New diabetic kitty

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Callie & Patches, Feb 10, 2020.

  1. Callie & Patches

    Callie & Patches Well-Known Member

    Joined:
    Jun 18, 2016
    Callie's twin brother, Patches, has been showing symptoms of diabetes. He has lost about a pound, seems to not be grooming himself and the litterboxes are wetter than in the past. I just took his blood glucose and it was 410 at 2:30 in the afternoon. I can't get him into the vet until Saturday morning. I plan to try to keep him on Fancy Feast till then. If he is diabetic, I want to try a trial of Pate food only before going on insulin.

    Callie passed away in her sleep about 6 weeks ago and I still have all her supplies and Lantus insulin. For some reason, I haven't been able to give her things away. I knew siblings were more apt to have diabetes.

    I do have some questions, how often should I test Patches's blood glucose if he isn't getting insulin and how long should I keep him on the food only trial before putting him on insulin?
     
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  2. Juls and Billy

    Juls and Billy Member

    Joined:
    Dec 28, 2019
    So sorry to hear about Patches diabetes. I'm sure more experienced members than me will be in to help soon. Switching his diet before insulin is a totally legit choice, and I wish I had done that with my Billy as well. I imagine it would take at least a few days for the carbs to completely leave his system. Then he might very well need some insulin to give his pancreas a chance to heal, but you know that already.

    So sorry you had to say goodbye to your Callie. I had a cat named Pyewacket years ago and my friend had his brother Sasquatch. Despite living with different owners in different states, and having different diets as well, both developed thyroid problems. Both boys ended up passing on within 2 weeks of each other. You are so right about sibling cats often having similar issues.
     
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  3. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    One week on the food only trial before starting insulin. IF, a very BIG IF Patches is showing no signs of ketones. Do you still have some ketone test strips left? For urine testing of ketones.

    You might think of this food change before insulin as being like an OTJ trial, but for a shorter period of time. 7 days instead of 14.

    OTJ Trial instructions (These are the criteria we use when following an OTJ Trial.)

    Here are the instructions for an OTJ trial: If on Lantus or Levimir, depot has to drain first before trial starts, about 3 days or 6 cycles. No depot with in and out type insulins (NPH, Vetsulin/Caninsulin, Prozinc).

    If you are posting in the Lantus/Levimir forum, please start a new thread each day which says ‘[Cat name] OTJ trial Day 1 BG xx’ (where xx is the BG reading for that cycle PM), then day2,3 etc. If you are posting in the Main Forum, we don’t require you or need you to do that separate post for each day. In fact, if you have never posted before over in the Lantus/Levimir forum or use a different insulin, you are fine staying in the Feline Health (Welcome & Main Forum). We’ll cheer you on!

    1. Test at your normal AMPS and PMPS times. Feed multiple small meals throughout the day as much as possible (small meals are less likely to overwhelm a newly functioning pancreas). The morning test is now called the AMBG. The evening test is now called the PMBG.

    2. If your cat is green (0-99 mg/L human meter, 0-130 mg/L pet meter, 0-5.5 mmoL) at your normal test times, no need to test further until the next "PS" time, just feed small meals and go about your day. If the numbers are blue or higher (100-199 human meter, 130-230 petmeter, 5.5-11 mmoL), feed a small meal and test again after about 3 hours. Food raises BG's. So if the number is lower 3-4 hours after a meal, then the pancreas is working!

    3. After 2 weeks, if everything is looking good, we have a party! And boy, do we party hearty.[​IMG]

    Does that help you on when to do some BG testing?
     
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  4. Callie & Patches

    Callie & Patches Well-Known Member

    Joined:
    Jun 18, 2016
    Thank you so much for the help. A week long trial it will be. I really appreciate the detailed instructions on how to do a ATJ trial. I have some charts that our vet gave me for recording numbers. I'll use that until I get a dx from the vet. than I will have to get Patches his own account and his own spread sheet. I have ketone strips and a meter that measures ketones. I'm pretty sure if Patches does have diabetes it hasn't been for very long. With Callie, I had been away from home for 6 months taking care of my dying step mom and dealing with her estate. My husband fed and took care of our 4 cat's litter boxes but just didn't pick up her symptoms until I came home. When he said she was drinking lots of water and eating lots, I knew something was wrong. I think at that tim it was too late for achieving a remission.
     
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  5. Wendy&Neko

    Wendy&Neko Senior Member Moderator

    Joined:
    Feb 28, 2012
    I am glad you have an appointment to take Patches into the vet. Too bad it's going to be several days yet until you can get him in. In the mean time, I would test him a couple times a day, to see if his numbers are improving at all. The 400's is quite high, I wouldn't want to keep him in those numbers for a week without doing anything about it. The sooner you can address the higher numbers with insulin support, the better. And it will increase those odds of remission. You should know before the vet appointment if the change in diet is helping. You can go ahead and create a spreadsheet for Patches, and just attach it as another link in your signature.

    I'm glad Deb mentioned testing ketones. Make sure the ketostix have not expired. If there are any sign of ketones, poor appetite or lethargy, you'll want him on insulin even sooner.
     
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  6. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    I agree with Deb about testing for ketones. If levels are above trace, it's an emergency.

    I'm not sure I agree about the duration of a food trial, though. Generally, you'll see a response to the switch to a low carb diet within a few days. The other factor is that your vet should run a fructosamine test and get labs. The former will tell you if Patches BG numbers have been elevated over the past several weeks. Lab work will also tell you if there's an infection or anything else going on that could effect BG numbers. Please make sure that the vet checks Patches teeth. Dental issues can also raise BG levels.
     
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  7. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Good idea for Patches mom. No need to create a separate user id here on the message board. Patches does not need "his own account."
     
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  8. Callie & Patches

    Callie & Patches Well-Known Member

    Joined:
    Jun 18, 2016
    Ok. I will set up a spreadsheet for patches. My Ketosticks are only about 4 months old. I will check the bottle for an expiration date. The vet always checks my pet's teeth and he is due for his yearly check up.

    Another question. Should Patches get his regular shots? He is due for his 3year rabies shot. We live in a rural area and there are bats,skunks and fox in our neighborhood.

    Thank you for your help. Patches is almost 15 and I know there are many problems that can affect a 15 year old cat.
     
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  9. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Is Patches an indoor/ outdoor cat? Is there a risk of him escaping from your home?
    Then , yes, regular 3 year rabies.

    My formal feral colony cat escaped out the door once. Saw a squirrel, slipped past me as I was opening the door, and chased after but did not catch the squirrel. Took 4 days to get her back inside. Hunger got her lured back inside.

    Coyotes, fox, raccoons, un-vaccinated dogs. All more likely to have rabies than a bat. (Friend was a bat researcher.)

    Spreadsheet directions for you, so you don't have to hunt them up.
     
    Last edited: Feb 11, 2020
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  10. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    He is an indoor cat but Trixy is indoor and outdoor. We never know what gifts she might bring in. Trixie once brought in a not quite dead bird for Callie. We always give all our cats rabies shots just to keep everyone safe.
     
    Last edited: Feb 11, 2020
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  11. Judy and Freckles

    Judy and Freckles Well-Known Member

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    Oct 20, 2019
    Don't forget about skunks! Our puppy got bit by a rabid skunk when she was less than 3 months old. Everything turned out alright for the puppy and we still have her. The skunk, however, did not have a happy ending...
     
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  12. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    Yep, we have those too. Saw one dead on the road into town on Saturday. I was lucky I didn't run over it.
     
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  13. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    We got into the vet this am. They took blood and urine. The vet thinks by going by my numbers that he probably has diabetes. She wants to wait until she has the results from the blood test before starting on Lantus. Patches does have a UTI so she sent him home with Clavamox to take. The last few days on low carb food didn't do much, his BG was 310 this AM. I will try to get his SS set up this afternoon.
     
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  14. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    The vet called and yes, he is diabetic. She recommends 1.5 units. That seems high for a starting dose. I told her I would feel more comfortable with only 1 unit. You can always increase a dose. It's harder if you
     
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  15. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    It's harder if you..............What?

    Once the insulin is in, you can't take it back out.
    If the BG levels go low, you need to support with food to bring the BG levels back up.

    Have to keep reminding myself that we are not talking about Callie. That it is your Patches that is the newly diagnosed diabetic.

    Not comforting to you at all I'm sure, but at least you have some experience with treating feline diabetes.

    What have you decided to do on the starting dose?
    Our starting dose recommended here depends on if you are using the SLGS Start Low go Slow protocol. Or TR the Tight Regulation protocol.

    How much does Patches weigh?
     
  16. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    Patches weighs 7.5 lbs. I think we will go with SLGS. His last blood test was in October and everything was normal so I think we caught this early. To be honest, I have decided to start with .5 units. he has been eating Fancy Feast and I don't like taking chances with my kitties health. I have looked over the protocol again and it just feels right to me to be careful.
     
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  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Sounds like a plan.
    Starting at 0.5 unit for Lantus insulin.
    Fancy Feast wet/canned food for Patches.
    Starting with SLGS lantus dosing protocol.
    Keeping Patches safe and getting him healthier are what it is all about.
    Paws crossed for your boy Patches.

    p.s. Was hoping you had decided to lower the dose to the starting dose of 0.5U we recommend here.
     
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  18. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    Thank you so much for all your help.
     
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  19. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    I almost didn't give Patches his first shot. PMPS 204. I'm so glad I didn't follow vets instructions of 1.5u. He didn't even feel the shot because he was finishing his dinner.
     
  20. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    The lantus insulin "depot" is still filling. It usually takes 6 cycles for that to happen, less on a smaller dose. Right now, Patches is on a smaller dose.

    Testing at the beginning of starting your cat Patches on lantus should be more than only the pre-shot tests.
    I see from your spreadsheet that you have selected to use the SLGS or Start Low Go Slow lantus protocol.
    Since this is the very beginning of the journey for Patches and receiving insulin, you may want to monitor closely the first 3 days.
    Some tests during the middle of the cycle, to find your cat's nadir, will help you to see how low this initial starting dose of insulin takes your cat during the 12 hour dosing cycle.

    Some spot checks of BG can help you to find the onset, nadir, and duration for Patches.

    With Lantus and SLGS protocol, the BG (blood glucose) threshold or decision point for giving a shot of insulin is 150 mg/dL. That BG of 204 was plenty high enough to give Patches insulin.
     
  21. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    So far, so good. Patches is a real trooper. I don't know if it's because he has seen Callie get BG tests and shots or what. He stays still on the card table for testing and then his shot while he eats. I suspect we will need to increase the dosage, but we will wait a day or two before doing that. I am trying to test in the middle of the day and at bedtime.
     
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  22. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Ok. When you think you are ready, you might want to think about posting in the ISG (Insulin Support Group) for Lantus. No rush. Link to that forum is here.
    Lantus / Basaglar (glargine) and Levemir (detemir)

    It's a very busy forum. So they have guidelines on how to post over there. So you don't get lost in the daily shuffle of all those other members posting. Some of that "How to Post info" for the Lantus forum is in this thread I've linked you to here. As you get more BG tests for the day, you update the thread title with the new test numbers.

    The Basics: New to the Group? Start here!

    Before you do that, you might want to read a few of the "Sticky" or pinned posts at the top of that forum.

    Thread title updates are one way that people "scanning" the forum tell who might need help, immediate help, later help, questions, etc. They look for low BG numbers. They look for questions. The default prefix on a thread is to have a blank prefix. But there is also the ? prefix.

    Why don't you try those 2 things, changing the thread title and changing the prefix on the title to the ? prefix (? question mark is the actual symbol you will see in the drop down list.)
    Do you know how to edit your thread title?
     
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  23. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    I think I can. Just go to edit on the bottom of my post.
     
  24. Callie & Patches

    Callie & Patches Well-Known Member

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    Jun 18, 2016
    I can edit a post but can't add in the question mark. I will be moving over to the LL forum. Thank you again for all the help.
     
  25. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    To change the prefix on your original thread.
    Go to the top right hand corner.
    Click on thread tools.
    New smaller box pops up where you can edit the title.
    To the left of that, is the prefix. Drop down box with choices.
    Default is for blank prefix.
    Select the ? mark prefix instead when you have changed your title.
    Save.
     

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