Just Diagnosed with LOTS of questions....

Merianne Hadley
Joined:
Monday
Hello! My kitty, Socrates, just got diagnosed with diabetes & I am trying to come
To terms with this. I just got back from vacation & although I have a wonderful pet sitter, I came home to a mess. Long story short, I got him in to my vet on Monday & got the confirmation. I've had Socrates & his brother for 16 yrs so how could I not commit to giving him the care he needs?! I certainly could not bear to watching him live out his days suffering.
I just have so many questions, right now.
Here's where things are right now. I'm currently treating him with 2units of insulin for the next 10 days. He tolerates his injections with no problems whatsoever! I, on the other hand, am ridiculous!! I did a trial injection with the vet but I struggle with the way I inject. The vet told me, once I made the stick, to draw back a bit & let go. The syringe plunger should snap back a bit if it's in the right place. Then proceed with injection of insulin. He's so fluffy, I'm having a very hard time seeing the plunger snap back to know if I'm in the right spot. So I guess my first question is.....Once I've lifted a piece of the skin up, is it possible to inject wrongly?
Also, I have a very big concern on the timing of his feedings & insulin injections. My vet said to try injecting every 12 hrs. Since I'm to inject 30 mins. after he eats.....am I to ONLY feed him twice a day? And, do these times have to be exact?? How do I manage feedings & injections around my days I'm out with friends? They live anywhere from an 1-2 hrs away from me.
As you can see I'm feeling quite overwhelmed and unsure about this. The only thing that has been helping me are the frequent posts I see on here, encouraging newbies like myself & ensuring that life WILL get better!!!

**Sorry if this post duplicated! New to using threads!!!

 

Hi Marianne. Socrates has the most beautiful green eyes! My boy, Tucker's eyes are the very same color.
I am very new here myself!! June/2015 Totally overwhelmed and overwrought at the beginning, unable to see light at the end of the tunnel!!
I cannot say enough about the fabulous people here, their caring and knowledge is phenomenal and got me to a point of manageability pretty fast. So take heart, Merianne!
I will tag a few veterans for you, here in a second.
But first, a few important questions for you.

• What is the name of Socrates insulin?
• Do you understand the importance of home testing?
• What are you feeding Socrates?

@Robin&BB @Rachel

 

Hello Merianne!! Welcome to the best place you never wanted to be. First off, good for you for taking that sweet baby to the vet and committing to helping him! I remember when my girl was diagnosed...people told me I should put her to sleep. But I knew that she deserved my care and that I needed to try to help her in any way I could.

Brenda has asked some fabulous questions! If you could let us know about those things, we can help a lot more.

As far as the injections go, I'm not familiar with letting go of the skin. I usually made the tent at the scruff of the neck, inserted the needle, shot, and then let go. That way, I got it in, and it didn't really phase Gypsy at all. If he's too fluffy to see properly, try shaving a little bit of the fur in that spot. It will really help in the beginning.

It IS possible to do a "fur shot" which is when you don't get the syringe all the way in, or it pulls out and the insulin doesn't go in all the way. A lot of the times when this happens, you can smell the insulin and feel some wetness at the injection site. IF this ever happens DO NOT re-shoot. There's no way to tell if any insulin got in or not, and you don't want to give too much! And don't feel bad...EVERY one of us has given a fur shot at some point.

As for feeding, we can give better advice when we know what insulin you use. The feeding schedule can be different based on the different insulins. I can tell you that most insulins work best if given every 12 hours. I understand the concern of managing around going out. You may have to try meeting them later at night, after getting Socrates what he needs, or have them come to you, or something like that.

Don't let all this overwhelm you! It's a steep learning curve, but diabetes is manageable. We can help you!!! The most important step is committing to caring for your baby, and you've already done that!

 

Thanks for the encouragement!! To answer some of your questions:
1. Socrates is getting 2 units of Vetsulin--- not what my vet originally wanted to
try but the other brand had raised its prices to be way unaffordable for me.
2. I DO understand the importance of home testing---the way I understood my
vet, In 10 days Socrates will be retested to see where his levels are at. My vet
will start me off by doing 2-3 testing so but will be turning it over for me to
take care of. So, I will eventually be doing the home testing!
3. Socrates is now on Purina DM veterinary diet --twice a day

Please note that one of the problems I am having with a bit of an inconsistent
12 hr feeding schedule is that I work 3rd shift for 10 hrs x4 nites. The other 3 nights I
fall back into being a "day-shifter".

 

Hi Merianne and a hearty welcome to you and Socrates.

I see you're already getting some good advice about diabetes. I did notice you mentioned your other kitty may be showing signs of early CKD. Just in case you haven't found it yet, may I recommend Tanya's Site? It's far and away the most comprehensive one-stop shop on the web for reliable information on feline renal issues and treatment. It is a much-respected site; and they operate an excellent - and friendly - support group, too. Well worth joining. (My Saoirse was recently Dx'd with early stage II kidney insufficiency and I'm glad I signed up. )


Mogs
.

 

Hmmm, well I never used Vetsulin, so I can't advise much on it. It's not a common insulin around here (though some do use it) because it's generally too harsh for cats. From what I understand reading other posts, it might only last 8 hours in a cat. HOWEVER, every cat is different (ECID) and it has worked very well for some.

From what I understand, you do need to feed about 30 min before shooting with that specific insulin so that your kitty doesn't crash. As far as whether it is flexible at all with shot times, I honestly couldn't say. I'll try to see if we can get some more experienced vetsulin users over here after I reply to you.

I would start home testing now. It's much cheaper than at the vet, plus you can avoid the BG levels being higher due to stress. We have taught lots of people to test over the internet. You'll need a glucometer...it's not necessary to get one from the vet. You can use a human one fine. I used the relion confirm (from walmart). This way, you can also get a good idea of how the insulin affects Socrates. At the vet, they will give you an average of the last few weeks. If you test at home, you can see how quickly the insulin drops him, when his midpoint is, and what his before shot numbers are each day. This information will be much better for determining the dose.

Is the DM a dry food or a wet food? We recommend a good, low carb wet food as it can help BG numbers. HOWEVER...PLEASE DO NOT SWITCH IF NOT HOME TESTING. Low carb wet food can drop kitties by over 100 points overnight. It's super important to be home testing first to keep him safe. If the DM is wet, it's still probably too high in carbs. We try to feed under 8%. Most here use Fancy Feast classic or Friskies. There's a link to a food list around...we'll get it for you. You can return the DM and tell the vet he doesn't like it. The other foods are WAY cheaper (thankfully!) and also really better.

I don't want to overwhelm you, so I'm going to stop here. I'll try to round up some vetsulin folks for you over on Health...I really just can't give any advice about that insulin. Keep on asking questions! We are more than happy to help!

 

One of the key tips for using Vetsulin is to feed 30-60 minutes before giving insulin. This helps buffer the steep drop many cats experience on it.
So you will get a pre-shot test, feed, wait, then shoot, twice a day.

 

Home testing is a must and will save you needless trips to the vet plus money. There are lots of valuable tips and links on the home page and from members in the forum.
To get you started, here's a good link: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/

There's no need for an expensive prescription food like Purina DM. You want to aim for low carb wet/canned food under 10%. Here's a handy cat food nutritional chart: http://www.catinfo.org/docs/FoodChartPublic9-22-12.pdf

 

I use vetsulin, and I don't wait 30 min but that's just me...my cat's doing well for the most part.

 

Hi Critter Mom!
Thanks for that great tip! I will definitely check the site out!! I so hope your Saoirse is doing well!!

 

Thanks for the help, Rachel! The DM food Socrates is getting is WET. I've taken away all of the dry food. I am willing to learn how to home test now but am feeling so overwhelmed with just trying to coordinate a workable feeding schedule to coincide with my schedule, right now. I'm not sure that I understand what to do with doing home testing. Is this done on a daily basis? Are the daily insulin doses based on the BG numbers? I'm probably going to have to have occasional weekend boardings. Will my glucometer have to be in sync with the glucometer they will be using at the vets when he's boarded? I think I might be falling into my "over thinking" on all this!

 

I'm not sure that I understand what you mean by the "pre-shot" test.

 

Testing:
1) Always test before giving insulin to make sure it is safe.This is the pre-shot test.
For now, your no shot level is 200 mg/dL on a human glucometer (230 for pet-specific); this will lower as you collect data around the middle of the cycle to know how low he is going.

2) Mid-cycle tests between shots - whenever possible, test around the nadir (lowest glucose level between shots) for your insulin, to see how low he's going. For Lantus, this often falls between +5 to +7 hours after the shot. Some folks do this on weekends or set a clock for the middle of the night to get this test done as it helps determine dose adjustments. This number should be at or above 50 mg/dL on a human glucometer (68 mg/dL for pet-specific).

3) A before bed test is helpful in determining if you need to break out some higher carb food and steer the glucose level or go to bed with some peace of mind. Steering means giving 1-2 teaspoons of high carb gravy, waiting 30 minutes, and re-testing (repeating as needed) to make sure the glucose stays above 50 mg/dL.
Edited to expand:
Steering means giving 1-2 teaspoons of high carb gravy, waiting 30 minutes, and re-testing (repeating as needed) to make sure the glucose stays above 50 mg/dL for Tight Regulation depot insulin protocols, 90 mg/dL for Start Low, Go Slow depot insulin protocol, and 100 mg/dL for Vetsulin/Caninsulin insulin protocol, when using a human glucometer.

 

Vetsulin users are usually more conservative with low numbers. I personally wouldn't be comfortable with 50 on Vetsulin, especially with a relatively high starting dose.

 

If you've got a specific number, by all means, post it so I can provide a range or insulin-specific examples.

 

Vetsulin User Guide: http://www.felinediabetes.com/FDMB/threads/vetsulin-caninsulin-user-guide.302/

SLGS: http://www.felinediabetes.com/start-low-go-slow.htm

The User Guide suggests 100 as a nadir, SLGS suggests reducing the dose if the number falls below 90. Both of these were written with Vetsulin in mind. They also suggest a starting dose of no more than 1 unit, and since this caregiver is giving more than that, being more conservative might be wise.

 

Merianne, welcome to a wonderful, informative, supportive group of people. A "pre-shot" test is simply a glucose check prior to giving insulin. It is a safety check. There are many meters available out there on the market. My vet suggested the AlphaTrak2 meter as it is calibrated specifically for cats and dogs. It is very easy to set up and use. Check on Amazon for pricing. You might also ask your vet if they can suggest a meter for you to use.

 

It isn't necessary to use a pet-specific meter; using feline-specific reference numbers with a human glucometer has worked well for most members of this board. The test strips are the major cost in using a glucometer and AlphaTrak strips may run about $1 each in the US. The WalMart Confirm test strips run roughly $0.36 per strip. Starting out, you may need to test 3 or more times a day, so that can really add up over 1 month ($90 vs $32.40 with these 2 given prices)

 

Thanks so much for the tip, Marcie!!! If I'm not mistaken, my vet told me that whatever brand I decide to get, she would prefer if it can be calibrated with
their office machine. I was bombarded with so much information on that day that I honestly don't remember why, though.

 

We give our cat a teaspoon or so of cat food (warmed a few seconds in the microwave...haha) about a half hour before his injection. He has gotten into the routine and it works well for him. Hang in there!