with a rice sock or warmed washcloth in a zip lock. I never did but would rub and hold a cold war in my fingers first.

    If it's a human meter you are using they often come with 30 guage lancets.... Too small. Get 26 or 28 guage. Most find it easier to freehand poke than to use a lancet device. What meter did you get? What size blood sample does it require?

    When you poke aim for the sweet spot, not the vein. The vein will bleed more (too much) and hurts the cat. (Might be why she but you). Try to be as relaxed as you can so you don't make her tense. Singing as you do it might help.
     

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  4. JanetNJ

    JanetNJ Well-Known Member

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    Jun 8, 2016
    By the way, marks marine pharmacy in Canada is the go to place for many of the lantus users here.... Reasonable prices.
     
  5. Tuxedo Mom

    Tuxedo Mom Well-Known Member

    Joined:
    Dec 2, 2014
    Hello Scott and so sorry that Simone has been diagnosed with diabetes.

    The early days after diagnosis are very stressful so what you are feeling is not unusual. Home testing is so important but can take some time to master. My first FD kitty and I "learned" together. There were many tears on my part and a lot of fighting and howling on his part. It DOES get easier...trust me. I now have two FD kitties and although one of them is definitely not fond of the ear testing, it all goes smoothly. Find something that Simone just loves...whether a treat, or cuddles, or a brushing and always reward her after testing.

    This link has lots of information and tips on home testing:

    http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

    There is lots to learn and it can seem overwhelming but there are a lot of people here who can help you on your journey. The yellow stickies at the top of this page:

    http://www.felinediabetes.com/FDMB/forums/lantus-glargine-levemir-detemir.9/

    will give you a good understanding of how Lantus works and different approaches to the treatment process.

    If you have specific questions you can post in the Feline Health section here:

    http://www.felinediabetes.com/FDMB/forums/feline-health-the-main-forum.28/

    Please keep reading and asking questions...it does get better :bighug: :bighug:
     
  6. Gill & George

    Gill & George Well-Known Member

    Joined:
    Oct 27, 2015
    Hi Scott, and welcome to FDMB, sorry Simone has been diagnosed with diabetes, we've all been there and know how overwhelming this diagnosis can be.

    One of the things I did with George was to get him used to having his ears stroked/touched, at times that I wasn't testing him, I think that helped him get used to me messing with his ears.
    And as others have said a treat, whatever floats her boat, will be a great help in getting her to accept the testing.
    Try to be calm when testing her as well, as they can pick up on you being nervous, we've had a number of members sing to their kitties whilst testing, I can't sing so I would just tell George that it was going to help him get better, though to be honest, with George it was the freeze dried treats that swung it.:rolleyes:
    It won't be unusual for her to come running for her test once she gets used to it, hang in there.

    I don't know if you have already had a look at this site, but Dr Lisa's siteon feline nutrition has some fantastic tips on how best to transition your cat from dry to wet, the diabetic dry food is quite high carb (around 18%), ideally you want to keep the carb under 10%, the extra carbs in the diabetic dry could well be contributing to those higher numbers.
    As she's already on insulin, any transition to lower carb food (dry or wet) should be undertaken slowly as reducing the carb load of her diet can have a dramatic impact in numbers for some kitties.
    Here's the link for Dr Lisa's feline nutrition site, and here's a link to a PDF on transitioning hope the tips on transitioning are helpful, it can take a long time for some kibble addicts, but it really is worth persevering.

    Good luck with the testing, you'll get there
    :bighug::bighug::bighug:
     
  7. Zipdrive

    Zipdrive Member

    Joined:
    Feb 18, 2017
    Thanks for the kind words, encouragement and links everyone. Yesterday was just a bad day from the time I woke up but today Simone and I are going to try and work together to get at least 1 blood sample. There is no doubt that once all the kinks are worked out things will get easier to do and be less stressful for both of us. Thankfully she takes her insulin like a champ.

    The Lantus pens I bought were $110 for 5 with a box of 100 needle caps costing $36, so $146 CAD all in from a local pharmacy which isn't that bad. I think Marks Marine wants $149 US ($195 CAD) for 5 pens and I don't know if that includes the needle caps.

    I picked up a GE200 Glucose Monitor at London Drugs which has a 0.75 microliter minimum sample volume. The reason for that particular model was the relatively low cost test strips at $60 for a 100 (yeah I went cheap). Pretty much all the other test strips found locally were close to $80 for a 100 (which gets you a free monitor). Walmart Canada does not carry the low cost ReliOn brand of monitors/strips as they do in the U.S. and I wasn't aware of any good online deals.

    While the GE200 may be a lower end monitor compared to the Accu-Chek or FreeStyle brand I found a couple sites and postings mentioning that it was a pretty accurate device even when compared to the more expensive brands so that gave me peace of mind. Also once these strips are all used up I can always switch brands and try another monitor. When it comes time for Simone's next blood curve at the vet on March 1st I'm going to bring in my monitor and have them compare the readings to what they use.

    I'll try yet again to get her onto canned food but that will come once I get this whole blood sample, glucose curve thing straightened out.
     
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  8. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    good plan if you do manage to transition you want to be up and running with testing and monitoring.

    I think it's the US members that order from Marks, as it's cheaper than buying in the US.

    I think that you are using the pen needles, and there are a couple of issues with that.

    1) you can only make dose adjustments in whole units, you need to be able to adjust dose by 0.25u
    2) if you are using the pen needle device you cannot keep your pen in the fridge as it interferes with the dosing mechanism, this means that your lantus won't last as long and you'll end up wasting insulin because its gone off.

    We use U 100 syringes with 0.5 unit markings, I'll link you some info on that in a minute. And we just draw up the dose from the pen using it as we would a vial, we keep the pen in the fridge and it can last for a number of months and you will get your moneys worth from the insulin.
     
  9. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
  10. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    A note on dry food: until you can get her transitioned to wet, you'll want to use the lowest-carbohydrate dry food you can possibly find. The Royal Canin Diabetic food is unfortunately pretty high in carbs (~30%). I don't believe there are any truly low-carb (<10%) dry foods available in Canada, but there are a couple that are a bit better-- I think Orijen Regional Red is around 15-20%, and there's another brand which is escaping my memory right now. @MrWorfMen's Mom might be able to make some suggestions. Lowering the carbs could make a big difference in Simone's BG numbers and her overall progress.

    You've gotten a bunch of information already here, but come on over the Feline Health forum with any questions you have. And, welcome!
     
  11. MrWorfMen's Mom

    MrWorfMen's Mom Well-Known Member

    Joined:
    Feb 18, 2015
    Hello and welcome from a fellow Canuck. We don't have any kibble here that is under the recommended 10% carbs so if you can get Simone to eat wet food it would be the best option. That said, I know only too well the frustration of trying to transition a very stubborn kibble addicted cat who has refused any food that does not crunch she was a kitten. :rolleyes::banghead: Your lowest carb options in Canada are:

    Petcurean Go Fit & Free - 14%
    Wellness Core Original Formula - 15%
    Natures Variety Instinct - 15%
    Natures Variety Instinct Raw Boost - about 15%
    Nature Variety Ultimate Protein - 15%
    Orijen Fit & Trim - appears to be approximately 15% - waiting for as fed values to confirm
    Orijen Cat & Kitten - 18%
    Tiki Cat Born Carnivore - appears to be approximately 15% - still waiting for as fed values to confirm

    Note some of these foods come in different flavours and the carbs quoted above are for the either the Turkey or Chicken formulas. The duck and rabbit formulas offered are slightly higher in carbs.
     
  12. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Is Nature's Variety Instinct available? I believe that one is about 7%. Not sure if Evo is available, but that's 6-7 % as well
     
  13. Zipdrive

    Zipdrive Member

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    Feb 18, 2017
    Thanks for the kibble list. I'll see if one of the local independent pet stores carries any of it.

    The other day I picked up a couple tins of Fancy Feast (Chicken Feast, Turkey & Giblet Feast and Chopped Grilled Feast) and have been mixing that with the dry and Simone has been eating it so it's a start. Her AMBG number is still high at over 20 mmol/L (360) first thing and then goes down a little after her 3u dose of Lantus but no where near normal levels. The lowest it's been was 16.7 mmol/L (300.6) I'm wanting to increase her to 4u in both the AM/PM but will wait till I have the vet do the glucose curve on March 1st. I'm just hoping that with these high numbers, and not going lower quicker, that it's not causing her to develop more issues before we get to normal numbers. I'm going to leave my meter and strips with the vet during her curve test so that they can test and compare my meters readings with their equipment.

    The one good thing is that she is not drinking like a fish and urinating every 1 1/2 hrs like she was this past while. That has slowed down since I increased the dose to 3u (from 2u) based on her BG levels. She still drinks throughout the day but her urinating is about 4-6 times a day in a 12- 16 hr period. No signs of hypo either at the 3u dose.

    Now with getting the hang of the testing I'm going to do a mini curve to see how things progress throughout the day. I started a 2hr test the other day but was called out for the afternoon and couldn't get any results after 11 AM. I have more reading to do in the Lantus forum and will post some number there and see what feedback I get.
     
  14. Zipdrive

    Zipdrive Member

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    Feb 18, 2017
    Managed to do a 12hr curve today, so thanks to all of you for the tips on getting blood. Simone was pretty relaxed when getting her ears pierced with only a few "oh no not again" moments. Also she has been eating her dry/wet mix so hopefully that continues and I can slowly get her off the dry kibble in the coming weeks.

    The numbers still confuse me for the curve but Simone's BG went down to 5.8 mmol/L (104.4) at the +9 mark, then started to climb back up at +10 - 6.1 (109.8) then +12 - 13.8 (248.4). With not really knowing how the insulin shots work in the body to level out the BG I only gave her a 1u dose for the PM. To be honest I was scarred if I gave her a 3u dose this PM that she would of hypo crashed sometime in the night. After reading some of the Lantus stickies I think the 5.8 at +9 was her lowest on the current dose and the 3u PM +12 shot would of not caused her BG level to go any lower right away. But right now I'd rather play it safe until I understand this whole ordeal more.

    Simone's first 12 hr curve: http://www.felinediabetes.com/FDMB/threads/2-23-first-time-testing-number-need-advise.173695/

    or her spreadsheet: https://docs.google.com/spreadsheets/d/1UmSTCuVNgkU1QdOm1l8A1NCkWZR0EVa2Cfc8sQoJpz4/pubhtml
     
  15. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    If she's going G down to 104 definitely do no increase the dose! Glad she's enjoying the wet food. As you decrease the dry the bg will drop and you may find 3 u is too much.
     
  16. Yong & Maury GA

    Yong & Maury GA Well-Known Member

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    Jan 11, 2017
    Congrats on first curve, Simone and Scott!
    Totally understand how you feel :cat: I'm still learning as well.
     
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