Need Guidance: Diabetic care for 10 year old

Discussion in 'Feline Health - (Welcome & Main Forum)' started by OpacleMommy, May 19, 2020.

  1. OpacleMommy

    OpacleMommy New Member

    Joined:
    May 19, 2020
    My name is Nicole, in March of this year my baby Opie was diagnosed with diabetes. Opie hasalways had a lot of health issues. He was therunt of his litter, he had to be given yogurt as a baby, he was always getting eye infections and ear infections. I had a pile of vet visits by the time he was 3 but he was worth every visit, every second of care.
    When he was 5 he started having problems going to the bathroom, I had to start administratingenemas. He has always been attached to my hip, so much so he became dependent on me to bewith him every time he went to the bathroom.Yes, this wasn't easy but it was better than himholding in his urine, which he would do if I wasn't home.
    Eventually his vet said he had mega colon, and said Opie would always have issues but I was prepared to take care of him.
    Opie turned 10 in June. In January 2020 I noticed Opie wasn't playing as much, and he started to loose a lot of weight, even though he was eating. He was always drinking water and when he urinated it was a river. Finally in March I took him to his Dr and he couldn't believe how different he was, he was lethargic, and boney and I was a mess. He ran blood work, and took a urine sample and I waited 3 days to hear back.
    Opie was put on 1 unit twice a day of Lantus but after a month he had more blood work and his Dr upped his Lantus to 2 units twice a day.
    He was put on a prescription diabetic food. I bought a glucose meter and began testing at home.
    It is now the end of May and I have him on a scheduled injection at 8 a.m. and 8 p.m. but he is still lethargic, he is still very thin and he cries a lot during the day wanting more food even though he eats two big meals before his injections and he gets lil meals in-between. I added suggested nonprescription food because just the diabetic food alone was giving him diarrhea.
    I don't know what to do to get my baby back to almost happy. He is also blind now, his Dr says both of his eyes are completely cloudy. He is having more trouble moving, he already had arthritis but I understand the diabetes will make movement worse. I can't imagine my life without him but I feel lost as to what more I can do. I will do anything for him, I wish I could give him my pancreas but unfortunately I can't. I have been reading a lot of posts on this forum and it has helped but I can't do this alone anymore. I'm sorry for the rather long post but I wanted to give a little background on our journey thus far. Any guidance would be appreciated. Thank you.

    Many thanks to Nan & Amber for responding and helping me get here.
     
  2. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hi Nicole, good to see you here!

    As I said in the pm, I may not be able to help much on the megacolon and other non-diabetes issues, but I do know some general guidelines. The most important thing is, address other serious health challenges first, then try to adjust the diabetes treatment around that. You can always change the insulin dose to respond to Opacle's current needs, and we can definitely help you with that.

    So, I think we have two main strategies to try to get Opacle on the right track. The first is food, and the second is home testing blood glucose so that we can figure out the correct insulin dose.

    For food, this is definitely a case where step 1 is to make sure you're feeding something that won't upset the delicate balance of his digestive system. Prescription diabetic foods often aren't really good for diabetics anyway (believe it or not!), so losing those is no loss. Eventually, if possible, low-carb wet food is ideal for diabetics, but if you can't find anything in that category that agrees with him, just feed him whatever does. What kind of food were you feeding him before the diabetes diagnosis?

    For home testing blood glucose, it seems scary at first, but is really no problem, and it is absolutely the best tool you have for managing diabetes. Occasional curves at the vet are no substitute for home monitoring-- less stressful, less expensive, and a much more accurate picture of what a particular insulin dose is doing for Opacle. Without it, all you know is that the current dose isn't working for him based on the outside symptoms, and it's hard to know how to proceed. We have lots of tips and advice on how to get started.

    I have to log off for a bit, but I'm sure others will come around to fill in some of the blanks in the sketch I made above. People here are very knowlegeable and generous with their time. Welcome to FDMB, the best place you never wanted to be! :)
     
  3. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome to FDMB! You found us! TY Nan. Poor Ope. Boy Opie is a warrior and so are you!
    I'm not up on Opies issues like megacolon but there are folks here that are.
    Hang on for more replies. I see Nan already has. ;)
    Theres a wealth of information here and people t help you digest it all.
    Again WELCOME !
    jeanne
     
  4. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Member

    Joined:
    Dec 21, 2019
    Welcome Nicole!!!

    I second JT you’re both warriors and your dedication and commitment to him are inspiring to me :bighug:

    You said you’re already home testing, is that right?
    If you could transfer the info into a ss and share with us the link on your signature, like I have in mine, it will really help members help you with dose and adjustments. Here’s a link with instructions for both. The signature is a great at glance way to know the basics about your cat like the insulin he’s on, any other meds and food

    http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/

    Hang on for other replies and welcome again :)
     
  5. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Yes indeed-- how did I miss that you were already home testing????? So sorry, I was in a bit of a rush, I guess, luckily Ale was here to say something sensible ;). Yes, a spreadsheet collecting all the BG data you have so far will be invaluable to us in trying to figure out what is going on with your boy. Let us know if you have any trouble setting it up!
     
  6. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    Hi and welcome

    Hang in there diabetes seems like a lot and is a bit overwhelming at first but it gets better

    Is great that you are already testing at home,congratulations on that it is going to help you and Opie a lot

    For the looks of it Opie is still unregulated even though he's getting insulin the dose he's getting is not the right one for him (could be too little could be too much), and that is one of the reasons why he's hungry all the time and drinking a lot of water, but to be able to see what's going on we need to see the test results you are getting so please share them with us, and if you could use the spreadsheet we normally use here that would be awesome because is easier for us to understand it.

    Here's the link to the spreasheet and the instructions on how to use it, if you have trouble setting it up let us know so that someone can help you

    http://felinediabetes.com/FDMB/thre...te-a-ss-and-link-it-in-your-signature.130337/

    Regarding the food What was he eating? you do not want to have complications with his other issues on top of diabetes, so in Opie's case you may need to give him is regular food and work around it , it may not be ideal but you can handle his diabetes with out prescription food. Actually most of us do not give prescription food, ideally what you need is a low carbohydrate high protein food, and we have a list you can use to find one that is ok and that may be ok for Opie too as mentioned ideally you want food that is 10% or less in carbs( carbohydrate) in the list and as high in protein as possible (this is the link to the food list http://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf)

    Also for what you are describing Olie may have a neuropathy that causes their back legs to loose strength and to not work lets say properly, once regulated and with a bit of help most cats recover their normal mobility, a lot of people here use Zovaline (a supplement with B12 vitamin and folic acid) to help with that you may want to check with your vet if it's ok to give it to Olie

    Here's also the link to the Lantus protocols that we use, that you will find very much helpful to understand how to handle the dosing and almost everything related with Lantus http://www.felinediabetes.com/FDMB/...-low-go-slow-slgs-tight-regulation-tr.210110/

    I know is a lot of information but you can help Olie with this and we can help you help Olie so please ask as much as you need/want
     
  7. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    Just wanted to reassure you that diabetes isn’ta death sentence. You are already home testing which is half the battle. We are here to help.
     
  8. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Nicole and Opie and welcome to the forum. You are wonderful the way you have looked after him over the years. What a lucky boy.
    It is great you are testing the blood sugars. There is no need to give a prescription diet. What is the prescription food you are feeding at the moment?Ordinary low carb food is fine. I’ll post a link at the bottom of this post.
    When a Diabetic cat is unregulated they can’t absorb all the nutrients in the food so they need more food. If he’s thin and wanting more food give it to him. Just don’t feed for the 2 hours before you test to give the insulin.
    It would be very helpful if you could set up the spreadsheet and enter the data for us. We can then help you with getting your precious boy on the right track.
    Are you dosing with syringes or a Lantus pen?

    We do have people here who are dealing with Mega colon. I can’t think who they are at the moment but I’ll get back to you on that. Is the constipation under control at the moment?
    Bron

    foodlink
    http://www.felinediabetes.com/FDMB/threads/links-to-food-charts.174182/

    useful link for new members
    http://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
     
  9. OpacleMommy

    OpacleMommy New Member

    Joined:
    May 19, 2020
    I just wanted to thank all of you so much for your response and kindness. I will definitely fill out the spreadsheet in the morning when I have access to my laptop.
    Until than I wanted to answer some of your other questions. Opie was put on Purina DM diabetic food (hard and soft) however because it was giving him diarrhea I stopped giving it to him every day and started supplementing with healthier options I found listed on another diabetic cat help site. Brands like Tiki, Applaws, and Merrick were suggested. Opie seems to like them a lot better than the DM food but it seems to make his stool harder which isn't easy for him.
    I don't let him have the hard food very often because I did read that hard food of any kind isn't good for a diabetic cat.
    Before Opie was diagnosed he was eating Fancy feast, he wasn't a big fan of pate but it seems now a days my baby will eat anything.
    I am not getting too much help from his Dr anymore, ever since all of this Covid stuff, it is harder to get in contact with him, and I hate that I can't be with Opie for an appointment If I were to get one.
    As I said I will definitely fill out the spreadsheet tomorrow but just go give an idea he has had blood sugar readings as low as 34 and as high as 566.
    I appreciate you telling me diabetes isn't a death sentence but when I see how much energy and happiness it has taken from my baby it kills me.
    I appreciate any and all of your help and I know that after I set up the spreadsheet tomorrow you will only have more very helpful information for me and Opie. :)
     
  10. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    What sort of glucose meter are you using? if it’s a human meter any numbers under 50 trigger a reduction and you need to give some higher carb food to bring the BG up higher and test again within 30 minutes to see the BG is coming up.
    If it’s a Pet meter anything below 68 triggers a reduction and the need to give higher carb food and test as mentioned above.
    Did you reduce the dose when you got the 34?

    are you using syringes or a pen to give the Lantus?
    We recommend going up in 1/4 unit increments not 1 unit increments so you don’t miss the best dose and it’s safer.

    One of the Links above I sent also has how to set up the signature. Only takes less than 5 minutes and will tell us all about Opie which we like to look at each time we help you.
     
  11. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    If you are getting a low of 34 then your dose is too much. That number is dangerous. These high numbers are likely from his liver panicking and releasing glucose to prevent hypoglycemia. If you need help understanding the spreadsheet we are happy to help.
     
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  12. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    This is true of all of us but just wait till this all starts working. The rewards are well worth that killed feeling. ;)
     
  13. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    when I say it's not a death sentence, I don't mean they will just be existing. I'm saying once you get the diabetes handled they can have a long HAPPY life. My cat was diagnosed 4 years ago. She is a happy girl and living her best life. She is still the Alpha of my little group of 6... large and in charge, the Mayor of Cattown. She's definitely slowed down, but she's also 17 now and has several things going on with her in addition to the diabetes. We will help you get her into a better state of feeling good. :) You only had her diagnosed in March. It is a marathon not a sprint. We will help you!
     
  14. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Agree with everything Janet says... my own kitty Amber had some of the best years of her life after the diagnosis. Lots of attention, lots of treats with the tests and the shots, and she felt really good, too. She was very happy.

    One thing we haven't discussed yet-- did the doctor have an explanation for the blindness? I ask because, while blindness is a common consequence of diabetes in dogs, it really isn't in cats. Once in a while, if a cat's blood glucose has gone extremely low on insulin, there are neurological consequences including blindness (sometimes, but not always, temporary), but this sounds different to me if there's visible "cloudiness". Is there perhaps something else going on?
     
  15. Lalkabee

    Lalkabee Member

    Joined:
    May 1, 2020
    All good brands but some have more carbs than others even if they are high quality/bio/ etc... here is a calculator for carbs http://fnae.org/carbcalorie.html

    Edit: and no more dry food :)
     
  16. Lalkabee

    Lalkabee Member

    Joined:
    May 1, 2020
    Bee had a scratch in her right eye when we went to the vet and i found out about the Diabetes. The vet told me she could loose sight because her immune system was too low to fight the "conjonctivite" ( i'm french, don't know the english word for it). I guess any tiny infection can get worse?
     
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  17. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Conjunctivitis?

    Yes, I think unregulated diabetics do have trouble with healing otherwise minor injuries.
     
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  18. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

    Joined:
    Mar 19, 2016
    Hey, I can see your spreadsheet! Well done! Looks like you test quite a bit, which is great. A couple of observations off the top of my head:

    1) Opie has earned a reduction (at least) twice in recent weeks. Any lime green number (the 64 on 5/11 and especially the 34 on 5/14) means an automatic 0.25U reduction.

    2) He does seem to like to "bounce"! That's what we call it when the body reacts to an unfamiliar low BG by dumping sugars into the blood and sending BG to the moon. A lot of the red and black numbers you've been seeing are probably these reactions. The high numbers can last for days, so if you don't happen to catch a low, it can look like the cat is always high.

    3) Although you test a good amount, you don't always get a pre-shot test, including the nights when you got those lows (thank goodness you were testing at night! that's when many kitties go low).

    Going forward, we recommend testing before every shot, and aiming for at least one test sometime between shots to try to figure out how low the Lantus is taking him (dosing decisions are based on those lows). I would definitely take at least one 0.25U reduction, maybe even 0.5U given that 34 on an Alphatrak.

    What do you think?
     
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  19. Veronica & Babu-chiri

    Veronica & Babu-chiri Well-Known Member

    Joined:
    Aug 5, 2016
    I think I agree he needs a reduction on his dose (this is because Lantus dosing is done considering the lowest number not the highest), and even though they already mentioned it, sorry if I'm being repetitive but it is very important to always test before giving the insulin to make sure is safe and given the fact that he seems to like to drop quite a bit and then bounce, I also think it would be good if you schedule testing mid cicle as much as possible. Hopefully you can buy some syringes with half markings because those make dosing much easier

    They do go back to being their usual active selves (or potato coach selves in Babu's case he's a hymmie ;)), when Babu and I started all this he was also in a pretty bad shape he had UTI, on top of his other issues and hadn't eaten much so his liver was also acting up a bit but once he got regulated everything started looking ok

    Regarding the food keep looking for one that does not make his problem worse just remember that as long as it is low carb it is ok
     
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  20. OpacleMommy

    OpacleMommy New Member

    Joined:
    May 19, 2020
    Wow! Thank you all. I am reading through all of these helpful replies and am wondering why it took me so long to join this forum :banghead: Yes I definitely need to test him more often before his shots, I usually have to take the samples from his paws because he wasn't having it at all from his ears.
    Is it normal for the area on the paw to dry up after a bunch of testing? I noticed as I tested more I was getting less blood so I had to move to his back foot for samples.
    I think the vet just believes that his cataracts were made worse by the diabetes. Opie has gotten a lot of eye infections over his lifetime and a couple years ago during one of those exams the Dr saw cataracts forming. This last visit he said both of his eyes were worse and that was another reason he wanted to do the blood labs.
    I'm sorry for asking so many questions but how will I know when he is regulated? Also if he is crying and than I give in and feed him will I be putting him in danger of too high of a reading?
    He also won't lay on soft bedding anymore. He always lays on the floor now. I always try to move him to softer services but he never stays always reverts back to the flooro_O
    Thank you so much for listening to me, Opie and I appreciate it more than you know.:bighug:
     
  21. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    The only thing wrong with asking questions is if you dont ask enough. OK?

    ECID (every cat is different) with regulation. I dont think there is one set rule.

    An unregulated cat is hungry. I think several small meals through the day is better than two big meals.

    As for the soft spots...Is Opie seeking tile or hardwood to lay on? If so, it might be hes a bit warm? I know that NONE of my cats have ever chosen the bed to sleep on in the summer time. They preferred the cool tile.
    Positive being sent your way!
    j
     
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  22. Patricia & Noodle

    Patricia & Noodle Well-Known Member

    Joined:
    Jan 21, 2015
    Hi! I have tested on my cat’s back paws for the past 5 years. To prevent dryness, I’ve always used a small dab of antibiotic ointment (the “clear“ kind, not the cream, and NOT the kind with pain relief) before I poke and then a little more afterwards, after I put a little pressure to stop the bleeding. Using the ointment before helps the blood bead up, too!

    I typically have this one on hand: https://www.target.com/p/triple-antibiotic-ointment-2oz-up-38-up-8482/-/A-78294062
     
  23. OpacleMommy

    OpacleMommy New Member

    Joined:
    May 19, 2020
    I noticed Opie wasn't laying on my bed or wanting to jump on the couch with my anymore in January. He just slowly stopped until by March he wasn't even trying and when I would put him up on the bed where he use to sleep he'd get back down and sprawl on the hard floor. The floor in my room is tile but the rest of the house is hard wood. I thought maybe in the winter is was just that his arthritis was acting up and made it harder for him to jump but than when I'd help him and he'd still get back down I was confused, And I'd understand if he was trying to keep cool but he did it in the winter too...
    I don't know, just this baby of mine is constant with health issues and I'm worried constantly. I'd actually like to take him to a different Dr to get another opinion on his health, our Dr is nice but he was rather vague about Opie and his test results. He said there was a sign of infection in the blood test to and when I asked what kind he said he didn't know. When Opie had a second blood test he said he didn't check for it so he didn't know if it was gone, this frustrated me because I obviously want to know if Opie just needs care for diabetes or if he needs additional care for something else.
    Dr is so expensive though and as you all know the diabetic needs are costly as is. I think I will take your advice and space out his meals, cause he always seems hungry so quick and I hate letting him cry.
    Hopefully I'll make progress with all of the advice I've gotten here:bighug:
     
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  24. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I totally understand the cost factor. But it seems your Vet isnt really engaged? I dont know how long you have been going to this vet but...I'd seriously consider a second opinion. That said...I know...personally, I couldnt afford a second opinion were Opie my kitty.I would be in the same boat with you.:(
    Thats what most people here do (unless kitty is on some specific diet) several meals during the day.
    Good luck to you and sweet Opie,
    j.
     
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