Hi! Our Story + LOTS of questions! : )

Hi!
I’m brand new and have a lot of questions! (I tried searching for answers but I’m not having any luck--any tips on how to find specific information?)

My kitty Sushi was diagnosed with diabetes in January. He stopped eating and was throwing up yellow foamy stuff; I took him to the vet to find he had started going into liver failure due to diabetes!
He is 6 years old, very fluffy, and he’s a big guy weighing in around 18lbs. He's a few pounds overweight, but he's also just a BIG cat!

I haven’t been completely happy with my vet; he’s either too busy for me or not very knowledgeable. I don’t feel like he takes my concerns seriously. To make a LONG story short:
Sushi isn't regulated yet. When he was first diagnosed, I was bringing him to the vet to have his BS checked. After a few months, my vet sat me down and said that Sushi gets so anxious and mad at the vet that the BS levels are not accurate. He suggested that I begin checking his BS @ home with urine strips that he would order for me. A few weeks went by with several unsuccessful interactions in an attempt to obtain the strips. Then, I get a voicemail from the vet saying that the BS kit had come in; a kit to test his BLOOD (not urine). This was never discussed with me. The inefficiency, disorganization and oversight of the entire process made me decide to change vets. Shortly thereafter I lost my job. I’ve been hoping to move back to my hometown and pick up with my vet there who is wonderful! However, it’s taking me longer than I expected to find work and I fear I’m neglecting Sushi in the process. Here are my current concerns:
- He doesn’t groom himself. He may wash his face after eating, but that’s about it.
- He sheds a LOT. I live in South Louisiana and it’s in the dead of summer, but I feel as if he’s shedding too much.
- He started to develop minor dandruff right around the time summer started.
- Since he was diagnosed, I’ve noticed his eyes glow/reflect more. He has “laser beams coming out of his eyes” about 75% of the time when I look at him. Is this normal?
- He squeaks/whimpers when he poops.
- About half the time, he does not poop in the litter box. There doesn’t seem to be a rhyme or reason for when he does, when he doesn’t, or where he decides to go (he goes all over the house!). This is a PROBLEM!!!
- His poop SMELLS!! It’s so pungent it will burn your eyebrows off!
MY MAIN QUESTION: I USE LANTUS INSULIN AND RECENTLY STUMBLED UPON A FORUM ON THE CARTRIDGES OF LANTUS OPTICLICK PENS BEING A MORE ECONOMICAL OPTION. THESE POSTS WERE DATED FROM 08-10. I’VE SEARCHED AND SEARCHED, ON THIS FORUM AS WELL, AND IT SEEMS THAT THE OPTICLICK PENS HAVE BEEN DISCONTINUED? SO THEREFORE YOU CAN’T JUST BUY THE CARTRIDGES ANYMORE? AM I RIGHT OR WRONG? ANY INFORMATION/INSIGHT WOULD BE SUPER HELPFUL HERE!
I CURRENTLY PAY ABOUT $110 FOR A 10ML BOTTLE OF LANTUS. MY PHARMISIST QUOTED ME A PRICE OF $255 FOR A PACK OF 5 LANTUS SOLOSTAR PENS. THAT’S NOT A BETTER DEAL. AGAIN, ANY INFORMATION/INSIGHT WOULD BE SUPER HELPFUL HERE!

Thank you so much for your help and support!! I'm so glad to have found this forum!
Ashley n Sushi

 

Hi, Ashely (and Sushi)
I'm gonna link this thread with the lantus forum since your main question is lantus related. That'll get you a quicker response (I am a PZI user)
I'll post more later.
Carl in SC

 

hi there and welcome.

i'll address the lantus questions first. yes, the opticlick pens have been discontinued but the solostar pens have not so that is what most here use. we get the pens, take the cap off them, and use them just like a vial by inserting a syringe into the end of them and drawing the dose up. using the pen as it is made for humans to use is not very accurate for kitties unfortunately.

and yes, the outlay is more for the 5 pack of pens but they last longer than a vial of lantus. for instance, i started my 5 pack in february of last year i think it was and i'm on my last pen now. mind you, Mousie uses very little insulin (1/2 a unit twice a day) so while you may not get that long out of it, you'll get longer than a month or two that many get with the vials before the insulin goes bad.

some people have found that their pharmacy will sell them an individual pen though instead of a 5 pack so that would be a matter of calling around to pharmacies and asking them if they would do that.

does that make sense?

now as far as the other concerns, can you tell us some more so we can figure out where fixes might be? for instance, can you tell us what your lantus dose is?

what food you are feeding?

and do you have any of your glucose level numbers you could share? people here tend to use a spreadsheet to keep track of their numbers and perhaps you could set one of those up soon but for now, if you have any, you could post them here and we can take a look at them.

 

Hi Welcome to FDMB. that is a lot of question, and I'll try to answer a few at a time, plus ask a lot of my own.

Your vet was right that vet stress could be bouncing his numbers way high. It is much more accurate to test at home as well as way cheaper. I have no idea why the urine test strips were so hard to get, you can by them at any drugstore. But urine testing is a very general test. Blood Glucose testing is the way to go, but not with the vet meter, they are way expensive as are the strips, which you can only get at the vet. Most of us use human BG meters. The cheapest and most popular is the Relion form Walmart, I think it is about $9 and the strips are
are $5020 for a box of 50. There are other good options available online.

Cats who don't feel well will often have litter box issues. It may be due to the FD or another problem, urinary or intestinal. Have you had a urinalysis done? Preferably C&S (Culture and Sensitivity). That will indicate any urinary or bladder problems.

That sounds like he is in pain and should be checked by a vet.

Grooming and Fur; It will get better w/ regulation and most importantly w/ a proper diet! Dry food is really bad for cats, it is not natural for them. They are obligate carnivores and that means they eat meat. Most of their water intake comes from their prey and they do not naturally drink a lot of water. Thus they become dehydrated.

$255 is a little high for 5 pens, Costco is usually cheaper and you don't have to be a member to use the pharmacy. I usually pay a little under $200. Basically the cartridges and pens are the same, the cartridges went into a reusable case. It was a redundancy and the pens are simpler. Remember when you are getting the 5 pens you are getting 15ml of Lantus as opposed to 10 in the vial. Additionally, Lantus has a shelf life , mfg. recommendation is 28 days from starting the vial. Most of us use such small doses for our cats that we end up throwing a lot away. W/ the pens the countdown restarts which each pen. That said many get longer use than 28 days, but you can't count on it.

So now to my questions:

• * What are you feeding? First things first, get him switched to a canned food diet and NOT one of the expensive prescription diets. More on this later.
  * How much Lantus is he getting?
  *Are you testing?
  *What are his numbers if you are testing?
  * is he drinking and peeing a lot?
  *Where are you located? There may be a member close by who can help you w/ testing.
  * More to follow, this is just getting started.

Now breath, there is a lot to take in and learn, but we have all been in the same boat.

 

Cindy and Ann have asked a lot of questions. Once you have a chance to respond, we can offer more guidance.

If you are going to call around for prices for the pens, remember to call hospitals that have outpatient pharmacies. Often a hospital is able to sell single pens since the boxes are broken apart for use on the inpatient floors.

There is also a great deal of information available in the starred, sticky notes on the Lantus forum. Below is an overview with links to those posts.

• Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
• New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
• Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
• Lantus depot/shed: This is an important concept for understanding how Lantus works.
• Becoming Data Ready: What data you need in order to be able to work toward remission or tight regulation.

 

Sorry, I had to go test Tess.

Come over to the Lantus Forum there are a lot of Stickies (permanent posts) st the top of the list with tons of information. ETA: Oh I see Sienne has given you the individual links.

I can't stress food enough. Dry is cheap and convenient for us, but terrible for our cats. Even the stuff the vets sell. Check out this website for a list of catfoods with the % of carbohydrates and a lot of other stuff. Janet & Binky's List Diabetic cats should eat foods with no more that 10% carbs. Lots are available, in all price ranges.

 

Hi all!!
Thanks so much for your replies. First off, I meant to say that I do not feel that Sushi is regulated yet; I made a typo in my original post. Ann & Tess (Tess is a beauty!!), let me answer your questions:
* What are you feeding? First things first, get him switched to a canned food diet and NOT one of the expensive prescription diets. More on this later.
I feed him about 1c of dry Hills m/d food a day.
* How much Lantus is he getting?
I give 2 doses of 6 units of Lantus a day. After reading the FAQ's, I realize that is probably too much. I just feel like I'm on my own here since I've had so much trouble with my vet. I've basically been using his water intake/urination as my gauge of how he's doing, and it seems to be at a normal level with 10-12 units/day. At this rate, I'm not sure it would be more cost effective to go with the SoloStar pens.
*Are you testing?
no
*What are his numbers if you are testing?
n/a
* is he drinking and peeing a lot?
His water consumption/urnation seems normal when the bottle of Lantus is "fresh," but it has increased significantly as the Lantus "poops out." I can't think of the last time Sushi didn't have grimy back feet from litter (does anyone else know what I'm talking about?).
*Where are you located? There may be a member close by who can help you w/ testing.
I'm outside of the Lafayette, LA area. Oh I would LOVE to have someone that could help me with all of this!

Great information!!! Thank you so much. And my vet can show me how to use it?

I know that the squeaking/whimpering when he poops isn't good, but my vet didn't seem concerned (ugh, my vet's just terrible!). I was wondering if it might be a diabetes-related issue.

I thought of another observation/concern: His ears get really hot. That's how I can tell he's not doing well.

 

I wanted to fix what I am sure was just a typo.
The strips are $20 for a box of 50.

And 6 units twice a day.......... :shock:
Whew. that is A LOT!!!
You are about to get the greatest gift for your kitty. I'm talking about all the great advice form this board. Prepare for it! It may feel overwhelming. Just know it's cause we LOVE, LOVE, LOVE our sugar babies.

I'll start by saying the dry is what is keeping your kitty alive on that high a dose. Most likely, anyway. There could be other issues that would require that high a dose, but it's not common. I'm not telling you that to scare you. Just letting you know.
My Callie Mae started at 5u twice a day and was bumped up to 9 units twice a day by the time I found this board. Read all about a proper diet, reduced Callie Mae's dose to 1u, switched her to a low carb wet diet and she went completely OTJ (off the juice--no more insulin).

This may be possible for your kitty as well. We'll get you there.

Others will be along now, so I'll leave you with that.

 

Oh, and one more thing.

If your vet can show you how to home test, that would be great. But we can help with that too!

Have a look at this. :smile:

http://www.youtube.com/watch?v=_zE12-4fVn8

 

Thanks so much totallybeachin!

Yikes! So you're saying I should drop his dose, right? But he drinks SO much and urinates SO much if I go any lower. But I certainly don't want to be harming him!
Or are you saying that the dry food is what is causing such a high dose?

Oh my...I knew my situation was a mess, but I didn't realize how BIG! :?

 

You don't want to cut back that dose without switching to a low carb canned food, and you don't want to switch to the low carb canned food without cutting back the dose. Either one can be a dangerous situation for different reasons. If you do make the switch completely to a low carb canned food, then I personally would recommend cutting the insulin back to 1u twice a day and work on getting a blood glucose reading at home.

I am so glad you guys found our forum here. You have been given great advice already, so I just want to say welcome!

 

Okay, I am a bit overwhelmed. So break it down into steps for me. What's my first step to making things better for my guy?

I also wanted to say that Sushi already feels loved by all of you. I haven't done anything different, but as strange as it sounds, he can tell he's being loved and cared for a little bit more now that you are around. Thank you!!!

 

Hi and welcome,

If this were my cat, my first step would be hometesting.

Your kitty has been on that dose for about 8 months now, correct? If that's the case I'd want to hometest and see how that dose is working.

Then I would start changing food but not until I got that Walmart meter and could see exactly how he's doing.

 

Hi, sorry to disappear last night, but Tess was keeping me dancing close attendance and i missed when you came back online. Sorry on that typo on the price of the Relion strips! I definitely need new glasses.

I know there is a ton to learn about FD, but most of it is available right here. We all make mistakes when we start and sometimes our vets are no help.

First off, you need to be testing. It is the only safe way to give insulin. No one would give insulin to a child without testing. Our cats can't tell us when they feel low and giving insulin to a cat w/ a low BG is dangerous. Hypoglycemia (Hypo; very low blood sugar) can kill a cat in a matter of hours. It is better to have high BG for a few days than to have low BG even a few minutes. We have a saying, better too high for a few days, than too low for an hour.

I'm not an expert on dosing but , boy that is an awfully high dose to be starting out on! :shock: :shock: I would reduce the amount of insulin too , at least by half if not back to 1u. when you start the transition. I hope someone w/ more dosing experience can weigh in on this.

Switching diets can be tricky, ideally we switch first and then start our cats on insulin. That usually isn't the case though. Does Sushi like canned food? That can be half the battle right there. Some cats are totally addicted to dry food, they spray a coating on it to make a totally unappealing food seem like candy to them. We call it Kitty Crack. Start by offering both foods and gradually reduce the amount of dry available. Do it at a time when you will be available to monitor his BG frequently. It may take a week or two, you want to go slow. I might start with a Medium Carb (MC) food, around 10% to prevent too sharp a drop. The carbs in dry food tend to remain in the system longer than those in wet food. HAVE A HYPO KIT READY, High Carb (HC) food, usually one w/ gravy, MC food too, some Karo syrup and plenty of strips.

Cats can also bounce into high numbers if they suddenly drop very low. The liver can produce glucagon which spikes the BG when it senses the BGs have gone too low. It can be a vicious cycle of low, high, low, high. This is why we usually start at 1u. and if the cat needs more gradually work our way up in .25u increments. Once you get Sushi transitioned over we can walk you through this step by step.

I'm sorry but I have to leave now. Please first thing get a human BG monitor. It may not be the one you want to use in the long run, but it will get you started. My main meter is the Maxima, not the fanciest, newest model around but dependable and I can get very cheap strips directly from the mfg. I think w/ the worry of expense off you mind you feel more free to test frequently. That is important. I also have a backup meter that I can get strips for locally, should I, :roll: horror of horrors, run out of strips for the Maxima.

Please do whatever reading you can get in from the links Sienne and I have posted and watch the uTube video on testing. It isn't as hard as it seems at first. BBL

 

Sushi's Mom,

As other have said, starting home testing should be your #1 for right now. Get you hands on whatever meter you can comfortably afford. I have had no issues with my ReliOn Confirm from Walmart. In fact, I wish I would have known about it earlier. I started out with a TrueTrack from CVS. It required such a huge drop of blood I wanted to cry when it was time to test Callie Mae. I couldn't get the poking right and I had to prick her ear sometimes 6 times to get a drop big enough. I thought for sure she was going to hate me. I learned how to test with that, and got comfortable doing so, but when I read about the ReliOn meters from Walmart and the cost of the strips, I made a switch. And I am so happy I did. With the truetrack meter, I had the lancing device all the way to 5 (the deepest setting) in order to get the big drop of blood I needed. With the ReliOn, I can set it to 3, sometimes 2 and get the tiny amount that is needed. I feel better and I'm sure Callie Mae does to. She noticed the difference. I can tell. Plus the cost if the strips were so much cheaper than the CVS one. And in the beginning, that's a huge difference. You will tend to use more strips until you can get some kind of data collected and some regulation going. But that takes a little while. The cheap strips help on that end.

Once you can start testing her, then you should get her transitioned to an all wet diet.
Here is a link on feline nutrition and Janet & Binky's famous food lists. There are 2, old and new. The longer list is the old one. It has most of the values for the Fancy Feast. The new one has the Friskie's. That's what most of us use. We look for food that is lower than 10%. Personally, I use 7-10% as a med. carb. and I stick with ones 4% or less for everyday meals.

http://catinfo.org/
http://binkyspage.tripod.com/canfood.html

PLEASE, don't take away the dry and start Sushi on all wet while giving that high of a dose.
I'm sure others will come in and weigh in on this, but this is Callie Mae's story.
Her vet had just advised me on 5/6 that starting with her pm dose, I need to increase to 9 units. She had started on 5 BID. I had just found the board a few days prior and had done some reading and just felt in my gut that was not right. I had gone out that afternoon and purchased what I thought were good wet choices (they weren't!!), but at pm dose time, I went ahead and gave the nine units as well as put some wet out with her regular dry kibble. That was the scariest night of my life. It was the folks here that stayed with me until the scary stuff was over. I knew RIGHT THEN, I was NEVER going to give my baby that much insulin ever again. The very next day, I dropped her to 1 unit and started the transition to all wet. She didn't want it all to much in the beginning. I had to mix it a little with her dry, stuff like that, but I was determined. After a few days, she realized she liked it. Now she can't get enough of it!!
Needless to say, after switching her dose and her diet, little by little her pancreas started doing it's job. By giving her proper doses, I was giving her pancreas a much needed rest and it began to heal itself. When that started happening, with the advice and suggestions of the people on the board, I started just giving little "token" doses of insulin. A little tweeking here and there to find the right micro-dose and within a few weeks of that----OTJ!!!

I have seen it happen to a few cats whose bean (as in human being!) joined after I did, and they have success stories similar to mine. 2 that come to mind right of the bat are users ohbell and carlinsc. They were both newbies not to long ago, and both their babies are now in remission.
I think there is a good chance you could see it too.
Not EVERY cat will go into remission, but it IS possible. Just want you yo know that. And even if Sushi doesn't go completely OTJ, you will still know you are doing the absolute best for her by having the power and knowledge.

Now, go get that meter and get a spreadsheet going!! :lol: :lol:
We're all dying to know what kind of numbers Sushi is throwing out.

Oh-and 1 more thing. With that high of a dose, you could very well just be on a perpetual up-down-up-down cycle. That would cause all the peeing and such. Once we can have a look at her numbers, get her on a proper diet and dose, you will see that change. (Hopefully, if there is not something else going on too.)
And that reminds me of one more thing to put on your shopping list.
Ketodiastix. They are with the diabetic supplies. You want to have them to check for ketones. Ketones can cause DKA, and you DO NOT want to have to battle that. More on that later. Just focus on the little things right now. I don't want to worry you. Just make sure to get some so we can keep that little monster in check.

Keep us updated, and ask all the questions you want.
We are here to help you in any way we can. That's all we can do is pay it forwatd.
One day, you will be tapping the keyboard helping another newbie who will be a scared as you were. You'll see. We'll get you there!!!

 

Sushi's Mom,
Remission is of course, everyone's goal. Nobody wants their precious kitties to be sick. I was devastated when Bob was diagnosed. I blamed myself. (I've since gotten over that feeling). I am so thrilled to be able to post about Bob's OTJ today. But here's what is really important to me - even if Bob regresses, and has to go back on the juice in the future, or he develops some other condition related to diabetes, at that point in time, I will understand what is going on, and I will know how to deal with it. THAT is the most comforting feeling in the world. THAT is what you're joining up here will do for you as well some day in the future.

Now - go get that meter and let us know what's going on with Sushi's daily cycles! THAT will enable you to feel so much more in control of the current chaos. And it will enable everyone here who wants to help a much better opportunity to help you and Sushi.

Looking forward to hearing what Sushi wants to tell us....

Carl in SC

 

Thank you so much everyone! I'll write more later, but I'm on my way out the door to pick up more insulin and the supplies you suggested. One quick question:
How should I decrease the amount of insulin I give? Do I do it all at once or a unit at a time?
Take today's evening dosage for example, I would normally give him 5u. Could I just drop back to 3u? Or is that too drastic?

 

Cutting back the dose while you are not testing is a safe thing to do but as some have said, do not cut back too much or you can run the real risk of complications like ketones.

There is no way to know how much to cut back, so perhaps by 1-2 units. Learn to test, then see where things are at. Meanwhile, test the urine every day for ketones and watch for any signs that he feels worse.

Things WILL get easier

Jen

 

bumping you up and I sent a message to a more experienced member in the Lantus group. Jen is right it is a balancing act on just how much to reduce at this time.

 

When do you shoot? You are in Central Time Zone, right?

 

I'M SO ANGRY I WANT TO CRY!!! I just spent an hour in loud, obnoxious Wal-Mart gathering supplies and waiting in a LONG line. I arrived at the counter to discover my vet still hadn't called in our insulin prescription. A prescription I requested at 12:30 and was assured would be ready this afternoon!! As if I haven't had enough trouble with this vet!!! We may have to skip tonight and tomorrow morning's dose because of this! Dealing with this FD hard enough; my vet makes things so so much more complicated and frustrating!! cat(2)_steam

I noticed there were 3 types of ReliOn Meters: Confirm, Ultima and Micro. Any suggestions on which to get?
Confirm: http://www.walmart.com/ip/RELION-CONFIRM-METER-BLUE/13863716
Ultima: http://www.walmart.com/ip/ReliOn-Ultima-Blood-Glucose-Monitor/3555238
Micro: http://www.walmart.com/ip/Micro-Blood-Glucose-Monitoring-System-Kit/14053308

 

Welcome to the family,

To answer your question about the Relion Meters...Either the Confirm or the Micro are good meters I don't know much about the Ultima, no hands on experience with it, but I do use the Relion Micro for my sugarcat Maxwell.

Really sorry you are having such a difficult time with your vet, but you ar already getting great advice from the folks here, and you will soon learn you have been incredibly blessed to stumble on to us.

Mel, Maxwell, Musette & The Fur Gang

 

The Micro is small and really easy to handle when your other hand might be tied up with Sushi. I also like the 50 reading memory (but they all probably have that ability) in case I forget to write in Bob's Log right away. The Confirm is just a bit larger. Nice thing is that they use the same strips, so if you try one and don't like it, you can get the other and not have to pay for different strips at the same time. In the local wal-mart yesterday, they were each $9. And strips were $9 for 20, or $20 for fifty. I've got a Micro.
Likewise, I have no experience with the Ultima.

Carl

 

Thanks again everyone!
The drama continues...after several phone calls to my vet, and 10 (yes, 10!) calls to the WalMart pharmacy, I still don't have an insulin refill.* I think I can squeeze one more dose out of this pooped out bottle for tonight (even though we're 2 hours late), but what about the morning? I have a bottle that expires 7/12 that I started using in January and began pooping out in May. Is it better to use old/pooped out insulin than none at all?

*No lie, the pharmacist said my vet called, and his voice started to slow down "like a broken tape recorder," and then the call cut off before he authorized the prescription. Really!?!?! You can't make this stuff up! :roll:

 

Ashley
I just bumped up your post in lantus.

carl

 

Wanted to pop in and say hello! You've gotten wonderful advice so far and I don't want to pile on a ton of additional info. With your Lantus question...Has the vial been in the fridge this whole time? If not, it's definitely dead. If so, it still probably is, but might be better than nothing. I don't know that it would be harmful, just likely ineffective.

As an FYI, since costs are a concern right now, I'd echo the suggestions for the Relion Confirm or Micro meters. They are great little meters that require very little blood for a reading and their strips cost much less in store than most other meters. You can also get the strips for them online at American Diabetes Wholesale. Once things calm down for you, I can happily provide you the info!

Your first step is definitely home testing... the key to being able to make good dosing decisions is knowing how the insulin is/isn't working for Sushi. I know it must be extremely frustrating to be spending all this money on insulin, food and supplies only to have your sweet kitty still be miserable. The folks here were a GODSEND to us when we were first diagnosed and we too had problems with a vet (who eventually kicked us out of her practice for being "noncompliant!!"). I have put Willie's life in their hands many times and have never been steered wrong. In no time, you'll have a full handle on Sushi's care and will be able to be a strong advocate for his care.

Once you're home testing and you can monitor his progress, the next step, if you're amenable is to make the switch to low-carb wet food if you can, and if you're able to do that, also reduce the dose. The wet food definitely doesn't have to be pricey... many here feed Fancy Feast or even Special Kitty from Walmart. The large cans are very economical options. You'll also want to get some high carb foods from the Janet and Binky's list (think food in cans with gravy) and some karo syrup for situations in which Sushi's numbers are too low and you need to get them up. Others have mentioned Ketostix as well. These are important for you as you attempt to lower the dose. You test Sushi's urine with them to determine the presence of ketones. They are very dangerous, but if caught early, you can take steps to help flush them from Sushi's system. If they continue, Sushi can develop diabetic ketoacidosis (DKA), which is a very dangerous condition that involves days in the hospital to treat, thousands of dollars, and it can still be fatal. $15 for that little jar of strips is money VERY well spent.

One more question... any chance we can get a first name? Would love to give you a proper welcome!!

 

Okay, I'm getting really worried. Sushi is in rough shape. He hasn't eaten anything since 6:30pm, so I haven't been able to give him his PM dose yet. He's sleepy, uninterested in food, his breathing seems labored and every now and then he lets out a sigh/groan. All of these things happen frequently, but not at the same time. :cry:
I so hope tomorrow's a better day!!

 

Any luck on getting Sushi to eat? Those symptoms are a bit worrisome, but not an area in which I've got a ton of experience... you may want to add your comments to your post in Lantus Land as well to get it some more eyes.

 

are you able to test your kitty's blood sugar now? did you say that you did pick up a relion meter or are you still deciding between models?

sorry, i just skimmed your long thread and am fixated on your last post. if you can test now, please do so and repost.

and btw, could everyone not go on about the large dose? if the cat's been on that dose for awhile the dose is likely not a crisis. my cat came here on a high dose as well and there are reasons sometimes for it. before you mess with the dose, the first step is to get hometesting.

 

fwiw, the ultima is the older version. the confirm and micro are the newer meters and require less blood and no coding. very much like the freestyle meters. also, some people have found that their walmarts don't keep a lot of the test strips on hand for the ultima

 

sushie's person (god I wish I knew your name)
can you let us know what is happening. do you need help? we are here with you ok.
we can help...just let us know.
do you need a phone number to talk to someone?
Lori

 

At the start of this thread she said her name was ashley

 

thank you carl!
dear ashley,,,,we are here.
you know that right?
we will stick this out with you....
lori

 

Hi!
Yes, my name is Ashley; I'm sorry I haven't answered questions, I just feel distracted by all of this, but I do plan to! No luck with getting Sushi to eat. I've tried all sorts of tricks but nothing's worked. I gave him a treat about an hour ago; he ate that...I picked him up and put him on the floor to make him walk, he got some water and settled on the floor for another nap...just looked over and he's snoozing sprawled out/belly up as usual. I'm really really trying not to worry. I know this is a bad situation, but worrying as much as I want to won't help!

I didn't end up getting a glucose meter today*--I'll go get one now if you think I should. I'm anxious about the fact that I haven't ever used one before; do you think it would be okay to try and tackle that new task in this situation?

Thank you for all of your support!!!!


*I was going to try a prescription discount card today. The pharmacist said I could put the glucose meter and all my other supplies on the discount card if my vet prescribed them, I decided to try to get that accomplished. I didn't expect that I would be insulin and supply-less when the day was done or I may have decided differently!

 

yes it would be fine to test now. i'm a little worried that sushi is acting lethargic - that can be one sign of hypoglycemia. did you give sushi insulin tonight? if so, how many hours ago?

 

honestly, if you gave insulin tonight and this is not normal behavior, i think i would assume that you might need to get some sugar into sushi.

is there anyone else who can go to the store and get a meter and test strips while you stay with sushi?

 

I just thought of another trick AND HE'S EATING!! HOORAY!!!!! :razz:

Now, is it too late to give him a dose?? He was supposed to get it at 6:30pm; it's 10:30pm now here I am.

 

No, the last dose I gave was around 6:30AM.

Okay maybe I got excited too soon--he's finished eating, so he only ate a few bites--still, should I give him his PM dose?

 

lantus is a 12 hour apart shot insulin. if you shoot now, you need to be ok shooting 12 hours from now.

but if i were you, i would want a meter to test him, ashley. is sushi a he, btw?

also, my kitty is a big boy, on a large dose of lantus as well. you've got company. my punkin's been diabetic since december.

 

sorry! i see he's a he! ohmygod_smile

any way to pick up a meter & strips still tonight? i don't think it matters that much which model, as long as it's not on its way to being extinct! :lol:

 

That's do-able for me; in fact that would prob work best; it would give me more time to get his insulin refilled. SHOULD I DO IT??

Yes; Sushi's a boy.
I'm glad to hear it! I was getting wigged out about my large dose--we'll see how it shakes out!

 

ohmygosh - i just saw your avatar picture. sushi's GORGEOUS! and he is a big boy! he looks so proud! there can be underlying health reasons why a cat might need larger than average doses of insulin, btw.

i don't know if you should shoot or not. it's up to you - your hand on it.

i'm a fan of hometesting so i don't shoot without testing, although i did it for 3 months at the beginning before i found FDMB.

if his last shot was 16 hours ago, i don't think he just had a hypo event. more likely the heat or something else, or you'd have had it happen sooner. lantus hits its peak around 6 hours after the shot. so again, it's up to you. i want to really encourage you to not wait on getting hometesting though. the soonest moment possible, pick up the glucometer and let us help you get started.

 

So is Punkin (that's who is in the picture, right?) I thought the same thing when I saw him. Our guys look very very similar in the face--they could be brothers! : )

 

did you decide to go ahead and shoot?

and yes, this will give you time in the morning to get your new insulin bottle. with a dose of 6u, for now, you're going to find that the vial will probably be worth the money. i figured out that 7units is about the dividing line between being more effective to buy the pens versus the vial, unless you are able to find some pharmacy to sell you 1 pen at a time. some will do that. you're on the line for cost effectiveness, so it probably doesn't matter much if you go pen or vial.

when you get the new insulin and a meter with strips, also get neosporin OINTMENT with pain relief. then you'll be set to get back on here.

the next step is to get a spreadsheet set up and get the hometesting figured out. just know it will take you a couple of days to get the hang of it and don't be discouraged until you've gotten it. i remember at 4 days thinking "i've only been doing this for 4 days. i can keep doing it and i can get it!" it's often rough to start!

also, since we don't know if sushi's BG is high or not, one good tip is to add water to his canned food. you can add up to 50% and he probably will eat it just fine. diabetic cats pee out their water and end up dehydrated - all cats have a poor thirst instinct, so just add the water in. at the least it won't do anything except fill the litter box more, but at best it will keep him from developing ketones if his BG is high.

when you're a little settled, come on over to the Lantus forum! that's where i "live!" :lol: along with a lot of other lantus users. the main forum is the awesome place where you are now that greets everyone new coming in. someone from here posted in lantus that you needed advice for sushi.

hopefully you're ok now. i'm gonna think the lethargy was not diabetes related, or at least not hypoglycemia related.

are ya ok? if so, i'm gonna leave you in these able hands and will see you in the lantus forum tomorrow!

ah, just saw your post. that's punkin - but he's all orange everywhere. there's pics of him in my signature line. i think he's gorgeous, but i admit i'm biased!

 

Thanks Julie!
I decided that he didn't eat enough to "shoot" him. He seems to be a bit more perky so I'm not as worried.
I also think I've been helicopter-ing over him all night, and I need to leave him alone. He might just be annoyed with me and won't eat out of spite (he's hardheaded like that). So I set a timer for 30 mins and told myself I'm not allowed to bother him again until it goes off.
Go ahead and go; we'll pick up the adventure again tomorrow.
Thanks again!! : )

 

it's a marathon, not a sprint! someone wise on FDMB told me that and i've repeated it in my head 2,000 times. see ya tomorrow!

 

any chance you can test his urine today to see if he's developed ketones???

 

I'm trying! Still fighting to get the vet to call in the prescription for the insulin and supplies... :YMSIGH:

 

Was there an original refilled allowed on the vial? Can you check you label? You would need a new rx for the pens, but for now a refill on the vial would do.

Has Sushi eaten any more? What did you feed him? Any canned food yet?

Paws crossed that the vet gets his act together soon. At least try to get the meter and ketostix today.

 

Hello Ashley! My cousin's name is Ashly, w/o the "e". Welcome to FDMB!

Cedric was on insulin for a month, and thanks to the good folks here, was able to get into remission quicker than my vet thought. My vet has some experience with diabetes in dogs & cats, having one of each at home (his vet GF, I believe). he was still impressed with the quickness of Cedric's remission. I don't think that wouldn't have happened if I hadn't taken away the dry. I also think that shooting the inculin into his side belly area helped as well.

I use the Relion Micro because it's small and cheap (strips are cheaper too). My mom works for McKession (a company that supplies medical stuff to dr's offices) and would have gotten me a meter and strips, but this was better (mom lives 1000 miles away - and might be laid off from her job anyway). Testing is what I have always had problems with - even today! I still test Cedric about every 3 days, even though he is diet controlled. I buy the lancets that are 28 gague and get them from Target. It's more convienent that Wal-Mart, and I like them because they have a cap. Cedric gets too interested in things and I don't want him to poke the needle of the lancet in his mouth!

To be blunt, I'd ditch that frackin vet for a new one. :evil: I'm in FL, so I can't give you any advice or refererals, but I would consider looking for a new vet.

Hugs to you both!

 

Doombuggy may be right, it may be time for a new vet. many of us have had similar problems. Remember, the vet works for you! Final decisions are yours. Here is a link to a vet finder Just type in your zip code.

Call around and ask questions.

• --Do they have diabetic cat patients?
  --What is their usual treatment plan?
  --How do they feel about home testing?
  --Client involvement in the treatment?
  --Nutrition?

Some where on this site there is a list of question to ask your vet. I'll try to find it.

I like my current vet (the one who dx Tess only lasted the weekend he gave me so much wrong info on diabetes and that long because he was closed all weekend), but it does bother me to walk in and see the stacks of Hills food. It really isn't a good choice!

We didn't want to scare you about the dose. WE were just trying to warn you about switching to wet food from dry when Sushi is on that much insulin. The dose in combination to the change to a low carb food that can be tricky.

 

Can you go to the vet and pick up a paper script and bring that to Walmart yourself?

 

ohmygod_smile Duh! of course that's a great option!

 

Sushi ended up eating 1/2c of his usual Hills m/d dry food throughout the night. He ate another 1/4c (if that) around 8:30am and I gave him 6u at 9am.

I am giving my vet 1 more hour to get it together and then I'm going to make an appointment with another vet. If I went to pick up a paper script, I'd likely just spend a ton of time waiting in the lobby (I do that anyway...)--it seems that the vet is too busy to call in the script. I've gathered from the receptionists that he's hesitant to authorize a refill because I haven't brought him in in a while. (that's the short story--I'll elaborate below)*

I haven't switched to canned food yet. I'm going to get the hang of testing, do a curve, and take it from there. It's in the plan; I'm just trying to take it one step at a time.



*I mentioned some of this in my first post, but here's more of the story: I'm new to the little city I live in so I don't have a clue about who is a good vet, etc. I found a recommendation for my current vet on Kudzu. I truly like him, but he just hasn't been good to me or Sushi at all. The final straw happened in April (that's explained in my 1st post), and I decided to switch vets. I also decided in April to start looking for another job would allow me to move back home to Baton Rouge, LA (my job was the reason I moved to my current city in the first place). I have a wonderful vet in Baton Rouge, so I was thinking we would move and pick up with him. However, it's taken me longer than expected to find another job, and everything has just been in flux since then. I figured we'd just truck along without any vet visits until we got moved back to Baton Rouge. I was excited to find such a vast amount of information and support on hometesting here; I was thinking I could start implementing some of this in the interim. I'm unhappy with my vet here, but don't know how to find a new one (I've since made some progress, and you've provided some great resources as well!). And it's a lot to go through if I'm going to move to a city with a great vet next week, you know? I've just felt stuck and pulled in a million directions at once, time has gotten away from me, and (don't want to admit this!) I suppose Sushi fell through the cracks? It's all such a mess!

 

:YMHUG: :YMHUG: :YMHUG: Sorry you are having such a hard time of it. How long has it been since Sushi saw the vet? We usually get refills for a year at a time and checkup about every 6 months. Quite frankly my vet has admitted I know more about FD than she does. That has been the experience of many here, since we can focus on just the one disease. Then there are other vets who feel they have to be superior to mere pets owners in everything.

Getting home testing down is the first step. I think you have a good plan of action, however if you end up unable to get a refill and will be w/ out insulin it would be a great time to try to switch to LC food. Has he ever eaten canned food? Some cats are so used to dry that they don't recognize real food when they see it.

I can't figure out where I got the Vet Questions list, but I had down loaded it and here is a copy.

 

Any luck w/ the Rx? My DH brought up a good point just now. If Sushi is getting 6 units of "old" insulin the potency may be way down and if you get a fresh vial and use the same dose it could act like a big increase. How long have you been using that vial? How did you get to the 6unit dosage? Vet recommendation or gradually upping the dose? And if so in what increments?

 

I did FINALLY get the Rx and supplies!! Hoorayyyyyyyy!! Sushi's been in rough shape over the past 36 hours or so, so at this point my main concern is getting him to eat. I'm going to attempt to test his urine for ketones, but we're not going to do any glucose testing just yet. I feel like it's important to get back to the "normal" we were at originally first.

HELP!! I fed him around 5:30pm. He didn't eat much at all (maybe 1/8-1/16c?) and I gave him 5u of fresh insulin right away*. I didn't realize how little he ate until after I gave him the medicine. So I started freaking out. He didn't/wouldn't eat any more, so I resorted to pouring a little (maybe a Tablespoon?) chicken baby food onto his food. Is that okay?** This worked like a charm--he ate about 1/4c. All of this before about 6:20. He's been sleeping since then. Do you think he's in trouble for hypo? What are the symptoms I need to be looking for?

-->Another question: I typically feed him -- let him eat and lounge for about 30 minutes -- give him his medicine -- he eats a bit more. So it's like I give him his medicine while he's eating. This is what my vet recommended; what do you think?

Yes, true! Thanks DH! ; )
I'll answer your other ?s in a bit.


*I know I gave him his morning dose at 9am, only 8.5 hours between doses, but it was a dose from a bottle that was totally pooped out and Sushi was REALLY worrying me.
**A few years ago, my other cat was on medication I had to shoot down her throat. She's very feisty and it was NOT going well. Plus it felt very inhumane! I researched online and found an idea to mix it with some chicken baby food. It worked like a charm!
What do you think about baby food as a treat or snack or last resort to help your cat eat? How bad is it for a diabetic cat on a scale of 1-10?

 

As for the insulin, if it really was pooped out there should be no problem, but there is no way to know for sure. Keep a close eye on him tonight. Did you get a meter? I really wish you were home testing . Giving an early shot is like giving an increase. You are adding more insulin before the last dose has finished it's work. But if the old insulin was no good it wouldn't make a difference, but we don't really know.

Lots of us use baby food for cats that won't eat, Just make sure that it is meat only, NO ONIONS.

Also lots of us shoot while the cat is actually eating, they barely notice the shot. Onset for Lantus is usually 2 to 3 hours so we have more leeway in getting them to eat. Some other insulins are very fast acting and you have to get food in right away.

Other things to try are the water from canned tuna, crushed freeze dried chicken or salmon or shrimp treats, bonito flakes, parmesan cheese or Fortiflora (a probiotic that has the same flavoring sprayed on dry food to make it palatable) just a little sprinkled on. We also use the freeze dried treats as a low carb reward for tests. You can get them at Petsmart, the chicken is cheaper in the dog treat aisle.

 

Aww Ann! Thank you so much for this and all of your answers.

I had the same thought. But Sushi was worrying me so much that I decided to go ahead and get him on some fresh insulin instead.

I got that vial in early May. I got the 6u dosage by gradually upping the dose, in 1/2 increments, using (don't kill me!) Sushi's water intake and urination as my guide. They have continued to increase as the insulin has aged, but I have not increased his dosage beyond 6u.

YIKES! Didn't know that!!!!!!

Again, thanks for all of the other wonderful info!!!
>>Parmesan cheese--the sprinkle kind or fresh?

Tested for ketones--I'm SHOCKED!! It was between negative and "Trace" (5 mg/dL)! What a relief!! I was sure we were in trouble there!



Here's some other info:
Tonight's insulin/feeding scenario was different than normal in that Sushi didn't eat as much as he normally does. He barely ate anything and I have him his usual huge 5u dose. I understand that insulin + not enough food = hypo. I thought that I might be able to predict whether he was in danger of hypo by evaluating how much he ate tonight .vs. how much he normally eats .vs. his insulin dose. In other words, I thought I might be able to assess whether he was in danger by a description of how tonight's feeding/insulin schedule differed from the norm.
>>One big question I have: how much should kitty eat before you give insulin? What is the minimum amount a cat can eat before receiving insulin without becoming hypo?

To recap on our schedule:
Normal Schedule -
[AM] 6:30am: Feed 1/2c Hills dry m/d food | 6:45-7ish: Give 5-6u of Lantus
[PM] 5:00pm*: Feed 1/2c Hills dry m/d food | 5:30: Give 5-6u of Lantus
He ususally eats 1/8-1/4c intially and then grazes on the rest until the next feeding.
Yesterday -
[AM] 6:30am: Fed 1/2c Hills dry m/d food | 6:45ish: Gave 6u of pooped out Lantus
[PM] 6:30pm: Fed 1/2c Hills dry m/d food but wouldn't eat; skipped evening dose
Today -
[AM] 8:30am: Ate ~1/4c Hills dry m/d food | 9am: Gave 6u of pooped out Lantus
[PM] 5:30pm: Ate ~1/8-1/16c Hills dry m/d food & 5u of fresh Lantus

Sushi still hasn't eaten since 6pm-ish; he usually grazes throughout the evening. Should I push him to eat more or just let him be?
He does seem to be doing better and better! Wahoo!!





*I was not aware that Lantus was a 12 hour insulin. I have a strange schedule; this schedule with 10.5 hours between doses was what my vet and I agreed on. This is an issue I would like to discuss; I'll bring it up once the dust settles.

 

OKAY! I DID IT!
Sushi was much more tolerant of it than I expected and didn't flench or yelp at all. Here's what happened:
The lancing device allows you to adjust the depth of puncture. I set it on the shallowest setting, assuming it was a cat ear so it wouldn't need a lot of depth. I tried, nothing happened.
So I moved it to the middle setting. I got a teeny tiny drop of blood. I tried massaging Sushi's ear, but I wasn't getting anything. I tried putting the tiny drop onto the test strip. The users manual says "If there is not enough blood, 'E-7' or 'Lo' will be displayed." It didn't display either of those, so I don't think there was enough blood to register. Am I right or wrong?
So I tried it on the deepest setting and bam we got something! But the manual also says "Do not add blood on top of the test strip, as you may receive an inaccurate result." Do you think it's inaccurate? Should I try again?


Our #? 215, 5.25 hours after insulin. What does that mean? :-|


I just took a look at Sushi's ear and he has a little bruise or blood blister! :sad: What do I do?!?

 

Whooo Hoooooo! Congratulations! Testing accomplished! What meter did you get?

Usually you need to start w/ a fresh strip after a test like that, but if it gave you a reading it might be OK. Some do allow you to add if the drop is too small, but it sounds like yours says not to. You might want to try again in an hour or two. Next time after the test, pinch his ear w/ a tissue to stop the bleeding and prevent bruising. Many peeps treat w. Neosporin _w/pain Relief, not every time though. Maybe once a day.

We always test just before shooting so that we know our kitty is not too low to shoot. A mid cycle test is also valuable. We need to find the nadir to know how to dose. I usually test one or two hours before as well so that I know if the number is rising or falling.

215 at +5.25 is not bad for a start, especially after an early shot.. Lantus is dosed based on nadir, the lowest point in the cycle. It is often around 6 hours after the shot, but it isn't always always the same. A typical Lantus curve looks like this:

At shot time it is usually test, feed shoot. We try to avoid food before the preshot test so we get a test free of food influence. You don't need to worry about that so much for other tests. If you are going to test and feed , test then feed.

On the shooting schedule, I know there are others that have life interfere and they work things out. I don't think I'm qualified to advise on that. Please come over to the Lantus group and ask there.

 

I totaly get how you feel about moving to another city and having to rely on someone else or instinct on finding the right vet. My best friend lived here (outside Orlando) when I moved here in 2004. In fact, Midora and I lived with her for 3 weeks while I waited for my stuff to come from Philly. I went to her vet, which was in the transition of being sold to another doctor. I always saw the old owner, who was still working there part time. I feel (as hind sight is 20/20) that if I saw Dr. Josh (the new owner) sooner, Midora's kidney issues would have been diagnosed sooner and maybe something could be done. When I fianly got to see the new owner that Wednesday morning, he took x-rays of them and one was shrunken the other enlarged. She died early the next morning and I beat myself up for months.

If you can, I would still try to find an new vet, even though you have hopes to move again. Good luck and sending some pixie dust your way!

 

Hi!
I wanted to post this real quick...
I'm working on a spreadsheet right now. Here are #'s I've collected today:
6:40am (before feeding or insulin): 279
6:45-7am: ate ~1/8c dry Hills m/d food - 5u Lantus
7-8am: ate ~1/4c dry Hills m/d food
1:10pm (6 hours after insulin): 235
I haven't had time to read/research what all of this means!! This stuff has kicked my butt--I'm SO TIRED and can't shake it! Can you help me interpret? How is he doing?

Thanks again!
Ashley

 

OK, i replied to the other thread too. Start a new thread (condo) for today as I explained in your other post. When you do I'll bring this thread over in a link.