Hi, my name is Dianna. I am new to this forum and I am really lost with what to do to manage my cat, Grape's diabetes and diet. I went on a trip for a couple days and came back to my cat in skin and bones and not being able to walk. I had a pet sitter feed my animals at home during that time and she said my cat hasn't been eating. I rushed her to the vet and they said she went into DKA and was severely dehydrated. She stayed there for 5 days and was placed on prozinc insulin 6 units once a day. Her diet changed from dry to canned food. In the beginning she started doing very well and then slowly she went back to before. She became very picky of her food, still eating and demanding food but sometimes would be too lazy to chew anything even if it is soft canned food. She is definitely drinking enough water but is becoming hypoglycemic. I changed different wet food, broths, different flavors to try to find something that would be tempting enough for her to eat properly but it's been a battle. I ended up changing the insulin dosage from 6 units to 5 and then to 4 units. I am very worried because she still hasn't gained any of her lost weight back. Sometimes her blood glucose would be low and she would be wobbly on her legs. The vet just instructed me to give 6 units a day and change her diet to wet food, that's it. I was checking this forum out and realized that insulin should be given twice a day...I am at lost of what to do. I just ordered a pet glucose monitor on amazon today because I realized the necessity to monitor her glucose regularly. I was never told the need to check it by the vet and didn't realize it until I came across this forum. She is my first diabetic cat and I am very lost with what to do. I tried following the doctor's instructions only to find my cat not getting any better and is constantly going into hypoglycemia. I read the pamphlet on Prozinc insulin and knows that it needs to be given twice a day but my vet instructed me to give 6 units once a day. I have decreased it from 6 units to 5 units to 4 units right now because I noticed she is wobbly at her feet and showing signs of hypoglycemia. I will be stopping by walmart on my way home from work to pick up a human glucometer before receive my pet glucometer tomorrow by mail. Right now, I am feeding her 2 times a day with some FF broth packs during the day. She is very picky and isn't eating as much as I would li Any advice or help is appreciated!!
That your vet started her out on 6 units once a day indicates he has no knowledge of how to treat diabetes. Having a prior DKA definitely needs to be taken into consideration but 6 units once a day is irresponsible... as you have already noticed! Prozinc should be started at 1 unit every 12 hours and slowly work up from there in .25 or .5 unit increments. Symptomatic hypos are serious business. I applaud your decision to start home testing. This is the best way to keep him safe! Also read the stickies at the top of this forum, and prepare a hypo toolkit, so you can steer him back up if you find 4 units is still too much - which I suspect it is. 4 units is still a really high dose so I would encourage you to test often until you see where his numbers are. It’s so unfortunate that you can’t depend on your vet to give you good advice in this, but you have come to the right place!! Edit: the only reason I’m not saying to reduce his dose right now is due to the DKA. It’s risky for her to not have enough insulin.. but it’s also risky to have too much... so test and see where she is, then adjust accordingly. Hopefully someone with DKA experience will chime in soon....
Hi Dianna! Welcome to you and Grape! First piece of advice: breathe. It's going to be okay! We can definitely help you to help Grape...you're not alone in this. It sounds like you'e got a good handle on things so far. You're right...insulin should be given twice a day, 12 hours apart. You said you're down to 4 units now? You can split that in half and give 2 in the morning and 2 in the evening. Getting a human meter is great. A pet meter is fine too, but if you'd rather, you can stick with the human meter...the strips are way cheaper. A lot of vets don't suggest home testing for some reason...I think they figure owners won't do it. For testing, you want to do it a few times a day. Before every shot for sure. If she's under 200 at shot time, don't shoot. You can try stalling 20 minutes without food to see if she is rising and can give a shot. You can also post here to ask for advice. Then try to get whatever mid cycle tests you can. Between 5 and 7 hours after the shot is good because that's around the middle of the cycle. But I know that can be hard with work, so just get what you can (we usually get a before bed test on work days) and then try to get that mid cycle during the weekends if you can. Since you don't have a meter yet, how do you know she's going hypo? Just symptoms? I know you said you're giving wet food. What kind? We recommend low carb wet. Most people feed Fancy Feast or Friskies pates, but I wouldn't change food until you're home testing regularly. As for the eating, you do want to get her to eat as much as you can. With DKA in the history, it's super important she gets enough food. While you're picking up a human meter tomorrow, try to get some ketone testing strips too. They're the same ones used for humans (just ask the pharmacist if you can't find them). They're urine strips. You just dip them in the cat's urine and wait 15 seconds (I think...check the bottle) exactly and then compare the colors on the strip and bottle. Anything above trace is an emergency. If you need help getting some urine for a test, let us know...we have some good tips. I don't want to overwhelm you so I'm going to stop now. But please ask ALL the questions you have. It's a lot to learn at first, and we're happy to answer anything!
Thanks for the replies! Right now she has been eating Friskies prime filets right now alternating with some fancy feast broth packs when she is picky. It is extremely hard to find something she would actually finish....I will be picking up a human glucometer today on my way home and I have also ordered a pet monitor online which should arrive in a day or two. Will there any dangers in splitting the insulin to 2 units AM and 2 units PM since she has been getting it 4 units PM after eating her meal. I only know she is in hypo because of her symptoms. She is still perking up and demanding for food but definitely gets wobbly on her hind legs when she is hypo.
You've been given good advice. No, if anything she'll have better BG control around the clock by splitting the dose. Give 4 u once a day can cause her to drop low then go high once the insulin wears off. With two doses a day you're giving another dose as the previous one is wearing off.
Nope splitting the doses is fine. It's possible it will actually help the hypo stuff since she'll be getting less at one time (but testing is still the way to go for sure!). As for food, just keep trying. We can help you find a good lower carb food, but stick with what you have for now. Does she eat it better with the broth on it? You can try tuna water on it too, or forti flora (cats love the flavor of that). Or some cats love parmesan cheese on it! Will she finish her food later or does she just refuse to eat the rest of it all day?
Hi Dianna and welcome! Rachel, Kris, and SpotsMom have already given you some great advice. One thing about the wobbly legs is that diabetes often causes neuropathy in cats where their legs are really wobbly and they don't walk right, have trouble jumping, will sometimes just sort of flop over....all kinds of things like that. So that may be contributing to what you're seeing as well. Once you are able to get a few tests in and we see the numbers, we can help sort out some next steps. We have so many tips and tricks for every part of this, so we are more than happy to help you get this all figured out. Where there's a will, there's a way! I'm so sorry your vet wasn't much help, but you've come to the right place now!
Hi Dianna, and welcome. I’m too new to give much advice except on very practical matters (especially with a cat who has DKA), but you’ve certainly found the right place with many wise, generous folks to help you help Grape. And I always love it when people cross-post! With both Rachel and Kris &Teasel posting the same advice and the same time about splitting the 4 units, you can be confident it’s the right thing to do!
Thank you so much for all the information! I can't tell you how grateful I am. I was so lost and worried but now I feel more confident in what I have to do to help Grape feel better and I know I have all the help I need here .
Hi, so I just got home and my babysitter had given her a pack of FF broth, I just tested her BG and it is extremely high. It is 470. I don’t know if it is just high because she was low earlier on. I haven’t been able to get a ketone test done on her because she hasn’t peed since I got home yet. She is still wobbly and hungry. What should I do at this point? I am so worried.
If she is asking for food, I would feed her. When cats are not producing insulin well, their little bodies cannot properly use the glucose from what they ingest, and so in a sense they are “hungry” on the cellular level. Josie was constantly eating as if she were starving — and yet still losing weight — until we got her more or less regulated. I don’t know about the carb content of the FF broth, but I wouldn’t worry about that much right now. Here’s a sortable food chart created by Dr Lisa Pierson, a feline nutrition expert. Generally speaking, less than 10% carbs is optimal for a diabetic cat. We feed Josie FF chicken pate and chunky chicken; on occasion, she gets the roasted chicken or roasted turkey. http://catinfo.org/chart/index.php From your description, it seems likely that your kitty is “bouncing,” which happens when their BG (blood glucose) level drops too low or lower than they are used to. @Kris & Teasel has a great explainer for it ... but it’s pretty much the cat’s way of releasing an “emergency supply” of glucose in response to the low number. And that’s a good thing because it can pull them out of a danger zone, but it has the consequence of resulting in a period of high numbers until the bounce/emergency glucose clears their system. Now that you’re testing — great job on that, by the way!! — it would be very helpful if you set up a spreadsheet and link it in your profile so that we can all see it and help you to figure out what is going on with Grape and how best to help here. Here’s the link to the instructions for setting up a spreadsheet: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
Thank you!! I will feed her now. Do you generally give the insulin after feeding or before feeding? Also how long after feeding and insulin should I recheck her glucose??
Also at this point do I go with dividing the dose to 2 units AM and 2 units PM or change it because of how high her BG is??
Dianna, when you are starting insulin you need to take into account your work schedule. It is best to shoot 12 h apart although Proz is more forgiving.
If you are going to shoot now will you be able to keep the schedule? It might be important. Let me ask someone for help before you shoot tonight. @Kris & Teasel @Djamila @Rachel
I am able to give it around 12.5 hrs apart. But that schedule would have to start tomorrow morning since I’ve been giving once a day at night...
Okay! I won’t be able to keep the schedule at the current time if I shoot tonight. I would have to start over tomorrow morning (about 10 hrs from now).
she needs insulin.. can you please hold a little bit while someone answers? I cannot possible tell you to skip the shot after DKA. I would give the dose for sure tonight and work out timing /schedule beginning tomorrow. To dose is more important, IMHO.
Before I forget, here’s a link on how to set up a profile so that we’re all not constantly asking you the same questions: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/ The general protocol is to test and, assuming the number is above 200 (at first. You can adjust that lower after you and Grape have more experience and data about how she’s handling the doses), feed and give the shot. We “shoot” while Josie’s face is shoved in her food bowl, and she doesn’t even notice, the little glutton! If I’m worried about a shot, I test at +2 hours after the shot. That number should be about the same or slightly higher (because of a normal “food spike”) than the pre-shot (PS) test number. Otherwise, it depends on what we can get. I am fortunate to live close to work, so I try to get a mid cycle (+5 or +6 hours after the shot) during the day, and we get a “before bed” test (+3 or +4) in the evening. Whatever you can get is what will be best! But definitely a pre-shot test to be sure Grape is high enough for the injection. You can use non-work days for more tests to fill in the gaps. Do try, though, because of the “food spike,” to pick up her food two hours before her pre-shot test so that you get a “true” number and not one that is inflated because of a foodspike. EDIT: written in reply to post #13.
Dianna, just FYI. I checked the other brand you mentioned feeding, the Friskies Prime Fillets. They are either 14 or 15 % carbs. You are doing very well, and really trying to take good care of Grape.
@Chris & China are you able to advise Dianna about dosing Prozinc tonight? She is needing to shoot and is waiting for advice.
Do I continue to wait? It’s been 30 min since I fed her and I normally give insulin right after or during feeding. She ate about 1/4 of a can of Friskies pate- Mariners catch.
@dianna_liu If you do not hear from anyone and it is time to shoot... You were planning on giving 2U, the split dose, right? Perhaps that is what you should do.... It might be getting late in the East Coast and no one will see the tag...
You are a trooper, Dianna! Good luck! Don't forget that she's hungry because she is high and unregulated. Feed that baby girl, more, smaller meals of the low carb foods.
I think that I would give the 2u. It is half of what she has been getting and unlikely to bring her too low. And certainly better to give something with the recent DKA. The question is what/when to shoot in the morning. It seems like your work schedule will mean an AM test/shoot about 10 hours (+10) after this shot? If you could please give a shot time for this shot **and your time zone** that will help for people in the morning. I’m sorry I can’t be more helpful.
I just gave 2 units at 11:18PM (central time zone). I am hoping to start the schedule at 8:45AM and 9:15PM. I am a nurse so I work 12 hr shifts and the schedule I can give the insulin on is 12.5 hrs apart. But I don’t know how to start tomorrow considering how late I just gave the insulin....
that why I was hesitant.. I use Lantus and 2 hours early = dose increase effect. Proz is different but I'd rather someone from ProZ Forum confirms.
Can you adjust his shot times for the next few cycles? If you're 2 hours late tonight, we wouldn't suggest shooting before 10:45am in the morning, then 10:15 Saturday AM, 9:45 Sunday AM, 9:15 Monday AM or PM We usually suggest making time adjustments by 15 minutes per cycle or 30 minutes per day
tomorrow AM post here and list all of the tests you are going to take tonight. Allow sometime before your shot time for ppl to reply and refresh you r screen to get their reply faster
Okay. I don’t work tomorrow so I can give it at 10:45am tomorrow and try to adjust it slowly during the weekends. How should her BG look like after a couple hrs of shooting and feeding? I’m not too sure of how to regulate and decide when to go up or down on the insulin.
I am in CDT! And I believe Rachel is, too. She is often here early mornings, around 4-5am our time, so hopefully she will be able to weigh in before tomorrow am’s shot. Although we try to keep a 12/12 hour schedule, ProZinc allows up to an hour leeway. With that hour + the reduced dose, I would *think* you’ll be good getting on a regular 2u schedule every 12.5/11.5 hours beginning tomorrow am, but again, hoping someone more experienced than me can weigh in especially with the DKA.
ProZinc is a little more forgiving than some of the other insulins, so if she's high enough at your regular shot time, you may be able to shoot
Okay! Got it! Thank you all so so much! I don’t know how I would’ve gotten through tonight if it weren’t for your suggestions!
A +2 test is a good test to get....a lot of times it can give you an idea of what's going to happen later in the cycle.....the +2 should be about the same as the Pre-shot test....if it's a lot lower, it's important to get tests in later in the cycle. Hold this dose for 2-3 days while you're getting some data on how she's responding. I haven't read through everything but if nobody else has suggested it, it's a real help to us to start keeping track of her test numbers on our spreadsheet. Here are Instructions on getting the FDMB spreadsheet
What great timing! Excellent that you are home tomorrow and so can ease her into a regular schedule! Recording your tests and setting up the spreadsheet would be super helpful for helping you figure out the best dose.
Dianna, I have to go off to bed now, but you are doing great, and Grape is a lucky kitty to have you taking care of her. Remember that the “take action” number is 50 on a human meter, and her PS number was quite a ways away from that, so while we definitely want to work to get her average numbers down, she should stay in safe numbers tonight on this 2u dose. Edit: But do still get that +2 and maybe a +3 if you can (Josie tends to begin to show insulin’s onset around +3 although “every cat is different “ [ECID]). It will be great data to have for the future!
Agree with Jenna. post #42. I too should be heading to bed. If she is very significantly lower in 2 - 3 hours after the shot - feed her.
Gooooddddd morning! What I love is that Jenna knows my schedule . Yes, weekdays at least I'm here between 4-5. Weekends I'm usually much later since I'm just up to feed the cats and back to bed...but I'll always check in if I know someone is going to need me. So let's see. Yes, I am in CDT (why I missed your tag...I'm up early so I go to bed pretty early). I'll be at work when it's your shot time, but barring anything nutty happening, I should be able to pop in around 10:45 and see what's going on. Most likely someone else will be around too, but if not, I should be around. When you pop in later, please do list any and all tests you took last night. Let us know how many hours after the shot each test was. That will help us figure out what's going on. As Chris said above, you want to hold the dose before raising. We usually hold 3-4 cycles, which is 2 days or so. As for lowering the dose that happens after some low numbers that you weren't expecting, and we'll help you figure that out. So you'll be doing 12.5/11.5 for shooting? That should be fine. Prozinc does have the flexibility, and if we notice that it isn't working, we can adjust the dosage some, but I'd start with 2u/2u. Looking forward to seeing what your numbers look like today!
Good morning! Yes, we are an early rising little group, and tend to sign off fairly early in the evening. Jenna takes the night shift . @Jenna Josie, you did a really great job with your advice (as usual). I know you don't love giving dosing advice, but you definitely know enough at this point to do so! Dianna, great job getting started with testing! It will make such a difference for you in helping keep Grape happy and healthy! If you need any help getting the spreadsheet linked, just ask and we can connect you with someone who can help. I hope you and Grape had a good sleep and enjoy your day off today!
Hi Dianna and Grape. You have found the right place. I have only been at this month and without these guys I would have been a puddle on the floor or in a straight jacket! I cannot contribute much regarding dosing as I am still trying to get little regulated but I have switched her food and dosing many times over the last month. I found that Fancy Feast fish and shrimp is like kitty crack. Both my girls love it although it smells awful... I spent days analyzing the food chart that someone sent you in a post below and that flavor of FF is said to have 0 carbs which can only help. Perhaps you should give that flavor a try. 1 can is 87 calories so let her eat and and eat if she will.. I hope she does. Good luck and welcome. And take a deep breath. I can say after only a month and not much regulation I am calmer and more confident that I am doing the right thing.and heading in the right direction. You will get there too I promise
Good morning! Thanks for the replies. I checked her BG at +2 last night and it was 552. I just checked her BG at the ideal time I would be giving later on (8:45AM) and it was 183. She was hungry so I gave her food which she took a couple licks to before laying down and resting again. Can you all give me advice on what the plan of action would be depending on the values of the BG? When should I feed or be alarmed or be worried that it is way too high?
The best way for us to help you is for you to set up the spreadsheet we use here and enter all data you have to date. We look at the trends, the whole picture to assess a dose. If you need help with the SS just ask. There are people here who can set it up for you. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
That's great! Give the 2 u dose for now. Here's a pile of info I put together for new members. Read it over and ask any/all questions you have: __________________________________________________________________________________________________________________ It would help us if you set up your signature (light grey text under a post). Here's how: This is very useful for us. click on your name in the upper right corner of this page click on "signature" in the men that drops down type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has. Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/ You just did this. ............................................................................................................................................................................................................. Here's the basic testing routine we recommend: test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe test at least once near mid cycle or at bedtime daily to see how low the BG goes do extra tests on days off to fill in the response picture if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose post here for advice whenever you're confused or unsure of what to do. This is useful: http://www.felinediabetes.com/FDMB/threads/hometesting-links-and-tips.287/ You seem to have the testing thing well in hand. ............................................................................................................................................................................................................. Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high: BG goes low OR lower than usual OR drops too quickly. Kitty's body panics and thinks there's danger (OMG! My BG is too low!). Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing). Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing. ............................................................................................................................................................................................................. Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!): put the end of the test strip right in his urine stream as he's peeing slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee. Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.
Thank you all!! I just updated the spreadsheet with grape’s BG before and +2 after shooting this morning. How many times do you all feed your cats? Should there be a set feeding schedule? Since Grape is so picky and oftentimes just take a couple licks, I would feed her multiple times whenever she’s hungry on top of the set schedule of feeding AM and PM. Another question I have is I have four cats in the house (Pepper, Grape, Chili, Cheese- all girls) so whenever Grape doesn’t finish her food, the other cats finish it. The other cats have regular dry food but since they’ve been finishing Grape’s food, they’ve gained a lot of weight- especially Cheese.... That also means I can’t just leave Grape food hanging around because they will just finish it. Other than the AM and PM feeds, I am unable to feed her snacks or broth packs during the day when I am at work. Are snacking a requirement for diabetic cats or should there just be two set scheduled meals? I know many of you mentioned that I should feed her multiple times as long as she’s hungry but how will that affect the insulin and BG? Since she will be snacking multiple times, wouldn’t her BG be continuously high?
Most of us feed several small meals a day. Kitty is generally more satisfied and it can help stabilize BG levels. Just make sure you take away all food in the two hours prior to the pre shot BG test so you get a proper, non food influenced reading. Is there any way all your girls would eat the same low carb wet food - it's a great diet for all kitties. Failing that you could invest in one of those microchipped feeders for Grape. I love your kitties' names!
Great job getting the spreadsheet and you signature set up! That was a very pretty +9 number she gave you last cycle. And I think we all should just take a minute to acknowledge how adorable your Grape is. I just love her asymmetrical blaze! Convincing all your girls to eat the same low carb (LC) food, as Kris suggests, would be very good for everyone, including you since then you wouldn’t have to worry about them stealing Grape’s food or her getting into their higher carb food. Our two cats don’t actually want to hang out together all that much, and so we are able to keep Josie in a spare room (with her own food, litter box, window, cat bed, etc) when we’re at work. We use a PetSafe timed feeder for her “snacks”: she gets 1/4 of a 3 oz can of FF at +3 and another 1/4 at +5. It makes me feel better to know she definitely has access to her own food as she’s headed into the lower part of the cycle (or what should be. Josie doesn’t really have smile-shaped curves like other cats do ). We like this one bc it is small, is digital and therefore pretty accurate, and has a low battery indicator for peace of mind.
I'll chime in too on the suggestion to get the kitties all on a low carb diet. My two ended up not liking the same food, so I feed two different low carb foods, but I still have the peace of mind of knowing that whoever eats whichever food, they'll be fine. Plus, I really really didn't want to end up with TWO diabetics, so I made my non-diabetic switch to something safer when Sam was diagnosed. One kitty on insulin is enough! Great job getting your spreadsheet set up, and also hooray for a blue number! In answer to your earlier questions, if you get to 50, it's time to get out some food and monitor a little more closely until you are sure the number is rising. They are still safe at 50, but you don't really want them going much below that. As far as the number being too high, there isn't much you can do about that except wait for the next shot time. Hopefully Grape will get out of those high numbers soon and you won't have to worry about that anyway. Keep trying to get those ketone tests in at least once/week, but more if Grape isn't eating well, or if her numbers are high. As you have already experienced, those are bad news, so you want to stay on top of it. I love your kitties' names! and that picture of Grape is precious!!!
Hi, so I just checked her glucose and it’s >600 so the glucometer doesn’t read and just says HIGH. Do I still wait for her shooting time or shoot her cuz it’s so high right now? She’s unable to walk right now because of how high it is....
We rely pretty heavily on the spreadsheet around here, so could you input your data from last night as well?
I wasn’t able to check her last night because my petsitter gave her the insulin at the right time since I was out. And I just checked her at 8:30AM with the HIGH (>600).
So it looks like 8:30am in your timezone is +10, or two hours before your usual shot time, is that correct?
I am heading to work right now so my sitter will be the one shooting her. I just don’t know if I should tell her to give it at regular time or right now..
If you are able to adjust your shot time tonight, I would say go ahead and shoot now, If your shot time tonight needs to stay at it's regular time, then you might wait and have the pet sitter do it. She is high enough and late enough in the cycle that you can shoot safely.
This will be helpful, Dianna, bc it will move you closer to what you want to have as your ideal shot time.
Given the numbers that you have so far, it's unlikely that you will need to adjust your evening shot time, but just in case she starts to run a little lower, you want to make sure you have you can wait the full 12 hours before the next shot.
Ah! Didn't realize she was trying to adjust anyway! Glad you are following that, Jenna! It doesn't look like the insulin is lasting 12 hours anyway right now, so adjusting backwards should be pretty easy.
Is 2 units enough? I don’t understand why her BG is so high before the 12 hrs is up....and also she can’t walk anymore...she seems a lot weaker now after starting the 2units twice a day instead of 4 units once a day. I’m confused and worried.
So here is the hard part: we can't tell if it's too much or too little without a mid-cycle test - somewhere between +4 and +7. When is your next day off? Or is it possible to get a +4 before you go to bed? My hunch is that we need to increase the dose, but you don't really want to start raising the insulin on a hunch. I would recommend starting her on zobaline (b12 methylcobalimin). That will help with the neuropathy. It takes time to heal though, so you'll need to be consistent and patient.
I will try to get a +4 test tonight when I get home. Do I need a prescription for zobaline? What does it do for her? Also, is there anything that can help increase her appetite? This morning she wasn't really into eating...I'm not sure if it is because she is just feeling too weak with the high BG or not. I will try switching all my cats to low carb wet food too. I have tomorrow off so I should be able to get the + 3, + 4 tests tomorrow too. I also have the hunch that the insulin dose is too low right now but I'll decide after checking her +4 BG tonight. My sitter will try to get the PMPS BG before shooting. Do any of you have issues with your cats getting stressed out and overgrooming? Grape has been overgrooming her legs since her DKA. She also haven't been grooming her self regularly anymore. I have put up the feliway diffuser at home to try and help with her stress but it hasn't really made much of a difference for her. I'm really worried that she will just continue to get weaker and then I'll end up losing her...
No prescription needed for the zobaline. I don't know the physiology of what B12 does, but it helps with healing neuropathy which is what causes the back leg weakness in diabetic cats. Zobaline is the brand, there are other brands you could get too, just make sure it's methylcobalamin form of B12. B12 comes in like three different forms, but that's the one that helps with neuropathy. There are meds that help increase appetite for cats with pancreatitis, but given her history of DKA, I would be more concerned about that having a recurrence (one of the leading symptoms is a lack of appetite). Have you been able to get a ketone test at home? If she isn't eating, please get her into the clinic where they can do the blood test for ketones. If she's eating, but just not enthusiastically, then there are a bunch of things you can try to make the food more enticing: Fortiflora is a probiotic which isn't great at being a probiotic, but it's super good at getting cats to eat. It acts as a flavor enhancer and lots of cats love it! Bonito flakes - you can buy them off amazon or most grocery stores. Thin little freeze-dried flakes of fish that cats love and if you put them on food, they'll usually eat more. Brewer's Yeast or Nutrtional Yeast - not the same as bread yeast - these are often in the health food section or the bulk section of grocery stores. Sprinkle on food. Cats love it. Parmesan cheese - the cheap powdery kind works best I've heard - my kitties don't like this one so I don't know much about it Tuna juice - the water that you drain off the can of tuna - pour a little on top of canned food I know this is all really scary right now. Sending you lots of hugs If you're going to test tonight anyway, why dont' you go ahead and increase to 2.25u tonight?
Oh, and the overgrooming could also be connected to the neuropathy. It can make their legs tingle or hurt a little, so sometimes they'll groom them extra to try to self-soothe. Are you in the US, or somewhere else?
Thank you! I'll try the fortiflora or tuna juice tonight. I am in the US. How do you all manage to catch the urine at the right time to do a ketone test? I know she goes to potty but I never catch the urine in time. I'll go ahead and increase the dose of insulin to 2.25 tonight. I'll also order the zobaline on amazon right now. I am just really worried. She got better when I just started giving insulin but now its like going back to losing weight and being weak.
If you're in the US, you might also try getting some CBD oil (charlotte's web is a popular brand that is legal in all 50 states). It can help with pain, anxiety, and appetite, so might be something to consider adding into your supplements/food. Not necessary at this point, just something to think about/learn about in case you decide she needs it. The urine tests can be hard to catch when you have multiple cats, that's for sure. Part of dealing with a diabetic cat is that you learn their patterns in infinite detail. For example, I know that my diabetic cat eats, washes his face, goes to the litter box, grooms, and goes to sleep. In that order. Every single morning. I honestly have no idea when my non-diabetic cat uses the litter box. But knowing my diabetic's patterns makes it easy to grab a ketone test. You'll learn Grape's patterns the longer you're at this. One trick is to lock him in a room with a litter box, and put wrinkled up plastic wrap in the box. Then you know it's him, that peed. The trick is to try to catch him before he buries the whole thing in litter though. Some folks with cats who have a history of DKA will get a blood ketone meter for home use. The test is just like testing the BG, except that the strips are kind of expensive. It does save the trouble of stalking your kitty to the litter box though. If you're prioritizing budget, I would get a ketone meter before the CBD.
Thank you for everyone’s replies...Grape passed away at midnight today. I rushed her to the emergency vet. She had a lot going on and was very very sick. I couldn’t watch her suffer anymore and treating her would put her at the risk of brain damage with the condition she was in. She waited till she saw me again after work and meowed at me a couple times. I knew it was time and she had held on long enough for me... I love her so much and she will forever be with me. I will see her again up on the rainbow bridge. Thank you again to everyone who has helped me on this forum.
Oh Dianna, I am sorry to read this. You did everything you knew how to do, and then had the love and courage to let her go. Peace and comfort for your sorrowful heart, she said her goodbye and gave her permission. She loved and knew she was loved. Tears for you, smiles for Grape cavorting in the wonderful place where our furbabies spirits go.
Oh Dianna! My heart is breaking for you. I am so sorry to hear that Grape has passed. Sending you so much love today as you grieve and remember your sweet girl.
Oh Dianna! I'm so so sorry to hear that. You did such a wonderful job taking care of Grape and I know she had the best mama she possibly could have had. Sending you lots of hugs. Fly free, sweet Grape! Land softly.
