New/Rescued diabetic cat, SO many questions!

Discussion in 'Feline Health - (The Main Forum)' started by Chels1440, Feb 22, 2018.

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  1. Chels1440

    Chels1440 New Member

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    Feb 22, 2018
    Hello everyone!

    I apologize for asking questions that might be redundant, I *have* read through the FAQ's and many other posts, but I've got a combination of issues/questions and I am not really sure what to do.

    Almost 2 weeks ago we rescued Talulah (Lulu), a little 12 year old girl from a shelter (6 years there!). She is 10.5 pounds, and had been getting 1/3 can DM and "some" DM kibble twice a day, coupled with 3 units of Lantus twice a day at the shelter.

    When we got her home, she had NO interest in the DM, I just couldn't get her to touch it. Fortunately I had read about all the super-low-carb/hi-calorie wet foods here (and my other two cats are 100% raw fed), so I had some on hand. She nibbled at the canned, but didn't eat a satisfying amount. Her blood sugar was only 180 or so, so I called the 24 hour vet to see if I should still give the insulin. They said to give 1 unit, instead of 3 so I did.

    The next day I talked with our vet. They said she should be eating 1 5.5oz can per day (seems really low to me, but that's what the shelter vet recommended as well), and to hold off on giving insulin unless/until the reading was over 180, between then and her scheduled exam two days later.

    Since her second day here, Lulu has generally eaten about 75-85% of a 5.5oz can per day, and won't eat much at once (she's been getting 4 meals--when I try to reduce the frequency, she reduces the quantity). She doesn't find any "enhancements" like crumbled freeze-dried or fish flakes enticing, no change in appetite with those, and she *hates* syringe feeding (I tried once, just to see if it could get her going). Her blood sugar has only been above 180 once, and most of the time, it's in the 140's-160's.

    The vet told me I was "overreacting" testing her so often (just twice a day, before giving the insulin, because I didn't want her to go hypo), and to stop testing, and just give her 1 unit twice a day. Well, I did that for a day and a half, and then she went hypo. Since then, I've been testing, still 140's-160's, and I'm afraid to give her the insulin when it's that low, but I also can't get her to eat two big meals, which might be the thing that gets her blood sugar high, and I'm anxious to call my vet about it, because I know she'll scold me for testing. I get it, new cat in a new home, she probably thinks Lulu is scared, but she's been getting tested for years, it literally doesn't even phase her! She sits there purring while I test her (not scared purring, regular purring), and doesn't even get up from her spot (or stop purring) when it's done!

    Also, I've read people talking about giving "half units" but I can't imagine how that would be--the needles we were given have 30 "unit" marks and they're only 1cc syringes! It's hard enough to be sure you don't get more than 1 unit...

    I should also add in terms of behavior, she is GREAT--all about the laser toy, super cuddling, very social...the only time she had any "red flags" was when she went hypo and started hiding.

    Anyway, I guess I'm just wondering what people's thoughts are...Should I chance it with the 1 unit twice a day even when her levels are low? Should I be fasting her, risking reducing her calorie intake more, to get her to a 2 meal day? Any other ideas/thoughts?
     
  2. Chris & China

    Chris & China Well-Known Member

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    May 10, 2013
    Which insulin is she on?
     
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  3. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    You are very fortunate to find her! Hello Lulu!

    That can be about right depending on the calories in the can.

    I use "ideal weight" in lbs x 13.5 +70. So for Jones 10 lbs x 13.5 +70 =205 calories. That is food and treats!

    4 meals a day is a good feeding schedule. Many people here use a timed feeder for snacks at the +3 and +6 part of the cycle. Just keep food up 2 hours before your pre-shot testings. You want to know that it is safe to shoot and the number is not food influenced.

    Would you give a human baby insulin without testing? No. It is the safest way to keep your kitty safe as you have discovered. Always do a pre-shot test and if you can a mid-cycle test. It can be as easy an out the door test and in the door test if you work or a before bed test. Use the weekend for your curves. With Lantus the important factor is how low will it take kitty - that is where those mid-cycle tests become important.

    So is Lulu on 1 unit BID now?
    What food is she eating now for carb%. DM is still quite high in carb and if you are changing to a lower carb food her insulin needs are going to change and maybe quite drastically. Also dropping the dry which is very high in carb will drop her insulin needs.
     
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  4. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    I recommend getting a new vet! Definitely keep testing. She's your cat and it's your decision. If she gives you grief for it I would be looking for a new vet. I switched vets right after my cat was diagnosed.
    Are you still feeding DM? Have you tried feeding her raw? With numbers like that I wonder if feeding raw or lower carb than the DM would help her get into better numbers without insulin.
    You can get syringes with half unit marks. That makes it much easier to eyeball 0.25u changes.
     
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  5. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    For syringes - I use the BD Ultra Fine 3/10 ml (30 units) 8mm 31 Guage with the 1/2 unit markings.
     
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  6. Chels1440

    Chels1440 New Member

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    Feb 22, 2018
    Thank you guys so much! She is 100% off the DM, and 100% canned now! Right now, she's mostly liking the Holistic Select Turkey, Wellness Core Turkey and Duck, and Ziwipeak Beef [I know the Ziwipeak is 10% carbs, on the high end, but I'm trying to get her to eat and she likes it!) When she was on the DM, at the shelter, she was on the 3 units, BID, now she is supposed to be 1 unit BID, but, again, I've been worried about knocking her into the low range again, and haven't been giving it for the past two days since then. Her numbers never get above 180, and usually 140-160's. I should add I'm using an alphatrak tester, not human tester, and I am using the right code for my test strip.

    Withe the 4 meal schedule, when should I test to try to find nadir? Like, in the middle of the night? Or just the longest gap between meals?
     
  7. Chels1440

    Chels1440 New Member

    Joined:
    Feb 22, 2018
    Lantus
     
  8. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Ok, I would keep testing for the next few days and complete your food changes. I think she needs a little bit of insulin but not sure what a good dose would be.

    Have you come across the sticky about the SS we use here? It helps give a picture of what is going on. It would be great if you could set one up and make it so everyone can see it. If you need help setting that up give a shout out. If you want to put your comments on what food is given at what time, it may also help.

    10% carb is on the outside of what is suggested but Lulu does need to eat!
     
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  9. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    Oh and for the dose just put NS for no shot in your SS, then we can see where she is at with her current food.
     
  10. Chels1440

    Chels1440 New Member

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    Feb 22, 2018
    Thank you so much! I'll give the vet a call tomorrow...not going to lie, kind of dreading it, but hopefully they will be more conservative with their dosing given the hypo episode!!!
     
  11. Tracey&Jones

    Tracey&Jones Well-Known Member

    Joined:
    Dec 12, 2016

    Just let them know you want to see where she settles with these food changes. Then decide on a dose. Keep testing though.
     
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  12. StephG

    StephG Well-Known Member

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    Sep 8, 2016
    With numbers like that, I wouldn't start on 1 unit. She might end up not needing insulin and be controlled by diet.
    If you start insulin again, I would post in the Lantus and Levemir group to get a better idea of what dose to start on.
    Personally, I would start low. Like 0.25 or 0.5 units because her numbers aren't that high and she had a hypo on 1 unit.
    Most cats get vet stress which can raise their numbers... If she's scared and still adjusting to her new home-- it is possible that it's elevating her numbers a little.
    I agree with Tracey&Jones about letting her get settled with the food change and see what it looks like then.
     
  13. Chris & China

    Chris & China Well-Known Member

    Joined:
    May 10, 2013
    All these syringes have half unit markings (very important when you're doing microdosing) and are the correct syringes for U100 insulin and are available from ADW online:
    UtiCare
    Monoject
    Carepoint
    Sure Comfort
    B/D

    They're also available at WalMart if you have one near you. Their Relion brand 3/10ml, 30 or 31 gauge, 6mm or 8mm insulin syringes all come with half unit markings and are only $12.58 for a box of 100 (although a lot of them don't realize they DO come with half unit markings!)
     
  14. Tracey&Jones

    Tracey&Jones Well-Known Member

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    Dec 12, 2016
    How is Lulu doing with her diet changes?
     
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