Luz and junior

Junior is a tabby cat. Approximately 12 years old. I found him outside and one day he came to me very sick and I felt bad and took him to the doctors and they informed me that he had feline leukemia. This was back in 2005. I then decided to adopt him and keep him as an indoor cat. He was given medication and antibiotics and two years later he was retested and was leukemia free. Once again a year after that he was retested and was negative. He had been healthy since then with the exception of developing Crystal in his urine. He has been on veterinary prescription moderate SO dry food since then. About two weeks ago I switch him to fancy feast chicken classic and he doesn't really like it much. I am thinking of switching him to daves 95% protein because it's very low on carb. Low phosphorus too. He was recently diagnosed with diabetes.

 

help! About to start lantus insulin. I was told to check glucose then feed him n 30 mins later give insulin. Is this correct??? Doctor has him on 2units of insulin twice a day.

 

Yet another kitty developing diabetes after being on RC Urinary S/O food; my Saoirse was also prescribed that food and since I've been a member here I've seen a number of other members report that their cats had been on it before they got the diabetes Dx.

Junior is a lucky kitty to have found you. I'm very glad to read about his becoming leukaemia-free!

It can take a bit of trial and error to find foods that a kitty likes. I'm not familiar with the Dave's food you mention but other members may be (I'm in the UK).

If you're in the US here's a shortcut list of additional foods that you might like to try.

US Shortcut Food List

If you're not in the US let us know and we should be able to point you in the direction of other low carb food lists for your region.


Mogs
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Thank you

 

Hi again,

The routine with Lantus is:

1. Be confident that your cat will eat enough during the cycle.

2. Test blood glucose (BG) level to make sure it is safe to give insulin.

(The FDMB general rule for cats with no BG data yet is to have a 'no shoot' number of 200 on a HUMAN glucometer but you should check with your vet to make sure that they agree. Note that human glucometers typically read lower than pet glucometers for the same blood sample so a human-specific reference range needs to be used with a human meter.)

3. Feed Junior.

4. Give the insulin injection.

5. Test BG again mid-cycle (anywhere from +3 hours after injection time would be a good place to start testing) to see how Junior is responding to the dose and to make sure he is in safe numbers.

Many members here who treat their cats with Lantus feed several small meals throughout the cycle. How do you typically feed Junior?

Another question: which type of glucometer are you using?


Mogs
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To help you learn more about Lantus there are a lot of information 'stickies' at the top of this board. There is a fair bit to take in in the early days so please don't be shy about asking for any help you need!

Lantus and Levemir Insulin Support Group's Board

Lantus is a depot insulin. Each dose you give will help build up a little 'tank' of insulin in the kitty's body so it takes several days to fully assess how the kitty is responding to the dose and home BG testing will let you know how Junior is doing.

Here are some links to tell you how to set up a spreadsheet in which to store Junior's BG numbers. As you gather more data it will help you to start understanding Junior's response to Lantus better, it will help you and your vet to make dosing decisions, and also if you add it to your signature it will help other members get a better picture of how Junior's doing and hopefully make better suggestions to you any time you may need a bit of help.

How to set up an FDMB spreadsheet

Understanding the spreadsheet

Also here are some links to important and useful safety information:

How to treat hypos (print this out and put it somewhere you can lay hands on it in a hurry should you need to use it)

Hypo toolkit

Are you testing for ketones? If not, do it! (Information on monitoring for ketones so as to prevent diabetic ketoacidosis, a complication of diabetes)

Sorry to bombard you with links but I think it's handy to get a bit of a leg up in the early days; there's a lot of educational information on FDMB and it can take a bit of time and wandering around to find what you need.


Mogs
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Junior was fed dry food for so long I am struggling with wet food. He cries for me to feed him and follows me around. Once I put the food down he eats a little a d walks away. I try putting tuna on top.also I heard Parmesan too. I also try taking food away for a couple of hours and then feeding him again but he doesn't care. He will only eat a little bit. His always ate in small portions throughout the day. I should also mention that he doesn't have many teeth. Could it be he isn't eating enough because his insulin is high and he doesn't feel well? He acts ok. He was just chasing the dog around the house. A coworker will give me her glucometer later today. Will let you know what type and I will read through the spread sheet and try to set it up. Tonight will be his first time getting insulin. I work mostly second shift from 3:30 pm-12 midnight. So I am thinking insulin at noon time and midnight. What do you think?? I really appreciate all the help. I feel so confuse

 

I am very confused with the spreadsheet. I think i downloaded it correctly. I am even more confused with the fact that I just did Juniors first ever Glucose test with the glucometer and it read 133. I did it again and I got 131. This doesnt seem normal. I am holding of on giving him his first insulin injection till i call the doctor tomorrow. I even took it as far as pricking myself and checking my glucose to see if it was working properly and it worked. I just looked through his medical records and his blood glucose at vet in February was 230 and they didnt tell me anything was wrong. At that time his urinalysis was normal. His current blood glucose at vet on 11.25.16 was 519 and his urinalysis showed 1000 glucose in urine strip. I am so very confused. Can someone please help me. I am wondering if i did something wrong. I am using the Alphatrack2 glucometer

 

Great job getting your first BG tests under your belt!

Assuming the meter readings are correct it was the right call not to give the insulin injection at 133/131 mg/dL; as measured on an Alphatrak meter those numbers are actually within the normal BG range for a non-diabetic cat.

Were the BG results from 11.25.16 from a time before you did the food change and Junior was still eating the RC Urinary S/O food? If yes, then the switch to wet, low carb food since that time may account for the lower BG levels. (The food change can make a dramatic difference in BG levels; some cats can actually go into remission as a result of the food change alone.)

There are codes on the pods of Alphatrak test strips (for CAT and DOG). Different batches of strips may have different codes. Did you set the code on the Alphatrak meter to match the CAT code on the vial of strips you're using? (The code number displays just after you insert the strip into the meter.)

Assuming that you set the right code before testing Junior then the 133 and 131 values you got should be valid (unless the strips were iffy - see next paragraph below). If there was a code mismatch between meter and strips then you'd need to set the correct code on the meter and then test Junior again.

You should have received a bottle of control solution with your Alphatrak meter. Check the Alphatrak documentation for instructions and run a control solution test. With the correct code set on the meter if you get an OK result on a control test it indicates that the batch of strips is OK. (Note: one does get the occasional duff strip but you've already ruled out that possibility for your earlier tests because the two results were very close.) If the strips fail the control solution test you'd need to get a new pod of strips (and presumably look to get your money back for the faulty ones - I've never had a bad batch of strips so don't know what the process is).

Can you please let us know whether the meter coding and the control test are OK once you've checked? (And you might want to run another BG test if all is OK.)


Mogs
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We can get someone to set it up for you if you'd like. Just shout!


Mogs
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Yes I had the correct code for cat. Prior to running his sample I use the control to make sure everything was ok. The glucose n urine results were prior to switching food. In fact it wasn't till I got the bad news that I really started playing close attention to what he was eating. His been on wet food for about 9 days. I am going to check his glucose in the morning it's 3:45 am right now. Then call doctor and see if he can be brought in to check his sugar at vet. I also am waiting for him to pee on an empty litter box so I check his urine glucose. As you can see I'm barely sleeping. Just worried. I'm so very appreciative for your quick response. It means the world to me to know there are those out there caring enough to help us through such a difficult time

 

Hi there. My cat Uncle was just diagnosed in September. I found this website and message board and it has been a life line for me and my kitty.
I know how much there is to learn and how worried you can be about it all. It's great that you are reaching out here with your questions. So many people will gladly help you and hopefully you know you aren't alone and overwhelmed. Since you are going to be giving Junior Lantus, you could also reintroduce yourself on he "Lantus (Glargine)/ Levemir (Detemir)" Forum. That's what was suggested to me when I first joined. Let everyone know how it's going!

 

*** LONG POST ALERT ***

That's very reassuring to hear! Now you know the 131 and 133 test results you got last night were indeed valid. And yes, the food change really, really can make that much of an improvement in BG levels - and that quickly.

To give you an idea of just how quickly things can improve here's an example: @MerMor is another recently-joined member who switched their cat, Merlin, from dry food to low carb wet food around Thanksgiving time. Here is a link to Merlin's spreadsheet:

Merlin's Spreadsheet

It's a slightly different layout to the FDMB standard template. Don't worry about the format, simply look at how quickly Merlin went from BG numbers in high blacks, reds and pinks down to very healthy BG numbers in the green range! Merlin's BG numbers are also measured on an Alphatrak meter so the reference range used is the same for Merlin and Junior. Merlin only needed insulin for a few days and he has been running in the lower part of the normal reference range for nearly a week without any insulin at all. If he continues to run in the normal range for 14 days he will be considered to be officially in diabetic remission (fingers and paws crossed!).

You are doing a wonderful job of looking after Junior. You made the decision to home test BG from the outset and you made sure you checked Junior's BG before giving any insulin to see whether or not it was safe to do so. If you had given the 2 unit dose last night it might have taken Junior too low so you did a great job of keeping your boy safe with your testing!

FDMB doesn't have a defined normal BG reference range for use with an Alphatrak meter; you'll need to confirm with your own vet about what s/he considers to be the appropriate BG reference range to use with an Alphatrak. In the meantime I'll give you the information my vet provided to me. I'm in the UK and my vet told me that the normal BG reference range for a cat not on insulin (the normoglycaemic range) as measured on lab equipment is 3.9 - 8.3mmol/L. Converted to US units that gives 70 - 150mg/dL (1mmol/L is equivalent to 18mg/dL). Alphatrak meters are designed to give readings for animal blood that are similar to lab values. For the purpose of illustration you can see that the 133 and 131 results you got last night put Junior's BG levels within the normal range for a cat not on insulin. This is most encouraging news!

The next steps are as follows:

1. Call your vets to let them know about the improvement in Junior's numbers.

2. Try to get some more BG readings for Junior at home today before taking him in for his check-up.

(It is much better to get these readings in the home setting because travel/vet stress can temporarily elevate BG. Any dosing decision is better when based on Junior's BG levels in his normal environment. Obviously you can also ask your vet to test Junior's BG during the consult as well.)

3. When you do the morning urine test check both ketones and glucose levels. If the glucose is negative then that will be another bit of good news because it will show that Junior's BG was under the renal threshold in the period since his previous pee. (Note: the renal threshold is the level at which excess glucose starts to be excreted by the kidneys - typically it is somewhere in the 200s but it varies significantly from cat to cat.) With regular BG testing urine glucose tests become less valuable as a monitoring aid because your glucometer readings will provide you with more accurate information about BG status over the course of the day. That said, it is good practice to regularly check for urine ketones as part of a diabetic kitty's regular monitoring.

(For information: If you ever get a trace ketone result call your vet straight away for advice; if higher than trace kitty needs to be taken to a vet immediately for emergency treatment to prevent problems with DKA.)

4. Ask your vet about what to do about insulin treatment based on the BG data you gather. If Junior stays in mid-range numbers your vet may advise you to give a very small dose of insulin for a short period of time to allow Junior's pancreas to rest a little bit in order to restore further function of the beta cells which are responsible for production of insulin.

(For an example, see how Merlin was treated above - numbers with a grey background show his dosing but Junior's dosing would need to be tailored to his own specific needs; every cat is different!)

Oh, we know all about sleep deprivation and worry round these parts! Goes with the territory, especially when it's all new and scary. We're only too happy to be here to help you both when you need us. When Saoirse first started treatment I could not get any support from her vet at the time for my wish to monitor her BG at home and for the first few weeks I had to give her insulin without any idea whatsoever how it was affecting her BG levels; I would not wish that fear and worry on anyone. Thankfully we found another vet practice closer to home who were much more progressive and switched-on about feline diabetes treatment and the relief was immeasurable when I was at last able to monitor her BG levels. I'm glad to be able to help you and Junior; in my turn I have received help from many, many of the kind members here and I am only too pleased to pay forward.

Be sure to let us know how things go during the day and just shout if you need anything. You're doing great!


Mogs
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Another useful link for you - forgot to post it yesterday:

Urinary Tract Health

catinfo.org is a hugely respected site authored by vet Dr Lisa Pierson. I recommend reading through the whole site at some point.

Several of my cats developed urinary tract issues which I now know were due to their dry diets. Saoirse actually had to have calcium oxalate uroliths surgically removed (that's when the vet treating her at the time prescribed the RC S/O diet ... ). I followed the advice of Dr Pierson about switching to a wet diet and adding a little extra water to her meals and there was no recurrence of problems with uroliths.


Mogs
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PS: If your vet asks you to just monitor BG at home for the time being without giving any insulin please be sure to keep monitoring urine daily for ketones.


Mogs
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Yes please can someone help me with the spreadsheet. I think I was doing ok until I had to rename the spreadsheet from the google drive. where so I enter his bg level if he doesn't get insulin?

 

On it!

@Marje and Gracie - when you have a moment please can you help @luz with spreadsheet set-up.

Thanks in advance!




Mogs
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His bg 12/7/16 11:55 pm. 137

Repeat (not sure accurate)
12/7/16. 11:58 pm 131

12/8/16. 8:43 Am. 107


Waiting for junior to go to bathroom but his refusing to pee because I removed the litter n it's the only way I know to get a decent quality Urine sample to test it for ketone n glucose. It may be a couple hours. They say cats can hold it for 24 hours. Hasn't per since midnight. Will be calling doctor in an hour to see if they will do a glucose at vet to confirm n re access plan

Thank you everyone.

 

Decide on what your normal shot times would be for morning and evening, for example: 7am and 7pm.

Do a test at normal shot time (say, 7am) in the morning and record it in the AMPS (morning preshot) column. Put "NS" for "No Shot" in the morning U(nits) column if you don't give any insulin, otherwise put the dose in this column If you do a test, say, 3 hours after the AMPS test put the result in the +3 column in the morning cycle section of the spreadsheet. If you do a test at +7 hours after the AMPS test then record it in the morning's +7 column.

Similarly if you do a test at, say, 7pm put that in the PMPS (evening preshot) column; NS in the evening's U column if you give no insulin else record the dose here; then the same drill with the +?? columns for any further tests you do over that evening cycle.

We use the "+" system of notation because we need to know how long after an insulin dose is given that the test is done so that over time we can get a better idea of where in the 12-hour dose cycle the BG is likely to be the lowest (nadir BG). Different insulins have different characteristics and this affects the time after the dose is administered when nadir is statistically likelier to occur (though there are variations day to day, even for the same cat).

Preshot tests are done to check whether it's safe to give the next dose of insulin. Mid-cycle tests (+3, etc.) are done to monitor the safety and efficacy of the dose.


Mogs
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That 107 is a really good result!

If Junior keeps going like this it seems he may be a good candidate for remission (anti-jinx!). Fingers and paws crossed over here.

If you get the chance try to do a BG test about 2 hours after a meal to see how the food he's eating affects his numbers. If Junior tends to go many hours between feeds (say 5 hours) it is a good idea to test after this fasting period to see whether his BG levels stay in the normal range or go higher. (Seems counter-intuitive but the way that the pancreas works is to produce pulses of insulin at mealtimes to work on the incoming food plus a basal trickle of insulin between meals to work on the stored glucose the body releases during that time to support normal metabolic functions. If the basal trickle is insufficient it can result in a kitty's BG levels going a good bit higher after several hours of fasting (impaired fasting BG level).

Try putting some plastic food wrap on top of the litter in his normal litter box, preferably over one of his 'favourite spots' in the tray. If you push down the middle of the plastic to form a little well you should be able to collect enough urine to do the test.

You can get non-absorbent litter like Katcor to put into a clean tray to enable urine collection. Some members use aquarium gravel instead (can be washed and re-used). Some members are able to sneak a ladle under their cats' derrières to catch a pee sample.


Mogs
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Junior isn't really eating at all. Maybe that's why his bg are so low. I call the vet n she said that even if his glucose is 107 to still give him 2 units of lantus insulin. I so don't think this is correct. He goes to a chain vet doctor so I called another vet location to talk to a different vet n they will hopefully call me back. If this doctor feels the same I may just take him to another vet even if I have to pay a good amount.

 

I would NOT give 2 units of Lantus at a BG of 107. I wouldn't give ANY insulin at this number. Your feelings about this are correct.

 

Did the vet give you any justification for that advice? Do you know how much experience that particular vet has in treating feline diabetes? If I were in your shoes I'd be looking for a second opinion about insulin dosing, too; not least of all because Junior's numbers are currently in the normal range and also he's not eating properly. A starting dose of 2 units of Lantus for a kitty who is eating normally and in high numbers is very significant dose of insulin - especially when there is no data for how that kitty might respond.

If you have no joy there are a number of highly experienced Lantus users who are members here who should be able to discuss approach with you. I'm tagging @Tuxedo Mom and @Chris & China to see whether they can help on this thread.

This is a worry, not quite so much from a blood sugar level perspective at the moment because Junior's numbers are in a fairly good range but if he were mine I'd be looking to get him in to the vet for a check-up today to see what might be behind the inappetence; it's a serious issue for cats because of the way their metabolism works.

For information (not to scare):

Cats need to eat regularly otherwise they can develop hepatic lipidosis (potentially life-threatening). Also given that Junior is a diabetic the lack of food could lead him to start developing ketones - and not necessarily when BG numbers are high. Ketosis even sometimes at lower numbers - which can lead to diabetic ketoacidosis (a very serious and potentially life-threatening complication of diabetes). I strongly recommend you get the ketone test done ASAP to be on the safe side and to give you peace of mind.

Is it just that Junior doesn't like the new food you're offering? I would suggest giving a small amount of different food(s) to see seeing if there's anything that he will eat readily (i.e. he's just being finnicky) or whether he might be showing any signs of nausea. If cats don't eat regularly it can lead to excess stomach acid build-up which can then set up a nausea-inappetence-further nausea cycle and they can be really tough to get on top of. Whichever way, if Junior has a poor appetite then it's something you need to respond to straight away. If my experience is anything to go by reluctance to eat is something that is best tackled head-on as quickly as possible.

Quick things to try are: raising the food and water bowls; warming the food; sprinkling a crumbled freeze-dried protein treat (or even a couple of crushed-up RC S/O kibbles if desperate) on top of the food; offering some food by hand and leading him gradually to the dish to see if he'll eat the rest under his own steam.

More tips here:

Persuading your cat to eat

Tips for stimulating appetite

Other things to rule out include possible respiratory issues (if a cat can't smell its food it won't want to eat it), constipation (can cause nausea), or dental issues.

Is Junior drinking enough? If he's dehydrated it could put him off his food.

Let us know how you both get on.


Mogs
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I'm still waiting for a different vet to call me. If she doesn't call me by noon time I may take him to emergency room. I finally got him to pee. I placed a plastic bag over his litter n he pee. His glucose and ketone where negative. Protein was 30. Which is low but present. He had many WBC leukocyte so maybe he had developed a urinary track infection. Specific gravity was 1.015 and his ph is 6

 

Very good news about the negative ketone test! Also good that the sample was free of glucose. Glad the plastic bag trick worked.

FYI, the leukocyte tests on regular urinalysis strips aren't accurate for kitties (I've used them on 2 cats and the result is usually "++") so that test doesn't really tell you anything about whether or not any infection is present.

If you're in any doubts about Junior definitely take him to see a vet today; it's always the safest thing to do. Perhaps ask about whether he might benefit from a B12 injection and whether he needs any anti-nausea or appetite stimulant medication to help him eat. (NB: cyproheptadine and mirtazapine are two commonly-used appy stimulants used in cats. Cyproheptadine is much milder than mirtazapine. Mirtazapine can induce serotonin syndrome.)

I'm quite tired again so I might not be online much from now. I'm asking Mary Ann (@Tuxedo Mom) if she'll keep an eye on you.


Mogs

ETA - that positive protein result needs checking out.

.

 

You are such a wonderful kind soul. I am so blessed to come across you. I hope I can do for others a half of what you've done for me. I got an appointment for 3 pm today. It's 10:53 am right now. Hopefully this doctor is more knowledgeable otherwise I am considering taking him to emergency or some type of specialist

 

This place runs on kindness.

I've been a member here for over two years and I will never ever be able to repay the help and the kindnesses the other wonderful members here have shown to me in that time - including helping me to save Saoirse's life and give her better care. Saoirse crossed to the Bridge a little while ago (not to diabetes) but I would probably have lost her around time of diagnosis were it not for the education and support I've received from members of FDMB (and not just help with the diabetes side of things). I am beyond grateful I found this place.

Keeping fingers and paws crossed that you'll get a good result on the vet side of things today. Try to keep the focus on getting Junior to eat; it's the most critical thing you're dealing with right now. If the worst comes to the worst and you have to resort temporarily to a dry diabetic diet to get him eating something Purina DM kibble for diabetics is the best of a bad lot but it will very likely raise his BG levels - you'll be able to monitor with the Alphatrak. Purina DM canned is under 10% kilocalories from carbs. If you get a chance order extra strips for the Alphatrak today to make sure that you have a good stock at home.


Mogs
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I am just checking in and I see you have got a lot of great advice, As was said with the glucose readings that low DO NOT give any insulin. With the eating have you tried a few different foods or adding some tuna or tuna juice to the food?

AS far as the readings on the chemstick go the SG and PH are acceptable, but having protein in the urine could be a sign of a UTI or some kidney issues. The leukocytes are not accurate for kitties so ignore that...I ALWAYS have a reading of 3 when I do it. Do your strips have a panel for blood? If so and it shows any there could be a UTI starting. I caught it with one of mine before the actual clinical signs started.


With the lower glucose reading, not eating and a chance of a UTI insulin should definitely not be given. The change from dry to a low carb wet food can makes a huge difference with glucose levels. There have been a good number of kitties that went off insulin just with a diet change. It is possible that the dry food diet was a major cause of the higher numbers...that and the fact that readings done at the vets are quite often higher because of stress.


ETA If you are in the US many members use the 9 lives pate for their kitties as well as the Fancy Feast classic pate and Friskies pate (not the green lid Indoor Cat formula..it is very high carb)

 

pH as show on the dipstick is good.valid. However, specific gravity is not that accurate at all. That is what I observed while in vet tech school and working at a vet. Also see:
http://adc.bmj.com/content/85/2/155.full
http://www.merckvetmanual.com/mvm/c...e_private_practice_laboratory/urinalysis.html

I have one of these:
http://www.bulkreefsupply.com/refra...KL8zhbRYCDwdG75JDr58qracKm8QWh0BSgaAgHH8P8HAQ

 

@Tuxedo Mom -

Thanks for answering the tag, Mary Ann; you're an absolute star!




Mogs
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He was eating fancy feast classic chicken. May have to switch him to frisked or nine lives. I work at a laboratory n I tested him with human urine strips. The secretary told me to bring his urine in so I refrigerated the one previously collected. I would love for him to pee again to have a fresh sample but not sure if that will happen. I tried watming food. Adding Parmesan. Adding light tuna water with no success. He is not eating at all. May run to the store n grab a couple friskies n nine lives n see if he will touch it at all.

 

No blood in urine

 

Ok..that is a good sign if no blood shows on the chemstick. With one of mine I had blood on the chemstick before any clinical signs showed up and took him in for bloodwork which showed an infection.

 

Any suggestion of which friskies n nine live to try. On cat info it says to try those because cat prefer by products which aren't the healthiest but may be more enticing to them

 

I am in Canada so I can't get the 9 lives, so I can't offer any suggestions for that. The friskies pates (NOT the green lid Indoor Cat pate) are all fairly similar in carbs. Although I am not overly fond of the seafood varieties they ARE stinkier which seems to attract some kitties attention more than other. You could pick up a few different type...chicken, turkey&giblets, seafood, etc and see if anything gets Junior's attention.

 

On the Friskies you're probably OK as long as it's a pate.....on the 9-Lives, they are called "ground" instead of pate......just avoid the foods that have "in sauce", "in gravy" (or anything else that makes it sound extra yummy) and you're probably going to get something low carb

 

So stressed and uncertain as to what to do. I took Junior to a different doctor today and she said base on his medical results he is diabetic. The initial glucose of 519 and high glucose in urine. Drinking a lot of water and urinating a lot. But heres the thing. Since I switched him to wet food his glucose have been normal. He isnt drinking as much or going to th bathroom as much. She told me NOT to give him insulin like the previous doctor had told me to even though his last bg was 131. She agreed with me that it could kill him. He has been on wet food for about 10 days now. His urine at the vet today was completeley negative. His glucose was also normal. She told me to put him back on the dry food he was previously on because he needs to eat oherwise he will get very sick. I know this but I am so hesitant to put him back on dry food because i do believe he is diabetic and his glucose will rise. According to catinfo.org Dr. Lisa says that if its imposible to get the cat to eat to give him wellness core grain. I purchased a bag and I mixed a few dry kibble in with fancy feast. What does everyone think about that. I wanted the vet to give me fortafine to stimulate appetide but she was against it because the primary reason for that medication is not food appetite. Does anyone know how much carb the wellness core grain has? Any suggestions would be greatly appreciated. The vet also ordered a fructosamine and thyroid test. I am going to give him a few days and see how he adjust to the food. I switched him cold turkey to wet food and maybe this is why he is responding this way. not eating. Will wait a few days and monitor him and if he is still not doing well i will be taking him to see a specialist. Although this doctor wasnt the very best with feline diabetes i felt like she really tried to take what i was saying into consideration and she even ask for Dr Lisa catinfo.org to read up on it and she also told me she would speak to her colleagues and see if there was anything else she may have missed

 

FortiFlora is really not a "Medication"....it's a mild probiotic that contains the same stuff they spray on kibble to make it taste good....it doesn't require your vet's authorization to buy or use! It's been a Godsend to lots of us when our kitties didn't want to eat! You can buy it from Amazon or Chewy (or multiple other places online)....a little sprinkle will usually get China to eat when she's being "difficult" and one packet can last me several days.....it's no different than adding something like parmesan cheese or oregano to tempt them to eat

You're totally right....putting him on dry will not only raise his blood glucose back up, it's a lot harder on their kidneys because it's dry...it has to be re-hydrated before it's digested and that pulls water out of the body!

The Wellness Core is too high in carbs....I think it's like 24%.....it's better than some dry foods, but the only 2 dry foods that are decent for diabetics are the Young Again Zero (only available online) and the Evo Cat & Kitten (which is around 12% I think)

If you can get enough food into Junior without the dry, I'd definitely stick with the canned only.....it's obvious from his numbers that it's doing him a lot of good!! I know it can be a tough fight with a real kibble addict, but the benefits of a species appropriate diet go way beyond just keeping the blood glucose under control.

 

@Chris & China i just purchased the fortiflora online. Thank you for telling me about it. I really thought it required a prescription. For the mean time I gave in and gave him about 12 dry kibble of dry wellness core food mixed in with a 3oz fancy feast chicken classic and his ate all the dry kibble n half the wet food. Just happy he ate. I know the fancy feast are all high in phosphorus but it's all I can get him to eat. ill try the fortiflora n if that works maybe I can completely take out the kibbles.

 

Tip: Keep an eye on Junior when you start giving the FortiFlora; most cats love it but it can make a few cats nauseated.

Sounds like you got on much better with the vet today and I'm very pleased to hear that Junior ate for you.

Will post again tomorrow.


Mogs
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Thank you. I'll be working a 16 hour shift tomorrow so it makes me feel a bit better to know he ate a bit

 

Junior is doing well as of this morning. His bg was 107. Yesterday evening he ate 3oz fancy feast classic with about 10 or so dry wellness core dry kibbles. I ordered young again zero dry kibble to use a few of those instead of the dry wellness mixed in with the wet food since there's no carbs. Wondering when is the best time to check is bg since first thing in the morning he is on an empty stomach. The goal is to eventually have been on wet food alone

 

Go Junior! Alphatrak 107 even with the contraband!

Thank the gods that you started home testing straight away and held off on the Lantus.

I'm really thrilled for you that Junior's eating. I hope he gets on well with the Young Again as a kibble topper when it arrives.

It's a good idea to get BG tests in both after periods of fasting and a little while after meals. Fasting BG checks will give you info on how well Junior is producing basal insulin and the post-feed BG checks should give you info on how well his pancreas is producing bolus pulses of insulin in response to eating. (Note: depending on the cat, some foods may cause significant spikes after eating; for example, some cats spike after eating beef or soy.)

While Junior is not yet receiving any insulin the easiest thing to do is make a decision about a time to assign to AMPS and PMPS (e.g. 7am/7pm) and then plug his BG numbers into his spreadsheet in the appropriate <+hour> column for the time the BG test is taken. For example, if you assign PMPS as 7pm but you don't get a test done until 9pm just put the BG test in the PM +2 column. Also keep a brief record of mealtimes, amounts and food variety offered. Then grab BG spot checks as and when you get the chance. With the food and the BG info all in one place you'll be able to learn how well Junior's pancreas is producing insulin. As long as you have the food and BG info in the spreadsheet you can always ask us to have a look at it and interpret the information in it for you while you're learning.

This vet is spot on; Junior is diabetic. Once a diabetic, always a diabetic. Even though he's now running in the normal range after the diet change he is still diabetic and always will be. However if he stays in the normal range (and preferably at the lower to mid part of the normal range) on his low carb food for a period of 14 days he will be considered to be officially in remission, i.e. a diet-controlled, non-insulin-dependent diabetic. You will need to keep Junior on low carb food (preferably a wet diet) for keeps. Feeding a high carb diet would send his BG skywards again.

I like the sound of this vet; she sounds very progressive, collaborative, not shy about acknowledging gaps in her knowledge and keen to fill those gaps! She also listens; and that's often more than half the battle. (The ones to worry about are the "My Way or the Highway!" brigade who ignore both hard evidence and caregiver observations.)

for you and some scritches for Junior,


Mogs
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Hello everyone. I managed to figure out how to properly create juniors spreadsheet. What I dont understand very well is using google drive. I've been up for the last hour and a half entering all his blood work and glucose test. For some reason they dont appear ( the lab section is empty) I've never used google drive so i am guessing i am doing something wrong. I am under the impression that i dont have to save anything because it automatically updates and shares to the link?? help.

p.s. Junior had quite an appetide today. Everything with him concerns me a lot now. He ate 2 (3 oz ) of fancy feast classic chicken. With 6 dry wellness core kibble in each. This was his meal for 12/9/16 from 6 am to midnight. I was working a 16 hour shift so the food was left out. As of 12/10/16 at 1 am i put out a 3 oz can of fancy feast with 6 dry wellness core kibble and he has ate 1/3 of it. Where is this sudden appetide coming from. He did drink a bit of water. I am guessing the dry kibbles. Waiting for his "Young again zero" dry kibble to come in to get rid of the wellness core dry kibbles. I will only be using the dry kibbles to get him to eat. Its working out putting a few dry kibbles inside the wet food. Now he is sleeping. Hopefully the eating and normal glucose continue. I am waiting for his Fructosamine test to come in as well as thyroid test. These test will give me a better understanding of what has been happening to him.

Questions?
How long do i have to monitor his glucose? Is this an every day for the rest of his life thing? Hows everyones babies doing?

THank you

luz

 

Few more question. What is considered a normal glucose range? Should i be concern that it was 107 in the AM and at night 187? How do i factor in if he just ate and the values? The lowest i ever want to see it is 68? the highest?

 

Normal blood glucose numbers on the AlphaTrak are 68 to about 150

It's possible that Junior might need a little support in the way of insulin.....try testing him at "Pre-shot" times.....and then testing again about 3 hours later.....that will help tell us what his pancreas is doing on it's own

 

junior ate last night at midnight:
(3 0z FF with 6 wellness core dry kibble)

Bg at 6 am 138
Feed immediately after: (3 oz FF with 4 dry kibble)

Will do another bg at 6 pm and feed and then bg 3+ hours later.
Hopefully this will allow me to better see what the food is doing to his glucose.

Tomorrow should be a lot better since I don't work and I'll be able to monitor him closely. I am also thinking that once his young and beyond zero carb comes in I'll have better numbers since the wellness dry has carbs.

Does this sound good? My goal is to have him on wet only eventually.

Here he is waiting for his food this morning

 

Sounds very good indeed, Luz.

Much better seeing Junior waiting for food instead of worrying about whether he'll eat at all. Long may he have a strong and healthy appetite.

Lovely pic; Junior's a real cutie. I like his Fu Manchu whiskers.

For the next few days you'll need to keep checking BG morning and evening and also doing spot checks after meals as and when you can (per Chris's recommendation above, +3 is a good time to check but it's handy to get +1 and +2 checks after food as well because it can give you a fuller picture of how Junior's pancreas is managing in response to meals; all BG data is helpful).

As Chris suggests above, it may be that Junior will need some treatment with Lantus to help his pancreas rest a little. I would think that if he does need support for a while a conservative approach to treatment would be wise. It is safest to start at a low dose (e.g. 0.25 IU Lantus), test regularly to both assess dose safety and efficacy and then, if necessary, adjust the dose in small increments (typically 0.25IU), rinse and repeat. Dosing is something you need to discuss with your new vet but I suggest that you ask for some of the more experienced Lantus users like Chris to have a look at Junior's spreadsheet data and perhaps make suggestions on dose before you go ahead with the insulin; as your own experience has already demonstrated it's unfortunate but true that some vets may prescribe doses that are either too high - or indeed unnecessary after a diet change.

If Junior needs insulin then we can help you further with when to test while he's being treated.

When it gets to the stage where Junior can stay in a good BG range without insulin for 14 days he would be considered a diabetic in remission (OTJ - 'off the juice'!) We recommend testing daily, much as you are at the moment, for a reasonable period after a cat first enters remission. If the numbers hold well then weekly BG spot-checks are fine.

For general information, diabetics are more vulnerable to infection (and possibly inflammation) and this can cause BG levels to rise. Therefore any time you think that Junior may be a little bit off-colour it is recommended to keep a much closer eye on BG levels. Also going forward, keep a steady eye on his oral health and also his toileting habits for early signs of common problems such as oral health and urinary tract issues. Prompt treatment reduces the risk of a cat falling out of remission.


Mogs
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Thank you for asking after the other fur babies!

My poor civvie's GI and diarrhoea issues continue unabated. Longing for a solid, healthy poop to appear and also to be able to find a food which agrees with her that she wants to eat ...


Mogs
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They are just so picky when it comes to eating. Hopefully your little one gets well soon and starts eating

 

Thanks for the good wishes, Luz. I am managing to keep her fed (temporarily on home-cooked chicken and rice and the prednisolone is stimulating her appetite a bit) but unfortunately what she eats is mostly just going straight through her at the moment.

When I tried introducing a different food she either started getting nauseated or would only eat very little, depending on the variety. With few exceptions, I think uncomplicated diabetes is much easier to manage than GI issues.

Sending some scritches for Junior.


Mogs
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Junior bg this afternoon was 108. I then fed him FF 3 0z chicken classic but a sprinkle of fortiflora. His ate about 75% of it. He loves to eat a little n come back for a bit more. I did another bg at 3+ it was 78. When should I do the next one? I wasn't sure if I should do it in 3 hours or maybe just 1?
Is there a link about understanding the bg values? How they rise n decrease?

 

The BG numbers rise and fall in response to eating, carb level of food, activity level, emotional state, presence of infection, insulin dose (if insulin is given). Many things can affect BG.

Junior isn't getting any insulin right now so you're free to decide how often you want to test because you're just gathering information to see if he actually needs insulin.

 

Oooh! We like this news. V-e-r-y much!!!

Because Junior's BG went down a while after eating it points to his pancreas producing good pulses of insulin at mealtimes. All of Junior's BG tests for the day have been in the normal, healthy range and those two double-digit tests are excellent.

Again I say thank goodness you took the initiative and started home testing before giving the prescribed 2IU of insulin.

C'mon, Junior; keep this up!


Mogs
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Really REALLY GOOD!!!!

 

Thank you everyone. I'm so very happy

 

(((Luz)))




Mogs
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Hello everyone. My vet called today to tell me his fructosamine level was 519. His hyperthyroidism test was negative. She says she consulted with another vet because she was perplexed on his initial glucose prior to diabetes confirmation of 518 and then his fructosamine result of 519. Then normal results so soon after. She says she has never seen this before. She ask me what I did and I told her I modified his diet. She told me to keep monitor bg at home and to call her if the numbers start to go up.
I also wanted to ask you ladies what the restriction on fortiflora are. I sprinkle just a bit on his food to get him to eat a little twice a day. Is this ok? Is it save to use this at every meal. Junior still doesn't love his food. He eats a bit and walks away and comes back. I wish he could just eat a 3 0z can in one sitting but he refuses. I don't want to change his food too soon because right now I just don't want to change too much with everything that is going on. Any ideas? I also checked his weight and according to my home scale he is 10.8 pounds. He only eats 2(3 oz can of FF)

Ihave wellness chicken formula grain free (wet)
30 protein 66 fat 4 carb 219 phosphorus

I have wellness turkey formula grain free (wet)
31 protein 65 fat 4 carb 200 phosphorus

Someone told me to try friskies.
Turkey n giblet dinner
41 protein 51 fat 8 carb 338 phosphorus

Does anyone here feed there cat this?

 

I feed mine this occasionally. Gordy goes back and forth on liking it. He seems to love the FF. Wellness makes decent food, so it's definitely worth a shot.

A lot of others here have had good luck with Pro Plan wet food. I don't know what the carbs are on those.

(PS - I'm SUPER jealous you were able to get your furbaby into healthy numbers with the diet change. Also very happy for you!)

 

Thank you. I was very lucky to find this forum. If it wasn't for everyone here I would have given junior insulin when he clearly didn't need it and I would have been in a sticky mess.

 

@CassAndGordy hiw much does Mr G weight? About how much does he eat in a day ?

 

Gord weighs about 18 pounds (he is a hunk of a cat lol).

He gets about 3.25 cans of wet a day (doing the 3oz ones) and a little bit of dry Evo.

I have a supply of the bigger cans of wellness that i use to freeze small pieces for his autofeeder.

ETA: its 3.25 cans, not 2.25 lol

 

his definitively a very handsome little man. I purchased Young again zero. Can't wait for it to come in to mix a few of those and see if I can get this cat to eat an entire meal. I didn't think to freeze the wellness. I'll have to do that.