Hi! I'm new and want to take the slowly, carefully approach!

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Phoebes mom, Aug 2, 2012.

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  1. Phoebes mom

    Phoebes mom New Member

    Aug 2, 2012
    Hi and thanks for letting me join your group.
    Phoebe was diagnosed just over three weeks ago.
    I have read a lot of material and the "slowly, carefully" approach seems to advise starting at a dose of 1.0 -2.0 units twice daily.
    Being very nervous, and wanting to err on the side of caution, I questioned my vet's recommendation of starting at 3 units twice daily. He seems to be quite knowledgeable about diabetes, and felt 3 units was a very cautious start.
    She was on this dose for 2 weeks, then it was raised to 4 units twice daily which was too high for her, causing glassy eyes and lethargy.
    So we are back to 3 units twice daily.
    She seems to be doing quite well; her water intake has dropped, and she just seems to be acting more "herself".
    Our vet seems to think she has a good chance of going into remission having reacted well to treatment. Her weight is slowly coming down, and I know that is important too.
    I'm not sure why I am posting other than to thank everyone for the information provided here..I know I HAVE to do what's necessary to make Phoebe feel better, and the comments here make me feel that I CAN!
  2. Re: Hi! I'm new and want to take the slowly, carefully appro

    Hi Phoebe's Mom!

    Glad you found us and that you have found the site so helpful already.
    Your instincts on the dose are right on the money. Even 3u is higher than we'd recommend unless there is something else besides just diabetes making her numbers high.

    How is her blood glucose being tested? Are you doing it at home, or are the dosing adjustments being made by the vet based on numbers that they have gotten from testing?

    Is Phoebe eating just low-carb canned food?

    There is no doubt at all that you can! Remission is certainly a possibility, and if you look around, it seems it happens for at least one kitty every week here. We would be more than happy to help, and will do our best to answer any questions you might have.

  3. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Dec 28, 2009
    Re: Hi! I'm new and want to take the slowly, carefully appro

    Hi and welcome to the group.

    Carl is right that a starting dose of 3 units is typically considered a high starting dose. Normally, we recommend a starting dose of 1 unit or even 1/2 unit and with home testing, slowly over time, adjusting the dose as needed.

    So, some questions for you:

    What insulin are you using?
    Are you home testing?
    If not, would you be willing to learn? We will happily help you.
    What kind of food are you feeding and how often?
    Where are you located? There may be a member close by who can help you in person.

    Now the reasons for these questions:

    There are three key factors to managing diabetes: food/nutrition, home testing and insulin

    1) Feline Nutrition: Now, as far as diet - definitely dump the dry food (if you are feeding any) and if the vet recommends purchasing prescription food like DM just say "no thank you". ALL cats, and especially those with diabetes, do best on a species appropriate diet that is high in protein and low in carbs. Dry food DOES NOT fit that bill and DM food, even canned, just really isn't that great as far as quality. Most here on FDMB feed low carb/high protein canned, raw bought from a pet store or they make there own.

    Here great links, one is to a food chart put together by one of our board members that breaks down the carb % and protein % of most of the commercial brand foods. You want to keep the carb % below 10% and around 7% is great. The other link is to a site by a vet "Dr. Lisa DVM" ... who also posts on this board from time to time ... there is in-depth info. there about many things, including nutrition and how to make raw food.
    Nutrition/food info

    The good thing with feeding your diabetic cat this way, is that it is ALSO good for any non-diabetic cat too. All your cats can safely eat the same food without worry and it may save you some costs and headaches of having to do separate feedings and keeping track of what they are eating.

    2. Home testing: It is impossible to convey the value of testing your cat's BG (blood glucose) level at home. Some vets will "suggest" this, but most won't even mention it. They will send you home with insulin and an amount to shoot and maybe some instructions about hypoglycemia (blood sugar dropping to a dangerously low level).

    Well, the thing is, human diabetics don't EVER give themselves insulin without checking there BG to make sure it is safe to do so, so why shouldn't it be the same for our kitties. Here on FDMB it is. You will notice that the vast majority of people here test their cat's BG at least 2x/day (before giving each shot to make sure the level is safe enough) and periodically at other times to see how the cat is responding to the current dose. We use a human glucometer, test strips and lancets - which are all very readily available and easy to use.

    Our kitties get lots of love and treats for "putting up" with this and most of them actually come out to be tested on their own 'cause they want those treats . Here is a collection of great links that "Carolyn and Spot" pulled together about hometesting. See what you think ... it truly is the best way to not only keep Your cat safe but also really get a handle on this disease and help him to live a healthy life with FD (feline diabetes).

    Home testing Links

    3. Insulin: There are several types of insulin available. Many people, myself included use Lantus or Levimer both of which are great insulins. They are gentle insulin and given twice (BID) per day in 12 hour increments. Or you could also choose PZI or the new version called Prozinc.

    Please read up on the insulins available, here is a link to the Insulin Support Groups:

    Insulin Support Groups

    However, one caveat and again this shows how these three things are inter-related:

    If you are feeding dry food or even a high carb food, BEFORE removing these foods, please make sure of your insulin dose as it will most likely need to be reduced, so as to avoid a possible hypoglycemic situation due to the removal of the dry/high carb foods that will lower the BG’s and reduce the amount of insulin required. Again, another reason why home testing is important.

    I know this all seems like a lot, and that's because it is ... there is a learning curve here. But as long as you are determined and keep at it, you will have it down before you know it and you'll be seeing the results in Your cat' overall health and happiness. Ask all the questions you can think of - that's why we are here!

    Also, if you haven't done it yet, take the time and fill out your profile. It will help when others come on and read this. Also, let us know where you live - city/state as there are probably people in your area who can provide on the ground support and help you to learn home testing, etc.
  4. Phoebes mom

    Phoebes mom New Member

    Aug 2, 2012
    Re: Hi! I'm new and want to take the slowly, carefully appro

    Thanks, Carl & Bob and Hillary and Maui for your welcome and responses!
    We have not yet begun home testing, but it certainly is in the plan!
    This just makes sense!
    Our vet is "babystepping" us through the process I think, making sure we are comfortable with giving shots and not following poor Phoebe around, making her crazy!LOL!
    The dose of insulin has been decided based on a weekly glucose curve done at the vet.
    Phoebe has always been a raw feeder, with the exception of a 1 year period where a previous vet convinced us we should supplemtn the diet with some dry food "to ensure she was getting full nutrition" ....I believe this was the start of her developing diabetes!
    She is now back on just raw, human grade meat.
    The insulin I am using is Lantus given twice daily, 12 hours apart.
    I am in Sydney, Australia. I feel so grateful that the www makes it possible for us all to communicate and learn, no matter what the distance.
  5. Hillary & Maui (GA)

    Hillary & Maui (GA) Well-Known Member

    Dec 28, 2009
    Re: Hi! I'm new and want to take the slowly, carefully appro

    We have other OZ members, I think she's in NZ, but close enough anyway. Her name is Allie & Myrtle, I'll send her private message to see if she is around and could stop by.

    I can understand the babystepping process, however, I have to disagree with the vet regarding home testing. Especially with the dose you are using, I would go out and pick up a meter, strips, ketone sticks, etc. as soon as possible, watch the videos (on health links) and start home testing ASAP.

    The sooner you learn to do it, then you won't have to take your cat to the vet for weekly curves, which sadly really won't give you relevant information, due to vet stress, which can artificially inflate the BG numbers by as much as 100 points. So, then the vet bases the dose on the wrong numbers.

    It's a potentially dangerous situation and one that can cause hypoglycemia and possibly death.

    Raw food diet is a great diet for a cat. While, it's controversial, it's the closest to their natural way of eating. So, good for you for feeding raw.

    Dry food and steroids are two things that can contribute to diabetes. And is something I learned the hard way, with Maui. she had both. That's a story for another time.

    So, how else can we help you.
  6. Re: Hi! I'm new and want to take the slowly, carefully appro

    I think "Vyktor's Mum" (Serryn) is also in Australia, and I just sent her a PM and asked if she could help with available food tips.

  7. Anyname

    Anyname Member

    Jun 8, 2010
    Re: Hi! I'm new and want to take the slowly, carefully appro

    It would be great if Serryn interested in helping you. She was so fantastic in getting Vyktor of insulin. I miss hearing from her.

    I would just like to add that home testing is really easy. My kitty-boy has been FD for over two years and I cannot exist without one or two tests a day. My vet seems to think it upsets me to do it but it upsets me not to do it. Luckily my boy is so used to it that I can easily do him any place any time - he knows the routine and accepts it as normal.

    My vet started LB on 3 units and looking back I wish I had listened to the advisers on FDMB coz much later, watching Serryn follow the protocol so intelligently, she got Vktor OTJ and I was never successful. My boy is a massive Maine Coon weighing around 10 kilo's so I'm not sure if size matters with regards dose but with the wisdom of hindsight I would do it differently and have used less insulin to begin with. I think everyone gets so caught up initially with the diagnosis and the high bgs but I gather that once they are receiving some insulin, correct dose or too little, they are in far less danger.

    I have recently changed my meter to an Accu-Chek Performa. Our vet uses this one and I can see why. If you are going to get one then consider getting this one. I was using Freestyle Optium but I had a lot of problems with the test strips not working and am glad to have changed over. I also have a spare battery-less Accu-Chek Advantage meter that I'm willing to post to you if it would save you some $$$'s. I live in Melbourne.

  8. Allie & Myrtle (GA)

    Allie & Myrtle (GA) Well-Known Member

    Dec 29, 2009
    Re: Hi! I'm new and want to take the slowly, carefully appro

    Hi Phoebe's mom!
    Glad to see you already have a lot of good advice, and also a fellow Aussie to help you out!

    My cat was a raw meat eater, with almost no dry food, so her diabetes was a bit of a mystery to me!

    Don't think I can help you, particularly, from over the ditch in NZ, but I wish you all the best with Phoebe and hope you soon have the reward of seeing her respond to the right dose!
  9. hmjohnston

    hmjohnston Well-Known Member

    Dec 30, 2011
    Re: Hi! I'm new and want to take the slowly, carefully appro

    I am a great big fan of the raw- making another batch later today for my sugar cat- chicken, unfortunately as we cannot get roo in the US- or at least not at prices I can afford :lol: .

    Remember that while raw is the best- cats eat the WHOLE thing- meat, bones, brains- all of it. So just getting the meat and feeding it will not give Pheobe everything she needs- there are also other needed vitamins and minerals to add. You may already be doing that as you have been feeding it to her for years but just in case here is a great link on what else needs to be added:http://catinfo.org/
  10. Vyktors Mum

    Vyktors Mum Well-Known Member

    Nov 15, 2011
    Re: Hi! I'm new and want to take the slowly, carefully appro

    Marilyn you make me blush!

    Raw food will be best as long as you add the necessary supplements, off the shelf wet food that is low carb and safe for Australian sugarcats is as follows:

    NO FANCY FEAST - the version we have here is different from the Classics in the US and it is high in carbs. I used that for bumping Vyktor's BG up when he was getting a little low.

    Ziwi Peak is excellent ingredients wise (the best) but I notice it gets Vyktor a bit constipated so I don't feed that to him as his sole food and I mix it with water when I give it (it's a good idea to mix all the food with water really)

    Natures Gift - usually you want to avoid anything with 'gravy' but their gravy varieties are fine


    Ultimates (not the varieties with rice)

    and don't give seafood meals than twice a week. The krill oil in the Natures Gift non-seafood varieties doesn't count as a seafood meal.

    Would be great if you can start home testing ASAP, due to the stress kitty is under the results the vet gets can be quite different than what you get at home. It's also a massive safety issue. I could not imagine shooting Vyktor blind. When I had to be away for a couple of shots once I elected to miss those shots rather than have the pet sitter (who couldn't test) shoot, other people cut the dose in half if they have a pet sitter shoot.

    Kind of ironic that you 'want to take the slowly, carefully approach' but your vet started her on 3U. That is a pretty high starting dose. The usual starting dose for Lantus is .25U/kilo of ideal body weight (or actual weight if kitty is underweight). Raising by a whole unit was not a good idea either we usually raise in .25U increments, occasionally .5U when kitty is still very high. That was a 33% increase on an already high dose and increasing like that means you will likely miss the right dose for Phoebe. Your vet may appear knowledgeable to you at this point but keep doing your research and I think you will conclude (as so many of us have) that the vet is not such an expert. Hardly suprising given how many different things your vet needs to know a bit about. Also not a problem once you're home testing and have set up a spreadsheet. I suggest once you do that you join one of the Lantus forums and you can get all your dosing advice there (suspect you may be advised to reduce dose right back and start again to make sure you find the right dose for Pheobe). The tight regulation forum is the busiest. The tight regulation approach is also scientifically proven to have the highest rates of remission when implemented soon after diagnosis but you don't have to be following tight regulation to post in that forum. However, if you prefer to follow the start low go slow approach, put it in BIG LETTERS in your signature block so people give you the appropriate advice.

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