? New to diabetes/Lantus--Jacqui & Thomas

Hi Everyone,

I apologize, as I didn't know the best place to post my issues, so I put this in both this and the Health forum.
Thanks in advance for any help you can give.

Hi everyone,

We are new (signing up) to the boards, but have read many of the posts. I posted an introduction about Thomas on that page. I apologize in advance for the long post, but I wanted anyone who could help to have as much information as possible.

My poor baby was diagnosed about 2 months ago. My vet is very good for many things, but I am now questioning her about a lot of aspects of his treatment, which she has not had a great reaction to (such as, when I tell her I read something online or on a post, she tells me 'fine, those idiots are killing their cats'. It is so disheartening, as otherwise she's been a great vet---comes to my home, is not a 'put them down' vet and always wants to try anything possible to save them, so I feel quite alone right now.

My first reason for calling the vet to see him was he was drinking and urinating a lot, and became a bit scraggly looking and I could feel his spine. When she first examined him, he was stressed beyond belief, as he is very afraid of people. She did get an ear prick and he came in at 407. But after learning more about feline diabetes, I figured he was probably really in the 300s, and the stress of the visit shot him up a bit. But she told me to start him on one unit at night of Lantus, which I did.

I then tried to learn how to home test, which like so many others out here, was not pretty at first. I felt so bad for him that I couldn't do it correctly and his poor ears had some bruising. I thankfully have gotten better at it, and so has he , but his numbers stayed in the upper 300s and sometimes low 400s for the first week. My vet then said to raise him to 2u at night. Not knowing about this board yet, or about diabetes or Lantus, I blindly followed instructions.

Then came the hind leg weakness; it was heartbreaking. He has trouble jumping and going up and down the stairs, but he is able to do it. I read about methylcobalamin and started him on 3 mg daily. My vet was against it saying it wouldn't help, and kept saying she didn't feel it was neuropathy, but since I found out it couldn't really hurt either, I went ahead with it. She also stated it might be his losing potassium as he was urinating a lot, and advised to give potassium, which I do. So far, no improvement in his legs, and even his front legs now appear to be weaker for him.

As an aside though, he had lost 1 lb during this, but he is back to his weight, back feels solid, and his coat looks nice again (although sometimes I see him plucking at himself and wonder if he's feeling prickly from nerve sensations in his legs.) So clinically speaking, there has been some improvement, even though his numbers are still high and he developed neuropathy (or at least that's what I think it is.) This occurred after I replaced his dry food with Young Again (both Zero and Mature, as he wouldn't eat the Zero alone). My guys have been on Fancy Feast pate's for years, so that stayed the same, although I increased him to 3 feedings per day, about 3/4 can each feeding. However, to keep him still for his shots, he gets 5 'bad' treats.

This pattern continued; every third day or so, she'd have me raise him 1u, until he was up to 6u at night. However, during all these increases, when I'd test pre-shot, or any time during the day, the lowest he ever came in was 240, and that was only one time. All the others he was still in the threes, so she kept saying he needed a higher dose. After about 2 days on the 6u dose, his normal hind leg weakness became sideways, like he was drunk. I tested him and he was 77. I had learned this is a normal BG, but apparently for him it was too low, so I gave him some food and watched him through the night. I then asked if maybe twice a day would be better for him, and she agreed it might.

She instructed me to just start on 3u the next morning. I did not feel comfortable with this after learning a little about Lantus, so I backed him off to .5u AM the next morning, and proceeded the next several days taking a half unit off the night dose and adding half a unit to the day dose. After he was on this for 5 days, I tried a curve (he was then at 3u AM & PM). He was 140 pre-shot AM, so I did not dose. Since then, however, he's been in the 300s consistently.

After learning a little more about Lantus, I started to wonder if he was getting TOO much insulin, and spoke with the vet. She did not agree at all, and said he needed more, and that cats his weight can be on up to 14u daily safely (he is around 14 lbs). But I also wondered why it would take months to get him even somewhat regulated and wondered if his dose was too high already.

So, in the 'killing my cat' theory the vet gave me, I decided to back him off to 2u twice daily. He was on that dose the past two weeks and has had numbers in the low 300s at about 6 hrs after his AM dose. So I raised it .25u in his AM dose for 5 days---same numbers. I raised his PM dose .25u---slightly better numbers, until today, when he came in at 411 6 hrs after AM dose, and his legs seemed worse today.

I am so confused and upset that I can't seem to help him, and am hoping maybe someone else has had a similar experience and could offer some insight. I want to add that I was originally using a CVS meter, but felt it was too inaccurate, so his last three readings (350, 319, 411) were done on a new Relion Micro.

Thanks for any help you can give us; we are both praying for some success.

Jacqui & Thomas

 

Welcome, Jacqui and Thomas!! This is the greatest place you never wanted to be. We are one big family, and everyone here is more than willing to help in any way possible - both technically and emotionally.

Sadly, your vet situation is not uncommon. Most vets are very weak in their feline diabetes knowledge. We live and breath it here, and while we are not vets and we are all volunteers, there is a wide variety of knowledge that you won't find anywhere else.

And, to reassure you, we have NEVER lost a cat here. Never. And, not only that, we have a very high remission rate. And even if remission isn't achieved, we have a group of very healthy, happy, regulated diabetics.

You have done the best thing ever by learning to home test. Are you only testing at shot time, or are you getting any tests in between, too? Those in between tests (we call the mid-cycle tests) are very, very important, because Lantus dosing is primarily based on the nadir, or lowest point in the insulin cycle. The preshot value is important, too, but in a different way. We very rarely use the preshot value for dosing decisions.

Do you have a spreadsheet set up yet? That will be the most important tool for both you and us. It's how we track our kitty's BGs and that in turn helps us detect trends. Here's the link on how to set up the spreadsheet...if you have any questions, just let us know!

Setting up a spreadsheet

I am sure many others will come along with support and suggestions, so I'll stop there. It can get very overwhelming, but we are all here to help make it easier for you and Thomas.

 

Jacqui also posted on the Health forum but I suggested that she keep her postings here to make it easier to follow;

Here is her post from the Health forum:

http://www.felinediabetes.com/FDMB/...mbers-all-over-the-place.156597/#post-1658018

 

Thank you Mary Ann!

 

You are most welcome. I did post another comment on your other posting so I cam copying it over here as well.

"Testing glucose levels before each shot and at least once between shots is very important to make sure the numbers are safe to shoot and to see what sort of response Thomas has to the Lantus. Many vets advise against home testing, but if they had a human child with diabetes would they only test once every week or two?? Certainly not, and the same is true of our furkids.

Don't let the amount of information overwhelm you...it can be extremely stressful trying to learn everything at once. With the help of the people here, who live and breathe feline diabetes 24 hours a day 7 days a week, you will be fine."

 

Hi Amy and thank you! Another person advised the spreadsheet as well, so I will work on that. I have kept a log of what tests I've done up to this point, so hopefully that will help a bit. They have been scattered, due to vet's advice, etc. I haven't tested the past week until two days ago, because all of a sudden, his ears were red and hot, so I did not want to prick them. He seemed stable enough though, so it wasn't too bad.

As to your remission comment, although that would be wonderful, I would be so happy if he could even stabilize enough to make him feel better and get some of his leg issues back to normal. It's so hard to see, as I'm sure all of you have felt during your journey with this illness.

 

Thank you. She wasn't against me doing it, just said it was overkill. But I totally agree--especially when trying to regulate, how could it be overkill? My only problem was last week when his ears become red and hot; I stopped testing until they were better, and took three mid cycle readings the past three days. When trying to learn all about diabetes and Lantus, it was certainly overwhelming, and I think I was under the impression the pre-shot wasn't too helpful, so I stopped doing it to give his ears a rest. But if it's needed, then that's what I'll do, as long as his ears don't act up again. Not sure why they did that, as he was fine the past two months, and everything else was normal (attitude, eating, etc.)

 

The more data you have the easier it is to see patterns about how well the insulin works. Preshot numbers are very important, since glucose numbers can change without warning. I have had a fairly high number for my kitty in the mid-evening 6 hours after his hot, then had a very low number 6 hours later when it was time for the morning shot. This required stalling without feeding and retesting to make sure the glucose numbers weren't going to drop anymore...this is all things you can get help with if they happen...but the point is a preshot test is definitely important.

When testing the ears, it helps if you have something to hold the ear after doing the test. I use a cotton cosmetic pad and hold it behind the ear when doing the poke, then fold it over the ear and apply gentle, but firm pressure for about 10 seconds, to help prevent bruising. Also if Thomas is co-operative you can switch ears for each test. Some people on here use a drop of neosporin or polysporin after the poke.

 

"Overkill" is not unusual for vet to say about how much we test...but really, as one of our other long term members here often says - ask the vet if she would inject her own child with insulin without testing? Insulin is a very powerful tool, and is potentially dangerous if not used properly and safely. Testing it why we have never lost a kitty here: we test to not only get our kitties regulated, but also to keep them safe and prevent hypos. Most kitties adjust to the routine very quickly, and many even come running when they hear testing supplies being gathered.

The preshot tests are important primarily because you want to know that it is safe to shoot insulin. They can factor into dosing decisions a bit, too, but safety is the most vital part of preshot tests. As I mentioned before, the nadir is more important when determining dose adjustments. So the two together - preshot and midcycle tests - really help fill in all the gaps and helps us understand how an individual kitty is responding.

One important thing to remember is that every cat is different (ECID) in how they respond to insulin. It is not guaranteed that any cat will nadir halfway through an insulin cycle - and, on top of that, even the same cat can change up when he or she nadirs. So random spot checks, rather than always testing, for example, 6 hours in, really help fill in your data gaps.

We do also suggest you grab a test right before leaving the house or right before going to bed, just to be sure Thomas will be safe if left alone for an extended period of time.

 

Hi,,,that's exactly what I use, the cotton pad! I do fold it over and apply pressure, and at first wasn't using the neo, but two weeks ago started it. Then all of a sudden, hot red ears (?) So I haven't used it the past few times now. At first he would only let me use one ear, but he's become better and I can alternate most times.

 

Thanks Amy! Yes, it certainly made sense to me and moreso when his first ever 140 came up pre-shot. I couldn't reach the vet so just didn't give the shot. And your last comment is what makes me wonder if this is all possible, as right now, I am out of work and can monitor him most of the time. But when I go back to work, I am so worried for him. Like twice already over the past three weeks, he vomited shortly after eating and his shot. I had learned enough to know that could be trouble, so gave him food and a few treats and kept an eye on him. But if you're out of the house 8-10 hrs a day or more, this can be scary.

 

Hello and welcome. Sounds like you've been through a lot so far with Thomas. The owner vet in the clinic I go to made some comment about crazy people on the internet when I started. Fortunately the vet I go to regularly is willing to listen and learn and I got to see a locum vet who told me to come here and showed me how to home test. To your vet's benefit, at least she got you started on Lantus which is a good insulin for cats, and is not against home testing - which we also hear. We can help you with the rest.

There is an overwhelming amount of information on Sticky Notes at the top of this forum. Start reading and rereading the notes. There is a steep learning curve but feel free to ask any question. People here love to help. There is also a note on doing Tight Regulation with a full time job. Whether or not you use Tight Regulation as your dosing protocol, there are still good tips in there to keep Thomas safe once you go back to work. If you haven't gotten one already an autofeeder can be really hellpful.

By the way, the amount of insulin a cat needs varies a lot. You'll see the expression ECID or Every Cat is Different. My Neko is also around 14 lbs and she's been on anywhere from 1 to almost 9 units of insulin. But she has a couple of high dose conditions (acromegaly and IAA) which impact the amount of insulin she needs. We've also got cats around 14 lb cats on .5U of insulin - it really does depend on the cat.

A question for you, is Thomas still on potassium supplements? Did the vet test his blood before prescribing potassium and after to make sure it's the right amount? It isn't something that should be taken blindly.

 

One step at a time. Many folks here do work and manage their kitties FD by themselves, so we will help you feel comfortable about that, too.

 

Hi Jaqui.

Welcome to Lantus &Levemir Land. You are in the best possible place to get help for Thomas. Most of us have had a similar experience with a vet. In their defense, they get about 5 hours of training on diabetes in vet school, and that covers both cats and dogs, which are very different. At least your vet put Thomas on the best insulin, although she clearly doesn't understand how it works. Lantus does best with consistency, so you want to give the same amount in the morning and the evening. The only time they should differ is when you are changing doses, or in special circumstances ( a really low preshot number, or kitty isn't eating, or you won't be able to monitor through the cycle, etc.).

You mentioned you are giving Thomas a Vitamin B supplement. What are you using? The most common one for diabetic cats is Zobaline. There are different kinds of B-12, and you want to be sure you're giving the right kind. My Cinco had neuropathy and I started giving him Zobaline. I can't recall how long it took to see results, but I think it was a couple of weeks. It made a huge difference, and I gave it to him for the rest of his life.

Are you testing for ketones? Did your vet ever test for ketones? When kitties are in high numbers for a while, it's a good idea to check for that, especially if they aren't feeling well.

Are you still giving any dry food? Even a few pieces can have an impact on BG. Some diabetic friendly snacks include freeze dried chicken or salmon, or bite sized pieces of cooked chicken (mine love boiled chicken, no spices or onions or garlic, of course).

The most important thing is that you ask questions. If you don't understand the answer, ask again. We were all new once, and we understand how overwhelming it is. This is a very experienced, knowledgeable community, and we all care.

 

Welcome to Lantus Land! There are numerous folks here who live Lantus life and are willing to share their experiences with you to give you ideas on helping your cat.

For those 'bad treats' which may jack the glucose up, you might consider using freeze-dried chicken or shrimp as a treat for allowing the testing. (ex Pure Bites - the dog size is cheaper per ounce).

Something which will help folks give you feedback is to put some details about you and your cat in your signature, to help folks have some context understanding your particular circumstance.

Editing your Signature

In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts

Click on your ID.

On the left, under Settings, Click on Signature.
This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -.
This is where you paste the link for your spreadsheet, once it is set up.
Add any other text, such as your name | cat's name | date of Dx (diagnosis) | insulin | meter general location (city and state/province) any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.

Click the Save Changes button at the bottom.

 

Hello and welcome Jacqui. I'm so glad you found your way to the FDMB!
I know this is all overwhelming, but it will get easier.
Don't hesitate to ask questions!

 

Welcome, Jacqui to you and Thomas!

I'm so sorry your vet has been passing along some inaccurate information. Typically cats do not get up to 1u of insulin per pound of body weight. There certainly high dose conditions and with those conditions, some cats need whopping amounts of insulin. At her heaviest, Gabby weighed about 14 lbs. I don't think I ever shot much over 2u of Lantus. That said, a kitty needs as much insulin as s/he needs to get the numbers into a normal range.

Home testing, understanding how your cat responds to Lantus and how Lantus works are all key to managing Thomas' diabetes. The people here are incredibly generous with their time and knowledge. And I promise, we're really not crazy cat ladies!

 

Welcome Jacqui and Thomas,
You have gotten lots of good information. Feline Diabetes care has a steep learning curve, but you will find that it gets easier every day. Read and re-read the "Stickies" (info. posts at the head of the Lantus and Lev. Forum).
I had a similar experience to yours with my previous diabetic kitty, Stu. Stu's vet kept raising the dose by 1 Unit every few days and Stu's numbers stayed very high. Then one day he crashed (at that point we were up to about 8 Units twice a day). I panicked and found this forum. The knowledgeable people here saved Stu's life. Like your vet, Stu's vet had heard that Lantus was a good insulin. And like your vet, Stu's vet had no idea how to dose a "depot" insulin like Lantus.
It might be a good idea to take a "vacation" from your vet for a while. It sounds like she overprescribes medications in general.

By following the protocol and feeding an appropriate canned diet, Thomas will do just fine.

Welcome again!

Ella & Rusty

 

Hi Wendy and thank you for your insight. I haven't done the autofeeder as I am home currently, but also felt that when I'm away, I'd be afraid if he needed food and wanted it, he'd hypo if he couldn't get it---I'm still learning how diabetes, and Lantus, work. I completely understand that ECID so am not completely against a high dose, but certainly was uncomfortable raising a whole unit at a time in 3-5 days each new dose---even though I knew nothing, it just didn't feel right, and when his numbers basically stayed the same or rose, I knew something must be wrong.

Yes, Thomas is still on potassium. And here's the scary thing after reading what you wrote---the vet told me it cannot hurt him, that he'd just pee it out if he didn't need it, and to give him one tablet (525 mg) daily. We have not been successful getting blood from him, so no, she did not have blood work to go by. She just felt it wasn't neuropathy and that I could try it. As it states on the bottle that is a dose for humans, I thought better of it and only give half a tablet once daily.

And oh my gosh, you couldn't be more right---people on this board are fantastic. I don't think I've ever 'met' a large group of people so compassionate and willing to help others as I have here. It's also so nice to know I'm not the only one so bonded to their babies----I can't begin to tell you the ridicule I've received from family, friends, etc., on how much time this takes and the cost of insulin, etc.,,,it's so comforting to know I'm not the only one who feels these guys are worth it.

 

Hi Ella and thanks for your comments. My vet can be good, but when challenged with my questions, especially about dosing, I get the staple reply that she is a diabetic herself, and had been on Lantus for over a year, so knows how it works. I've tried, delicately, to state that a cat's metabolism is not the same as humans, nor can they tell us when they're feeling a bit off until it's at a bad enough point to where we notice it, but then it's a battle of she's the vet and I am not. I've also tried to ask if it's possible he might have kidney or other issues, such as insulin resistance or acromegaly, and her reply was that I enough of a challenge getting him stabilized, so just focus on that for now. Kind of irked me a little, but realized without tests, she couldn't do much anyway. So I just finally learned to move on and learn for myself, and thank God Thomas is still here through that learning curve.

Thomas has been on Fancy Feast classics for years, so at least that part of his diet is on track. Do you only feed Stu a wet diet, and have his numbers stabilized?

Thanks!

 

Hi and thank you! Yes, people here are unbelievably great! And I have been accused of being the crazy cat lady, so I wouldn't even care if you all were lol. And I think I may have wrote the vet's dose info incorrectly---I think she said 1 unit for every kg of weight, and said that would mean he could technically be on over 20 units and be fine. But even if that were so, at that dose, I would be considering trying a different insulin.

 

Hi Julie! Omg, yes, overwhelming it surely is. I have SO many questions, but am trying to learn as much as I can from reading the posts and stickies, but it certainly is a lot to cover. So I may just make a list of my most important questions and post them, so at least maybe I'll get the answers I need sooner that I could by having to read all the notes here. I just want to help him feel better as soon as possible. And I am so glad too, and thankful, that I found my way to these boards!

 

Hi and thank you so much! I will be updating my signature as soon as I'm done reading all the helpful replies from everyone. I do use the Pure Bites at the moment, but he doesn't sit still for the injection with them, so I have had to give him a few 'bad' treats (Temptations Mixups) to get it done---he's like a heroine addict with them. But I will keep working on that with him!

 

As you've had to learn the hard way, veterinarians are human and therefore fallible. They get a scant few hours of education on diabetes in vet school split between cats and dogs. But that's really no excuse for a doctor to be so underinformed that he or she is dosing patients once a day based upon their own personal human experience when every piece of literature on feline diabetes notes just how important it is that Lantus be given twice daily.

Many times, you have to preserve the relationship with your vet because you need them for other things. If that's the case, you'll learn to become an Oscar-award-worthy actor like many here who face the same challenge. You'll go into the office, bite your tongue, grin & bear the lectures, acknowledge the vet's authority & stroke their ego, and then go home and continue doing whatever you feel is in the best interest of your cat.

It's that instinct that led you here, and it will be that instinct which will guarantee Thomas the best care possible. This community is full of amazing and knowledgeable people and they're going to help you out every step of the way.

I'm wishing you and Thomas the best, and hoping he's one of the lucky ones who doesn't have to stay on insulin for very long

 

Hi Tricia and thank you so much! Yes, Thomas is on the Zobaline, one tablet daily. Another poster recommended upping to 2 tablets daily, so I may try that, as he's been on it for well over a month and I don't see much improvement. But I've also been told that you won't see any improvement until his numbers are better.

And sadly, no, no ketones tested. I asked my vet several times about it, and she said due to him not acting sickly for the most part, she didn't feel it was a problem. But I pushed, and she said I could try the dipstick things. Well, I found out that apparently Thomas is very shy, and would just stop peeing and leave the box whenever I approached. But since most of the time he seems to feel and act okay, except for his legs of course, and the occasional vomiting, I didn't press her for any other ways to test it. However, he does not travel well and is an absolute freak about strangers, so she makes home visits. Even with that, she was only able to examine him twice, as he was completely freaked out and uncontrollable.

Yes, as he is a dry food junkie, he is still on dry, but I took his 'bad' stuff away and he is now on Young Again Zero and Mature (he won't eat the Zero alone, so I have to mix them, but at least that's less than 6% carbs, so better than what he was on.) He had also dropped weight so didn't want to cut it out completely, but he has now put some back on and hopefully if he keeps that up, I may be successful in getting him off the dry completely.

Questions---boy do I have a lot lol. I actually mentioned that on another poster's reply, that I'm going to make a list to make it easier for anyone to help us. Hopefully between tomorrow and Saturday, I can have that and the spreadsheet done. Unfortunately, my car broke down tonight and I have several interviews to go to tomorrow and Saturday, so am all over the place trying to get that taken care of as well,,,,,yeesh.

Thanks for your time and insights---everyone here has been just wonderful!

 

Welcome! Sienne gives excellent advice but I have to disagree, I really am a crazy cat lady and proud of it! So glad you found your way here, you are doing a super job with Thomas but the folks here can answer your questions and help out with his care. You are exactly right, potassium levels need to be tested and Zobaline will help with neuropathy but it takes a while.
Liz

 

Hi and thank you! Omg, you are so spot on----I started reading the university and Lantus boards before I found FDMB, and it was so apparent to me, a layperson, that there's just no way to regulate a cat with once daily dosing. And yes, due to the fact that many of my guys (13) are feral rescues and don't travel well, my vet comes to the house, so preserving the relationship is definitely a better option, as there is only one other in my area that does this, and the one time I tried them, it was a nightmare----my cat Skylar was barely sick, and the vet recommended putting him down. He is now 16 yrs old and very stable, although blind. My current vet is the total opposite---she will try anything to save them, doesn't recommend surgery in her first sentence, and is open to alternative/natural treatments if appropriate. So although I am at odds with her on diabetes treatment, she has her other strong points. Also, when euthanasia has been the only option (I lost 2 to cancer in the past three years), she comes to my home and is very compassionate during the whole process.

Oddly, she is a cat-only vet, so I was actually a bit surprised when I started to realize she is not that informed on feline diabetes, regardless of what she states. I guess though maybe they don't have a lot of downtime to actually study everything the way that us as parents make the time to do because we are connected to our babies.

I love your statement on becoming an award winning actor lol. And then I go do whatever I feel is in his best interest. I'm learning to do that, although at first it was scary---going against the vet! But my heart kept telling me things weren't right, and as I posted to another person here, if I do end up losing him, at least I'll know I tested, didn't shoot blindly, and learned all I could to help him.

Thanks again!

 

Hi Liz and thanks! I am proud of it too lol. As for the potassium, since we've been unable to take blood from him, do you feel I should take him off it? The vet had felt that since he was urinating so much, he may have been depleted and that's what was causing his leg weakness. It sounded logical, so I started him on it, as she told me it couldn't hurt him. But now I'm not so sure.

 

Thank you Amy. Yes, I'm thinking with all there is to learn and do, one step at a time is the only way to handle it all. But I just want to do the best I can for him, as of course we all do.

 

I don't know whether to continue the potassium or not. How much are you giving? I wonder what others think, @Sienne and Gabby (GA) or @Marje and Gracie .
Liz

 

Jaqui, the sad fact is that many people do not want the hassle of dealing with treating a diabetic cat, so most vets have not had much experience with a client that will shoot and test. I would be curious to know how often she checks her own BG, and if she tests before giving herself insulin! You will also find that they often think it's perfectly okay for the kitty's BGs to run in the 200s all the time. My very intelligent vets at the University of California at Davis Vet Teaching Hospital tell me to reduce the dose drastically when kitty drops below 100 and that he's headed for remission!!! I love them, but I just nod and smile and do what I know is right for my cats.

You are intelligent and intuitive and you know your cat. You are going to do very well at this, once you get the hang of it! You have my total admiration for handling that many cats at once, especially more than one with special needs. Until recently I had four cats that had cancer, two of which were diabetic, one that was blind, and one that had a leg amputated. So I understand a little about the challenges you are dealing with.

May I ask where you live (you can be as vague as you want - the main reason to ask is to know what time zone you're in)? You might notice that many of us have our location in our signature - we get tired of answering that question!

 

She's in NJ according to her profile, so she's East Coast

 

Hi again, Jacqui,
Stu passed away in Sept. 2010, age 13. He ate dry food until we found this board and learned how bad it was for him and switched him to wet food. He had developed multiple health issues: CKD, HyperT, and--ultimately--a fast-moving cancer. He had been diabetic since 2006 and had been on one of the older, PZI, insulins until it was discontinued. I never tested during those 4 years. He went to the vet for curves about once a month. He always seemed fine (he was very big and strong). We moved and had to find a new vet, who switched Stu to Lantus when we could no longer get PZI Vet. That's when the problems started because the new vet dosed Lantus the way the older insulins were dosed. Stu was never really regulated, but he did OK. A link to his spreadsheet is in my signature.

Rusty, our present kitty, was adopted as a diabetic. He only eats wet food (mostly Wellness Chicken and Wellness Turkey and Fancy Feast Turkey & Giblets; Rusty is allergic to beef and to fish, so we are limited to poultry). We don't know how old he is, but must be at least 16. He was found wandering the streets in Plymouth MA in 2008, taken to a shelter, found to be diabetic, fostered by Claudia for several years, adopted by Phoebe, but couldn't get along with her cats, and re-homed in Nov. 2010 with us.

So much to learn and absorb. You are doing a great job with Thomas. I wish I had found the FDMB when Stu was diagnosed!

Ella & Rusty

 

Hi Jacqui

We will get that SS going today as soon as you get a chance to PM me the info we discussed.

I am dumbfounded by a vet that would give potassium without first checking levels. While we see hind limb weakness in cats with chronic kidney disease due to low potassium, Thomas's is more likely diabetic neuropathy. When vets prescribe potassium for CKD cats due to low potassium, they monitor it very, very closely as too high potassium levels can be dangerous. Potassium is one of those elements that needs to be kept within a certain range or you start to see symptoms. If potassium levels get too high, it can cause heart issues and seizures.

Exogenous insulin (i.e. The insulin that we shoot) can cause potassium to be taken into the cells and so the serum (blood) potassium levels in diabetics are sometimes around 4 or so but that is on the low end of the range and the next test might be mid normal. Unless the potassium level is getting really low (e.g. 3.5)or is low because of another reason, like CKD, OR the kitty is starting to see symptoms that are attributable to low potassium, you wouldn't normally supplement it.

And he won't just pee out the extra potassium. I know you said he isn't good about having his blood checked but IMHO a vet starting a cat on potassium supplements without a lab test verifying that he needs it greatly concerns me.

 

Hi Liz. She advised one tablet daily (525 mg). I felt that was too much, so have only given him 1/2 tab daily.

 

Hi Tricia. I am in NJ. And thank you,,,I actually had 17 when I moved here. I used to be a horse trainer and ran a farm, and people would just throw their unwanted cats over our fence. Needless to say, I ended up with a LOT of ferals running around. So we trapped them, spayed and neutered, and I spent a long time hand taming many of them (lots of scratch and bite marks on my arms lol), but I was the only person who could get near them. So after some disappeared, and burying many due to cars (lots of tears), I had those remaining ones that were just too difficult/wild to find homes for, and along they came with me to this home. I had to build suites off the back of my house for many of them, as although they were hand tame with me, they were still too feral to do well in a completely isolated environment and needed to be able to go outside,,,,,so I built run-out pens for them. This way no cars, no animal fights, and a way I could spoil them beyond belief lol.

I was fortunate that for many years no one had any real issues, but now everyone is much older. I lost 4 in the past three years--2 to cancer, one I have no idea (I found him when I came home from work passed away on the floor), and one only a few months ago who was my first diabetic diagnosed. I still ache in my heart that he wasn't handled properly and that he went hypo, because I found him curled up in his bed like he was sleeping, but he had passed. I even tried to gently explain this to my vet when she seems annoyed with all my questions, but it hasn't seemed to help. She had found a mass and felt he had cancer as well, but something in my gut says otherwise.

I now have a diabetic (Thomas), a hyperthyroid who I almost lost but seems to be on the upswing now, a blind boy who lost his sight at 14 yrs (thank you major vet hospital), a deaf cutie girl, and one that isn't showing any symptoms of anything but looks like she swallowed a watermelon. Some of them my vet can't even get near, so I just monitor them as who knows them better but their moms, and if I have a crash situation, I swallow hard and go to the emergency hospital. I've had some very bad experiences with several of these hospitals, so please don't judge me for not thinking more highly of them. Most of my guys I've had since birth, and my oldest group is 17 yrs, so that's pretty good so far

And you are correct---my vet also feels that if we can at least get him stable in the 200s, he'd be doing much better. I do agree to a point, but it is still overworking his organs, etc. I did learn, however, that his low is higher than normal---he hit 77 once and was not doing well at all. Another time he hit 140 and seemed to feel very well that afternoon. I guess they all can have their own 'sweet spot' with numbers.

 

If your vet suggested potassium without the blood work saying the levels were too low and is not monitoring the potassium levels on a regular basis this could cause more health problems for your kitty.


If you read Marje's post :

 

Hi Marje. The exam when he was diagnosed we barely got to get blood from his ear, he was out of his mind in panic, so no blood was able to be drawn. I can certainly have her try it again, but with his stress levels, I doubt we'll be successful.

Now what you said about kidney disease is interesting---I had asked her if she felt there were any indications that he might have that, and although she did say she'd need blood work, she said that during his exam she felt a kidney was slightly enlarged, but didn't feel it was an issue because he is a large cat. So when she prescribed the potassium and the reason why (that he was urinating so much and diabetes can push potassium into cells and they become low and can casue weakness), I thought 'ok, I guess that makes sense, and if he does have underlying kidney problems, it could only help". Nothing was stated to me about any dangers, in fact I asked twice and was told there weren't any.

Are there symptoms you know of, other than weakness, that I can look for if we can't get blood?

Thanks!

 

Hi again,
I am so sorry for your loss---I didn't realize Stu had passed. And yes, a ton to learn and absorb! I am so happy that Rusty was lucky enough to be found by such caring people!

 

Hey Jacqui and Thomas and welcome. So glad you found us because there is a lot of knowledge here. I skimmed though so forgive me if someone all ready mentioned this but, we increase in .25 increments to prevent kitty from going past the correct dose. Sometimes too much insulin looks like high flat numbers. Another reason to increase in smaller increments is to keep kitty safe. As soon as you can get your Spread sheet up and going, it will be easier for the peeps here to help you with dosing questions. If you need help getting it set up and someone will assist, (not me because I am a mo-mo with tech stuff)

Here is an explanation on how to read and use one. Click on mine or anyone else's in the signature and you can view it.

AMPS is the AM Pre-shot test (always test before shooting to make sure they're high enough to give insulin)...then the U column is for "Units" (how much you gave)

The +1, +2, +3, etc are for how many hours since shooting...so +2 is 2 hours after the AM shot, +9 is 9 hour after, etc.....Since we're all over the world here, saying "he was at 148 at 8pm" doesn't tell us anything...we need to know how long since his last shot.

At the end of a 12 hour cycle, it's PMPS time! (PM Pre-shot) and the whole thing starts over

Keep asking questions as that is how we all learned.

 

Hi Jaqui.

Thanks for sharing your story. You will fit right in here. Everyone here loves kitties and there are many that do amazing work with fostering, especially special needs cats. Several have more than one diabetic kitty (I had two until I lost my Cinco last week). There are a lot of abbreviations and slang that are particular to FDMB, so if we use an expression you don't understand, please ask. FYI, (GA) after a cat's name means that kitty has "gone ahead" or crossed the Rainbow Bridge.

It sounds like Thomas is a real challenge. I hope you and your vet figure out a way to get a blood sample. It really would be a good thing to find any other issues, and eliminate some. Have they tried having you wrap him in a towel or something (with the vet out of sight)? A lot of times if the cat's head is covered, too, it makes it easier to calm them. You've probably tried that, but I just thought I would ask.

Your vet is correct in that he would be doing much better if he was stable in the 200s, but that really isn't good enough if you want him to feel good and be healthier. I haven't heard of a specific cat before that showed hypo symptoms in the 70s on a human meter, but ECID and it's certainly possible! You know him so well that you can tell when something isn't right, and that's great. We are very big on QOL (Quality of Life) here. Sometimes we get so focused on the numbers that we forget to look at the whole cat - is he eating well, playing, purring, grooming, etc.?

Please don't beat yourself up about the FD kitty you lost. How could you have known? I lost a kitty to hepatic lipidosis, and I blame myself because I didn't get him to the vet soon enough when he stopped eating, and then I put him through hell trying to save him. I just didn't know what to look for and when to act. Now I do. I can't change what happened to my beloved Kisa, but I can prevent it from happening to any other of my cats in the future.

We're glad you and Thomas are here, and we hope we can help you!

 

There can be a lot of different symptoms from low potassium so I'm just going to link the page on potassium from Tanyas CKD site which is the best and most comprehensive site for management of CKD in cats.

I wonder if your vet was referring to the same thing I said....that insulin can cause cells to uptake potassium so the blood potassium level is lower because "typically" diabetes itself does not do this. In fact, unregulated or untreated diabetes can cause damage to the kidneys which can also (but doesn't always) result in high blood potassium levels. Likewise, cats that have had DKA might also experience high blood potassium levels.