New Member 5/28-HELP!

Hi everyone! So we just rescued a cat from the streets who we are fostering. When we took him into the vet his sugar was 700, so we started on insulin and diet change. This is all VERY new and overwhelming for me. My vet is great but is much so on the "he's a tough one, I'm not sure what's going to be best" train...he's a skinny buddy, not your typical "fat cat diabetic" as she says. I need help...We did two rounds of an implanted "FreeStyle Libre" glucometer to get glucose curves. He's all over the place for most of the time, but we've had a few great days of sugars in range. My questions for now are:
1- She suggested the AlphaTrek II for at home sugar readings-the strips are SO expensive...any other good ones out there or is this the best one?
2- She says NO to any OTC food. He's on the Purina DM prescription. I'm reading Fancy Feast may actually be okay??
3- You test sugars before or after meals? And are you deciding on units to give based on sugars before or after meals?

Thanks everyone!

 

Welcome to FDMB the best place to help you help your kitty. Theres plenty of good dedicated folks here to help you decipher the in's and out's of diabetes.
You will be asked to set up a spread sheet and a signature you can find how to do that here:
Suggestions, Tech Support & Testing Area
If you have problems with setting up this info there are people that can help you with that.

I am no expert I will let others help you answer these questions . Again WELCOME to the best darn place to get answers and HELP!
Hang o for more replies!

One thing you wrote caught my attention. About food...
Fancy Feast is what MANY of our members use. The pate varieties have 10% carbs and some less! ALL dry foods are packed with carbs. Feeding dry food directly interferes with what Insulin is trying to do. Its like giving a human diabetic candy bars or popcorn to eat. That said if you remove the dry food (if hes eating dry that is) Removing dry from the diet could drop numbers to a dangerously low level. Home testing is the key to keeping that from happening.

Hold on for more replies!
jeanne

 

Hi Sadie and welcome!

good for you for rescuing and taking such good care of your foster. He’s lucky he found you!

no need to buy a pet meter. Most of us use human meters in fact you’ll see the 2 I have in my signature and there are the most commonly used. ReliOn is from Walmart and the test strips are the cheapest so I’d go with that if I were you.
Fancy feast pate is low in carbs and it’s totally fine for diabetic cars. Most folks here including me feed that.
As far as testing, you adjust the dose based on the lowest he gets on a cycle, which is called nadir. The pre shot tests are for you to know the BG level and whether or not it’s safe to give insulin or you need to give a time dose or even skip. what insulin is he on?

Here’s a link with some basic info for you to start at:

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

 

Hello and welcome!

Jeanne and Ale have covered a lot of the main things so far, but I do have one important question: what kind of insulin are you using, and how many units? (ok, I guess that's technically two questions!)

 

thank you for ht

thank you! So how do you make sure your ReliOn is calibrated for a cat's sugar reading vs human? Reading a lot about how it can be dangerous if you don't get that calibration right?

 

Hi this forum knows so much more than myself but from what I have learned . My Vet gave me a “ Don’t shoot insulin number” Dustys BG number was 100 or below 100 I always tested her Before her insulin time and then 1 hour later . If you cats numbers are too low you can always call the vet or hop on here and ask .
Fancy Feast is what most people feed But remember the classic and natural pate are the low carbohydrate ones FF with gravy is higher carbs . There are other foods but they can be a bit more costly . This is all Very Overwhelming just know your not alone ask as many questions as you have . Even if you just need to talk or vent feel free

 

Thanks Jeanne. I am using Lantus ( which is an issue because I'm having to buy syringes as well; the Lantus pen always leaks a bubble whether or not we hold the needle in for an additional 5 seconds after hitting the button).
As for units-its been all over the place. We went from up to 3 every 12 in the beginning, down to 1-1.5 depending on his readings. Basically now the rule is if its above 300 he gets 2 units, under 300 to 250, it's 1.5, under 250 its 1 and under 100, none. HOWEVER, the vet just told me to do 1.5-2 q 12 and spot check his sugar now. We had a FreeStyleLibre glucometer implanted to get curves for two weeks. At one point he was high 400s so we gave him 2, and he plummetted to under 100-like 50's. So now I'm uncomfortable giving this much. We've been doing 1-1.5 q 12 for the past two days without readings. Going to pick up a friends AlphTrek right now to check him until ours comes in or I go get the ReliOn (but I'm scared to use that bc it's calibrated for humans, not cats...idk but its way cheaper!). And I have no idea how to stick him. ANYWAY, sorry such a long rant. I'm reading the resources here and trying to educate myself and make decisions. I'm honestly quite frusterated with my vet.

 

hes on Lantus

 

thank you!! What glucometer do you use? And if it's a human one, how do you calibrate it for cats?

 

I had the Libre . Keep in mind the Freestyle Libre is made for humans . Most people here use the Relion Prime which you can buy at Walmart I cant see this forum recommending this meter if they did not have personal use of it . I believe there was just a post on this .Please let me say i have to commend you on your efforts and care you are putting it to learning to help your Kitty . Good job Mom ! I will let others answer about the meters that are more experienced

 

No need to calibrate. I asked the same question when I started here. The numbers we use here are based on human meters so no need to calculate or calibrate. If we say shoot above 200, that’s the number you’re looking for in your human meter.

I’m on Lantus as well and I like using the syringes especially because it allows you to increase in .5 and .25 increments which the pen doesn’t. I’ve been doing that from the get go. It’s usually easier to shoot while your cat is distracted eating

 

thank you! So I literally just before seeing this went ahead and bought the alphatrek 2 to just get one on board...so hopefully this group can still help even though I'm using an animal glucometer?? Also, I'm reading about getting a "curve". How many sticks a day does that entail? Seems as though I'm going to be poking this poor guy so many times a day

 

Yes there are others here using that meter.
Sadly poking and diabetes go hand in hand. Once you get to the right dose the pokes will get less and less. Remember diabetes is not a sprint...Its a marathon. (curves are the necessary evil) Cats seem to have a way of knowing youre just trying to help. That or its the treats...
j

 

Here is a video that Janet posted on how to test your cats sugar
How to test your cat's blood sugar

 

Yes they can just know you’ll be going through a lot of test strips and the alpha ones are the most expensive. I go through 100 in less than a month. 4-5 a day at least and that’s not doing a curve

 

How to complete a glucose curve
The procedure is as follows: shortly after your cat has been given its first meal (preferably at home), the first blood sample is taken just before the morning insulin is given. Blood samples are then collected every 2 hours throughout the day, for 12 hours if possible. You will then add this to your spreadsheet

 

how you can help us help you. First, create a signature. GO to your name on the top right, and then signature. Enter info such as your pet's name, date diagnosed, insulin you are using, meter you are using, and food you are feeding.... and any other health concerns.

next, follow this link and create a spreadsheet with whatever numbers you have. If you need help setting it up, just let us know.http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Your vet is ill-informed. Lantus is a depot insulin and craves consistency in dosing. No wonder your cat's numbers have been all over the place. I'll let other, more experienced members weight in on dosing. Tagging some people for you.
@Wendy&Neko @Sienne and Gabby (GA) @Nan & Amber (GA)

 

agreed and good catch! Lantus needs consistency. You need to pick one dose and stay there for at least 6 cycles or 3 days before adjusting. The spreadsheet will help us guide you through the process. We really need to see the numbers and how your cat reacts at different times of day

if you’re considering a human meter, I’d try to cancel the order. If you have a Walmart near you, you can buy their ReliOn Prime there along with test strips and lancets and don’t have to wait for shipping.

 

Oh my goodness thank you for the catch I’m very thankful for the help. So should I pick a low-dose? We are actually thinking of just doing one and one… He may get high but I certainly don’t want them to get too low

 

Yea the alpha trek is already on the way and I cannot return diabetic supplies so I’m stuck with it for now

 

Thank you we’ve been doing just boiled chicken for treats because it doesn’t have a carb count. Do you have any diabetic friendly treat you recommend?

 

Ohhh a product called Bonito Flakes or even Purebites?...We had to use the dreaded Temptations NOT low carbed but its all Trouble responded to. We just used them sparingly.
I'm sure you will get other replies on this
j

 

Those and also vital essentials. Minnie loves their freeze dried minnows

 

bimping up to the top for dosing advice.

 

Welcome to FDMB!

A couple of thoughts. I'd call wherever. you ordered your meter and see if you can return it since it's unopened. If not, we have a forum called, "Supply Closet." You can see if someone would want to purchase it from you. Some vets have a hissy fit fi you don't use a pet meter. (Somehow, they seem to have forgotten that meters calibrated for animals are a relatively new innovation. Most of. us have used human meters.)

You may want to take a look at this post from the Lantus/Basaglar/Levemir forum regarding dosing strategies. Because Lantus is a depot insulin, how you change doses is different than with other, shorter acting insulins. The sticky note that I linked provides you with two different dosing methods -- Tight Regulation (TR) and Start Low Go Slow (SLGS). Ultimately, you will need to decide which approach works best for you. TR has published research supporting it's use and has a history of getting newly diagnosed cats into remission. SLGS was developed here and in use before TR and has been used with good results. Once you start testing and have a spreadsheet set up, you may want to post on the Lantus forum. There are additional sticky notes at the top of that board that will help you to. understand how Lantus works.

You have a wealth of choices when it comes to food. There is nothing magical about "prescription" foods. (In fact, the FDA is cracking down on pet food companies for calling their food "prescription" diets.) What's key is that you feed your cat a low carbohydrate diet. We consider less than 10% to be low carb (LC) -- although most people tend to feed their cat around 5% or so. Lisa Pierson, DVM has put together a wonderful website on feline nutrition. She has a chart that lists the carb content and other nutritional information that is very helpful. For what your spending on DM, you can be buying a much higher quality food with human grade ingredients. The so-called prescription foods do not contain great ingredients. There is no reason to buy those foods -- my cat, for one, refused to eat DM. She did just fine on foods from Dr. Lisa's list although I did have to have a discussion with my vet when I returned all of the prescription stuff that I was able to feed my cat a lower carb diet than what she was recommending.

Also, I hear less about fat diabetic cats than skinny cats with FD. The way diabetes works, the food your cat is eating, once metabolized into glucose, isn't getting into the cells in order to provide energy. Instead, it's floating around in your kitty's blood stream (hence the term "blood glucose"). Insulin is what helps to transport the glucose into the cells. If your cat's pancreas isn't producing enough insulin to get the glucose where it belongs, your cat's BG numbers will be high. Your cat will also be starving -- literally. The other issue is your kitty was living on the streets. A good meal was likely not all that easy to find.

 

No one could have said it better, great explanation thanks Sienne!!

 

thank you for all this info!!

 

Again, thank you! I'm going to set up the spreadsheet now. We have done a curve for the past three days as best we can; he's been a really great "patient" during the last month UNTIL THE EAR STICKS! ay yi! And his ears don't bleed easily...I"ve read all about the lancets not being sharp enough; people use needles instead, but I'm a bit hesitant to do so. Also hopefully his ears will "develop capillaries" ( as Amy said in her video), and bleed easier soon..?
I do have a question about the "starving-literally". Yes, he is ALWAYS begging for food and scarfs it up so quickly when he gets it. I feel awful that he's always hungry. He's getting a tiny spoonful first thing in the am (7:30ish) then we check his sugar, feed him about a half a can (DM prescripton right now-it's been working with his sugars so I"m hesitant to switch to Fancy Feast just yet; we're just getting regulated..but the cans are 5 oz) and give his insulin while he's eating then he gets the rest of the can within that hour. So basically a full can between 7:30-9:00. Then around noon I give him a tablespoon of boiled chicken as a snack. Around 3:30 he gets 1/4 can of DM. 6:30 some chicken treats and 8:00 the rest of the can (3/4) of DM with his insulin. I'm trying to feed him little bits throughout the day, I've read this is helpful. Let me know if not. I just feel bad he's so hungry. BUT he's getting way more than the suggested feeding amount for his weight. He does need to gain weight. I was thinking of adding the fancy feast in for snacks instead of chicken, but again I'm worried changing what we've been doing will send his sugars too high again. We are just now seeing regulation after some crazy ups and downs...

 

There's no one "right" amount to feed your cat. It's all based on whether your cat is gaining or losing weight and the amount of calories Bodie is getting. Dr. Lisa's website has a formula for calculating calories that's a starting point:

Required calories per day = [13.6 X optimal lean body weight in pounds] + 70

For a cat who's optimal body weight is 12 lbs, he should be getting 233 calories a day. You may need to adjust the amount based on whether Bodie is gaining or losing weight. I wouldn't worry about your kitty's BG if you're feeding LC food. If he needs to gain weight, then give him more calories. You may need to dial the calories back as Bodie becomes better regulated, although his numbers look pretty darn good!

One recommendation -- please get PM tests. Many cats drop into lower numbers at night. You could be missing a dose reduction and not getting tests during the evening means you're missing half of your data. At the minimum, please start getting a test every night before you go to bed for the evening (i.e,. a "before bed" test).

 

Sienne, what about the feeding before testing she mentioned?

 

I agree with Sienne. He needs the extra food now. Minnie lost 7 pounds which is insane and she was on a 300 calorie diet to get her back to 16 pounds. She had gone from 17 down to 12

 

Just to give you an idea the 300 calories is the equivalent of 4 cans of FF a day

 

The amount of food is irrelevant if the kitty is lowing weight.

Try to not give Bodie any food 2 hours prior to shot time. You don't want the food to influence his pre-shot numbers.

Can you also check Bodie's labs or with your vet to make sure his thyroid was checked. Hyperthyroid can cause weight loss.

 

got it! before bed tests on the schedule..thank you!

 

Will ask about hyperthyroid!! He's gaining weight now though since we've started this journey! yay

 

Then it's likely the initial weight loss was due to the FD but it never hurts to ask.

 

I did read over Dr. Pierson's stuff; we're now in the process of switching ALL our cats to wet food only ! Very informative; thank you! So I've gotten a few night time readings...I can keep doing those. As for the freestyle libre we had, I can also enter the data I did read over Dr. Pierson's stuff; we're now in the process of switching ALL our cats to wet food only ! Very informative; thank you! So I've gotten a few night time readings...I can keep doing those. As for the freestyle libre (in the past two weeks prior to what I have) I can also enter that data. It was monitoring him overnight too and gave us a curve ( not exact numbers but we could see a range/if he went very low) so it may be helpful.
So, with that info and what we have so far, can we:
1-stop for a bit with the multiple BG checks per day now?
2-And how long do you have to do the pre-shot checks?
I did read all of the TR protocol when I started, then reading about all things diabetes I'm a bit info overloaded; I will go back and refresh, but any guidance is greatly appreciated. Thank you!!

 

I’d say cut back on the day checks, but you should do at least one midday test if you can. You have to always test preshot numbers. Always always always because otherwise you risk giving your cat more insulin then it can handle that cycle and it can go into hypo. Rhyming not intended

That’s 4 tests a day at least. I know

 

Congrats on all those blues and greens btw!!