New, Info Needed

Hi everyone,

First, thank you for those who put their time into maintaining this forum. It is much appreciated.

My female cat is nine years old and has been diagnosed with diabetes. We tried giving Glipizide a chance for a bit and tracked her fructose level but after her fructose test results this past Friday, it is time to move her to insulin. The Glipizide helped a bit but not enough.

I'm looking to get some more information from folks here around the daily monitoring of an insulin dependent cat. My catch-22 here is that my job is what gives me the money to afford her diabetes management but it also keeps me out of the house for approximately ten hours a day. I leave the house at 6am to commute to work and I typically don't get home until 4:30pm. Add a problem in on the interstate for the home commute, and it can push me to 5-5:30pm.

I have a lot of concern and anxiety over not being able to properly monitor her and end up doing more harm than good with the insulin. Can I get an idea of how a typical day w/monitoring works for folks?

Any feedback is appreciated.

Thanks,
Chris

 

It was scary for me too as I worked full time and some odd hours. What type of insulin are you using?

 

I don't know yet. I had a preliminary discussion about her last fructose lab with the vet yesterday and will be doing more follow-up with him today. From what I am reading, it seems that Lantus may be the best way to go even with the expense of it. She is scheduled to go and stay with the vet tomorrow to begin the process.

If I need to monitor her for one hour, then I would need to administer at 5am, if I need to monitor her for two hours, then I need to administer at 4am. 5am, I can work with as long as there is never an accident on the interstate. if it is 4am, I would never be able to be home in time for a 4pm if she ends up requiring two injections per day. What I don't know is if folks are needing to monitor throughout the day? The last thing that I want to do is give her an injection in the morning and then come home to find her in a bad state all because I couldn't be here. I think that would rip me up more than anything knowing that something happened with her due to the injection and that she suffered the whole day while I was at work. Or am I just being overly worried about the monitoring side of it?

 

Hi Chris,
ALL kitties require 2 shots a day, whatever the insulin (well, there are exceptions but they are very rare....)

Most folks here find that Lantus works best if the shots are given 12 hours apart (or as close as possible).
Prozinc and PZI insulins have a bit more 'wriggle room' when it comes to the timing of the shots (ie. if a shot needs to be given a bit early or a bit late).

There are plenty of folks here who work full time but can still manage their kitty's diabetes.
We do recommend that caregivers learn to test their kitty's blood glucose (a human glucose meter is fine). This shouldn't hurt the kitty at all, and isn't hard to learn. Would you be willing to give it a try...? We can help you learn.

Welcome to FDMB!

Eliz

 

Thank you, Elize. Yes, I would want to do the home testing and I would be fine doing that. She stresses with travel and I would probably get more accurate readings as compared to when she is stressed out at the vet's office.

Help define "a bit early or a bit late" and whether that is for the exceptions or on a more normal basis. From your reply that all cats require 2 injections a day, it is looking like I have a very narrow window of opportunity here if I am able to keep her injection times consistent. It's good to know that through-out the day monitoring may not be as large a concern as I have been thinking and that the hurdle left would be around the consistency of administration times.

 

I had a similar issue when I had diabetic cats. I used Lantus. I found that as long as I had 10 hours or more between shots and tested before giving insulin, it was safe for me to give insulin. Of course every cat is different. If you are hometesting you will know if it is safe to give insulin. For newbies we recommend using 200 as your "don't shoot" number. This means that if the reading is less than 200, skip the dose. The next reading will probably be higher than normal, but that is expected. As you become more familiar with how your cat responds to the insulin and dose, you will be able to lower that number.

 

Thank you very much!! That is very helpful and makes me feel better regarding the time frame I would be looking at for administrations. IE "as long as I had 10 hours or more between shots"

 

While a 12/12 schedule would be ideal, life happens.

Do you have a glucose meter yet? If your vet tries to push a pet meter, it is not necessary. Most of us use human glucose meters. With the pet meters, the strips costs a lot and you are very limited where you can buy them. Many of us use the Walmart Relion brand meters. The meter and strips are not expensive and you can pick them up at any Walmart or order online. Other meters also work well.

 

Thank you! No equipment yet. She is scheduled to go tomorrow for the day to begin the process. I really appreciate the referral to the Relion meter and all of the information I can get so I can handle tomorrow and the vet recommendations like this. This is a pretty daunting venture here on the front end and it's very helpful to hear back from folks who have been doing it.

 

It seems daunting now, but in a few weeks you will have found the routine that works best for you and you will be wondering why you were stressed out.

 

Thank you very much for that. I take her to the vet at 7am this morning to get the ball rolling.

 

Lantus is a good choice. If you have weekends off I would do a curve one day on the weekend and the other get 3 more tests in. which should give you a good idea of how it is working in the system. Do you have anyone that can check on her while your at work?

 

I am now at 3 weeks since diagnosis and have an even worse work schedule, some days are better than others in terms of timings but what I would advise is not to expect major changes too soon, read up as much as you can, learn to home test, establish a routine of test, feed, shoot, do a before bed test and do a curve on a day off. Also - ask any questions you need to as the experienced users will guide you through. If you have anyone who is available and you can train them how to test and give the injections that is really helpful if you think you will spend time at work fretting.

 

Welcome to FDMB, Chris. We are so glad you found us. The early days of FD at our house were scarey and uncertain, but as soon as we found this wonderful community everything changed. Take a deep breath and know that you are not alone. Lots of us have demanding jobs and busy lives and although there is a steep learning curve at first, we all manage the needs of our sweet kitties with the help of other experienced caregivers here. When you are ready to start asking questions head over to the Main Feline Health Forum where assistance with whatever you might need is waiting for you.

 

Hi, Chris. Welcome to you and your girl. What's her name?

One of the best things I found to help me deal with the worry side of insulin treatment is tracking doses and blood glucose (BG) levels in a spreadsheet. If you look at other members' signature lines you'll be able to see how we track our kitties' responses to their insulin.

If you start using the spreadsheet straight away to enter your test results it will help you get a much better picture of how your little one is responding to her insulin and (I hope) it will help to give you more peace of mind about keeping her safe during her treatment.

Here are links that you can use when you're ready to set up a spreadsheet for your little one:

FDMB Spreadsheet Instructions

Understanding the Spreadsheet Grid

If you need help with the setup, just holler!


Mogs
.

 

Welcome, Chris! You're certainly on the right track with learning to home monitoring and getting your cat on a good insulin, like Lantus. Getting her off the Glipizide is a very good thing; Glipizide is not good for cats because it actually puts more stress on the pancreas and can lead to permanent insulin dependence, and it's supposed to be used only as an alternative to euthanasia if the owner refuses to treat with insulin. Most cats (80+%) on a low carb canned diet, a slow acting insulin like Lantus, and dose adjustments with daily home testing according to the recommended protocol end up going into remission. And getting your cat into remission will be far easier on your schedule than anything else you can do--I speak from personal experience!

When Bandit was diagnosed back in 2009, I was working a full time job with a 2 hour commute (so I was also gone 10+ hours, with no way to get home on lunch breaks), a part time job on the weekend, and going to grad school. Needless to say, I was really overwhelmed in the beginning. Things do get much easier as you get used to the shots, testing, and routine. A lot of what I'm going to say below is going to sound hard, but trust me, it's not as hard as you think once you just start doing it.

Treatment is absolutely doable with your schedule. Lantus is best shot on a 12/12 schedule, so what you would do is test, feed, and shoot at 6am before you leave for work, and then test, feed, and shoot after you get home at 6am. The occasional late shot if you're stuck at work is not going to be a big deal--once you get an idea of how the insulin is working in your cat, you can off-set the overlap effects of the late shot by shooting a slightly reduced dose. (There's a ton of knowledgable folks on the Lantus forum that can help you with dosing on a tight schedule). And because you're leaving for work right after shot, you'll want to skip or shoot a reduced dose if she tests low when it's time for her shot at 6am.

When Bandit was on insulin, I would test/feed/shoot at 7am, leave for work, get home at around 6pm, and then test/feed/shoot at 7pm. Then I would get a mid-cycle test before bed at 9-10pm, and I would set an alarm to get a test at his nadir (the lowest point of the cycle, which is how the Lantus dose is adjusted), and then go right back to bed. I would get a curve and other random tests on the weekend to help figure out how the insulin was working on him throughout the day. I also made sure he had food on hand 6 hours after the shot while I was at work--I did this by freezing chunks of canned food and putting them in automatic feeders for the cats.

If getting up and going back to bed is not an option for you, I would also at times pay a college student to come in and get the mid-cycle test at 1pm when I was work. If you have a friend or neighbor or family member that might be willing to help you out on occasion, that certainly helps take the stress off a bit.

We all do the best we can with management, and I understand that not everyone is able to get up in the middle of the night and go back to bed like I did to get that third, mid-cycle test. Even if you're not able to shoot for remission, diabetic cats can live a long and healthy life still with twice a day testing, too! But if you can shoot for remission, it's a lot easier on your schedule in the long run to not have to give shots twice a day and be flexible with meal times, and test only once every week or so.

Check out this thread for more tips on how to work treatment into a busy schedule: http://www.felinediabetes.com/FDMB/...ion-possible-with-a-full-time-job-yes.129378/.

I am sorry if all that information seems overwhelming, but please ask away for advice in the Health Forum or Lantus Forum if you need more help figuring out any of this stuff---help with getting testing down, shots, finding more affordable Lantus, and how to work the best treatment possible into your schedule.