New diabetic cat Grandma

My daughter's off to College and I'm left with her newly diagnosed diabetic cat! His vet told her to inject 1u Lantus AM and PM after eating Hill's prescription diet w/d. The problem we are having is that he doesn't like that food. We were giving them(another male and a new rescue girl) Indoor cat dry food, I've read enough about that and will change them all to wet low carb food, but what worries me is that I' m not sure if he's eating enough for the insulin I'm giving... I am getting the meter and strips today to find out, the vet only mentioned the curves to be done after a week on insulin. What else can I do? Ah! We brought him to the vet because he was losing weight, actually he went from 18 to 13 pounds....

 

Good morning and welcome to FDMB.

Most cats do not like prescription foods and they are not good for treating feline diabetes anyway. Take it back to your vet and get a refund. Even if it is open you can return it for a refund.

You want to change over from dry cat food to canned food. It does not have to be expensive food either. Many of us feed our cats canned Friskies, Fancy Feast & Special Kitty (Walmart brand) food. You want to avoid any foods with "gravy" in the name. Pate flavors are usually lower in carbs. All of your cats will benefit from this change.

Good for you that you want to learn to hometest. :RAHCAT That is the best way to manage your cat's diabetes. You can use almost any brand meter. Many of us use the Walmart Relion brand meters. The Confirm & Micro only need a small drop of blood. Do not let your vet try to talk you into a "pet only" meter such as AlphaTrak. It is expensive and you can only get the strips at the vet.

You want to test before every shot before you feed her. The routine we recommend is Test - Feed - Shoot. For newbies, we suggest that you do not give insulin if the BG reading is below 200. As you become familiar with how your cat responds to the insulin dose, you will be able to lower that number. Once you begin hometesting, you can also eliminate the trips to the vet to have curves done. First, you will be able to do your own curve. This just means testing every 2-3 hours between doses to determine how low the BG level is dropping. Second, a curve at the vet's office is rarely accurate anyway. Vet stress can cause a cat's BG level to raise over 100 pts. So your vet may try to raise the insulin dose based on inaccurate readings.

Begin reading the info on this site. Start with info on diet, hometesting and hypoglycemia. Ask all of the questions you may have. Caring for a diabetic cat is not difficult once you develop a routine that works best for you. We are here to help you.

 

Thanks for the quick reply, I'll let you know how it goes with the testing. I' ll probably read it here somewhere but I've heard that some cats after a while can stop using insulin, is that true and how will I know?

 

Yes, many cats only need insulin for a short period of time. (Maui was one of them). You will know by home testing. It will tell you exactly what is going with the BG levels.

We typically put a cat through a 14 day trial and during that time the cat needs to remain in normal bg range 40-120 WITHOUT insulin. Most of the time 100 or lower. If the cat can do that successfully then we say it's OTJ (off the juice) or in remission.

Being in remission doesn't mean you can start feeding it dry or high carb food again. It means maintaining the food regimen of low carb wet for the rest of it's life. It also means that you need to be careful of medications you give the cat - such as steroids and any medical issues that may arise - need for a dental, illness, etc. as these could cause the cat to come out of remission and need insulin again. But hopefully only for a short period of time.

Please let us know if you need help learning how to hometest. And once you master this, you will not need to take the cat to the vet for a curve. You can do it at home and save time, money.

 

Welcome to the forum.

 

Welcome to the board!

Heres a shopping list below and some tips to help your testing https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub - let us know if you run into any issues:


Getting started shopping list
1. Meter ie Walmart Relion Confirm or Micro.
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
4. Cotton balls to stem the blood
5. Neosporin or Polysporin ointment with pain relief to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
8. Sharps container - to dispose of waste syringes and lancets.
9. Treats for the cat - like freeze dried chicken
10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

Wendy

 

Just tested him 315 in shock, thought it would be lower after 2 days..... Bought special kitty wet food, just hope it helps...

 

This is just one number. Try not to freak out over just one number. You just started this sugar dance and it's a marathon not a sprint. So patience grasshopper, patience.

Be pleased that you home tested and got a successful reading! YAY! This is good news!

 

Good job on the testing! But it is one number.

I usually recommend 4 tests a day to get a good idea of whats going on

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

We also have this handy dandy spreadsheet we use to track trends etc. We can help you set it up if you like? http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy

 

Thanks Wendy for the info! I might try the spreadsheet once I'm not as overwhelmed as I'm not much of a techie.... The 315 reading was like 8 hrs after his insulin. Let's see how it goes tonight. But reading this blog has really helped me understand what I can really do to help him overcome this and live a healthier life.

 

We can help you set it up. Just let us know when

Wendy

 

Worried! Was 383 before dinner, ate most of half a can; shot him with 1u Lantus , his antibiotic for UTI, and threw up his food....

 

Hi Rosy and sugarkitty Rayito and welcome to the FDMB.

You have received some good advice already. Hang in there. Remember to breath. This is manageable, cats can live long healthy lives with diabetes and we can help you every step of the way.

p.s. I'd remove your last name from your signature. Spybots, robobots, people trolling the internet on this public forum.

 

Did you happen to buy urine ketones test strips? Diabetic cat owners need to test for ketones at least twice a week, and whenever the cat is over 340. We want to watch for a serious condition called diabetic ketoacidosis - expensive and difficult to treat so you want to catch it early.

Wendy

 

I'm happier tonight! He's down to 198 this morning and 130 tonight, and ate almost all his food.

 

Just checking here -
Lantus has its maximal effect about 5 to 7 hours after the shot.
Was that 130 a pre-shot test?
If yes, how long ago was that in hours?
If that was a pre-shot, and it has been over an hour, please get another test now.

We don't like new folk to give insulin below 200 mg/dL starting out due to the risk of hypoglycemia.

 

Sorry! Didn't see that post, this morning pre meal was up to 257 and didn't eat much. Still having trouble with the new food, he licks it all over the plate but doesn't eat much of it.... Guess I will try different brands, bought the Special Kitty tuna and beef dinners.

 

The lack of appetite may be due to the antibiotic - a common side effect.

About 2 hours after giving it, you might give 1-2 teaspoons of plain yogurt with active cultures in it to see if that helps.

 

What time did you get the 130 ? ie how many hours after his last shot?

Wendy

 

I would say almost 12 hours, I will do the 5-7 hrs after morning during the weekend. So far I'm just testing him AM and PM before meals.

 

So did you shoot at the 130? We dont advise newbies shoot under 200 until they know how the cat will react and if its safe to do so.. see this primer on shooting low.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147

 

Yes, I did, because I thought it was a wrong reading being the first time so low and didn't want it to be 400 in the morning. Still trying to figure this out and all the testing, insulin and new food! But I now know not to do it again.... He's still at 257 tonight premeal/shot, gave him 1u. I'll try during the weekend to get 4 testings and see how that goes. I tried to fill he spread sheet but came back with an error message, can I do it in my iPad?

 

Yes but you need to install the google docs app.

Deb can you set it up for her and then she can just edit using her iPad google docs?

To start with you don't want to shoot under 200 but you are right, over time you will want to learn to do that in order to keep her low.. Shoot low to stay low. Take a read at the primer.

Wendy

 

Thanks!

 

Another roller coaster day, high AM, low PM, I just want to finish the antibiotic maybe it will help.... His ears look awful...

 

Are you putting a little pressure on the ear poke spot, 20-30 seconds, after you are done getting the test? This can help to prevent bruising. Also, triple antibiotic ointment with pain relief can help the ears. Apply a tiny dab, wipe off any excess and that should help.

Good thing you skipped the insulin this evening. That 58 is way too low to give any insulin at this point.

Is his appetite better today?

 

Thanks! And yes, he's eating much better now.

 

great job on the SS guys! Dont worry about the ears - they will heal. Its normal at first to see a little bruising but as you get better at it, and the ears learn to bleed, it will stop happening.

Given he dropped so low ( anything under 50 is an automatic dose decrease and he was close) I am thinking this is too high a starting dose. We need to at least start with a dose that you can give consistently without skipping as Lantus works best when dosed every 12 hours since it only lasts in the cats system for 12 hours. Do your syringes have half unit markings? I am thinking you could try 0.5 units instead.

Wendy

 

But he was 429 this morning... I'll try tomorrow to test him more and see what we should do. Thanks!

 

The 429 is what we call a bounce! Its a panicky overreaction by the liver to the low green number and is very common. It will clear

Bounces - what are they and is my cat doing them?
When a cat isnt regulated, the blood glucose has probably been high for a while. As the insulin starts to take effect and numbers start to come down, the liver has to learn to adjust to the lower numbers. We call this "liver training school". But before it relearns that low numbers are ok, when the BG drops to a number lower than the liver is accustomed, or if BGs drop low, or if the BG drops suddenly, the liver”panics” and reacts by releasing counterregulatory hormones and glucagon. This drives the BG back up. This is what we call a "bounce". Bounces can take up to 72 hours to clear so we are generally careful about increasing doses during the bounce. Once the bounce clears, then you can see the "real" numbers and determine if the dose needs to go up or down.

Wendy

 

Thanks! I feel that I'm not alone in this ordeal....

 

Rayito was really aggressive this morning and after two tries with the lancet with no blood I let him go.... I gave him 1u anyway because of last night's reading.... Let's see if I can check in 3 hours....

 

I hope so because he could be low if the bounce has already cleared. remember to give a treat even if unsuccessful!

Wendy

 

With Lantus, dose adjustments are made based on the nadir - lowest glucose level - between shots. The pre-shot number is important to make sure you don't give insulin when it is too low for safety.

In my signature link are some Secondary Monitoring Tools which may be helpful in assessing him.
While not as precise as blood glucose monitoring, in a slower protocol then may be used to carefully make small adjustments in management.

 

Under 200 since last night, no insulin and he looks happier, more alert! I also stopped the antibiotic which I think helped with his apetite. I hope that this trend continues....

 

Just looked at the SS. Those are fantastic numbers for Rayito! Keep it up. :RAHCAT

Yes, antibiotics are known appetite killers. Many cats will not eat much when they are antibiotics. It's hard for our sugarcats, because they need to eat.

 

Wow great numbers! If you get 50-130 for 14 days then he is officially in remission!!

 

2nd good day! I'm happy!

 

The 192 this AM was a little high. If that happens again, you get a number in the blue range (100-199), feed and test again in about 3 hours. If his pancreas is kicking in and producing insulin on it's own, we should see that +3 number come down after some food but no insulin shot.

 

Yep - 192 is high but he came back down. What foods is he eating?

wendy

 

Ok! I'll see what happens tomorrow AM.
He's eating Special Kitty canned food.
Thanks!

 

Pâtés only? No gravy ones?

 

No gravies or sauces, I'll post the names of the ones I bought tomorrow. I've tried to understand the % but gave up...

 

Where do you see a special kitty % list? I can try and explain it to you..

 

Are you referring to % calories from protein, fat, and carbohydrates?
Or to the label on the cans % weight?

 

I don't remember, I read somewhere in this blog about the best food being 10% or lower but I don't remember what it was, I thought it was carbs but in the label there are no carbs, so IDK!

 

Pet food manufacturers are not required to list the percentage of carbohydrates in their canned foods. They list protein, fat, water, ash percentages but not carbs. You have to calculate the carb percentage by plugging the other numbers into a carb calculator, or using the formula on vet Dr. Lisa Pierson's website catinfo.org.

 

What flavours of special kitty are you feeding? heres a list http://binkyspage.tripod.com/CanFoodNew.html - you want % carbs (third column) under 10%

Wendy

 

Thanks! All of them are below 10, so I guess that's why his numbers are so good, so far....

 

42 this morning! Didn't get to check last night but I'm wondering if his numbers are too low.... He looks fine and eats most of the foods well, I'm writing down his faves and in the no-no list the ones he kind of makes faces.... He's playing more with the other cats and not sleeping as much as before, so I guess that's a good sign!

 

That's a lovely normal glucose number!

How many days off insulin so far?

 

No insulin since Monday AM dose!

 

Since Rayito is not getting any insulin, those low numbers are not a concern.

Would you please make a minor update to your SS for us please? On those cycles where you do not give any insulin, would you put 0 in the units column for the dose. That way, we know you deliberately did not give a dose, and did not forget to update that column.

He's looking really , really good.

My civies, Delta and Monet have tested in the 40's. It's a normal number for them.

 

42 is not too low since you have not given any insulin recently (9/9/3013 was last time)

 

Still looking good, I'm happy! Tomorrow will be his 7th day without insulin!

 

Hey Rayito man,
what's the plan?
You're halfway through an OTJ trial,
making your grandma Rosy smile!
Keep it up for 7 more days,
and then you'll get to roll in the hay!


:RAHCAT Go Rayito Go! Go all the way to OTJ! :RAHCAT

 

I don't know why I cannot open google docs, but I'm still happy: 58 this morning!! :lol:

 

Maybe you need to login again?

 

8th day without insulin!!! :smile:

 

How's his appetite?

Rayito is on day eight
grandma Rosy can't wait,
til this trial is done,
and we get to have fun,
partying at the falls
where the tales told are all talls!

Rosy, please save the piñata for Rayito's OTJ party.

:RAHCAT Go Rayito Go! Go all the way to OTJ! :RAHCAT

p.s. As long as you post every day during the trial, you'll get one of my corny rhymes to cheer you on.

 

Go Rayito!!! :RAHCAT :RAHCAT :RAHCAT

 

LOL! Believe me I'm THAT happy!
His apetite is not what it used to be, he eats his canned food but seems to me he doesn't like it, he's just hungry and will try whatever is available... He will will not eat it all at once, a little bit and comes back for more, and so on.

 

Not starving due to lack of insulin may be part of the decreased appetitite - grazing is better for him, anyway, as it spreads out the load for the pancreas.

 

10th day, almost OTJ!!!

 

On the 10th day,
Rayito wanted to play,
down on the La Guancha Boardwalk,
where the tourists he could stalk,
and take a nice cool dip,
in the water and sip,
a nice cool rum punch,
and then stop for some lunch!

 

You are gooood! I have I question, once the 14 days are over how often should I check his glucose? drinking24

 

It's up to the caregiver, how much you test once your cat goes OTJ. I still test Wink once a week, and it's been 6 months. Some people only test every couple of weeks, some people only test once a month or once every couple of months.

I still like to test once a week, because if I see Wink's BG numbers creeping up, I might be able to catch an infection or inflammation or needed dental work sooner rather than later. If he is falling out of remission, I'll catch that quickly also with once a week testing.

 

Tips to stay OTJ

We say a cat is in remission if the cat can maintain BG levels for 14 days between 40-120 with most of that spent under 100. However, please keep in mind that once a diabetic always a diabetic.

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.

 

Thanks! 12th day without insulin! Almost OTJ,!! dancing_cat
I don't really like canned food because after a while it looks nasty but I guess I'll have to get used to it..... Until they figure out a low carb% dry food... How hard can that be?

 

Trial day twelve,
Rayito still doing swell,
two more days to go,
they sure won't go slow!
then we have a party,
for Rayito the little smarty!

No peeking ahead to the party menu Rayito!

Do you ever add a little bit of water to the canned food? 1-2 tablespoons and mix together. This can help to keep it from drying out.

 

Cats are designed to get their water from their food and their thirst mechanism doesn't prompt them to drink enough when on a dry food diet. This may lead to bladder and kidney stones due to more concentrated urine and to renal disease by making the kidneys work harder with less water to process solute for excretion.

Additionally, dry food is calorie concentrated, making it easy for a cat to become overweight or obese by eating too many calories. To understand how, compare the volume of a 10 dried grapes to 10 fresh ones and consider which would make you feel more full. Its the volume which partly makes you feel like you've eaten enough. This happens in cats, too.

The preceeding is based on information from Cat Info.

 

One more day and Rayito is officially OTJ!! flip_cat

 

Today is OTJ trial day thirteen,
Rayito showed us more green,
tomorrow we party,
for this cute little smarty!


I hope the bus is big enough for everyone that wants to come to Rayito's OTJ party tomorrow.

 

14th day without insulin! I'm happier than ever!

 

:RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT :RAHCAT​

Congratulations!!!​

 

:mrgreen: :mrgreen: :mrgreen: :mrgreen:

CONGRATULATIONS!!!


Tips to stay OTJ

We say a cat is in remission if the cat can maintain BG levels for 14 days between 40-120 with most of that spent under 100. However, please keep in mind that once a diabetic always a diabetic.

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.
wendy

 

Thank you so much! You all have made this experience much bearable, I felt like I wasn't alone trying to figure out what to do next. I'll keep you posted of Rayito's numbers, and hopefully he will stay in remission for ever!! Thanks again!

 

Here is Rayito at the falls today. Bigger than life.


Congratulations!