Newly diagnosed 15 year old male cat

Hi All! My name is Jennifer from Florida and I have a 15 year old male cat recently diagnosed as a diabetic. The vet came out for a checkup because I noticed that Howie was drinking and urinating a lot. With Howie being a little spastic with vet visits, it usually requires complete sedation for the examination. Due to the over urinating, the vet did not want to sedate him, so he was given a xanax. Still, this was a very, very stressful visit.

Needless to say, Howie’s BG was 475. After receiving the news, the vet said I had to check out this site. There was more information than I could have ever imagined. Knowing now that such stress can cause escalated readings, we decided to go out and purchase the ReliOn Confirm meter. We started testing on Saturday and have successfully been able to get 8+ readings. The lowest reading being 234 (before food) and the highest (after food) being 389.

I have a few questions for those of you that have been doing this for a little bit:

1 After removing the dry food from Howie’s diet, how long should we wait to start insulin?

2 If we decide to monitor the BG levels for 1-2 weeks after the removal of dry food, is that bad? If the numbers continue to be high 200 to high 300, should we just start the insulin?

3 Can we wait 1-2 weeks after removal of the dry food to see if the BG levels will come down? In a previous post, I saw that the BG level came down sufficiently enough after removing the dry kibble to not require insulin, so I don’t want to “jump the gun”.

4 The vet mentioned that he did not want Howie to lose weight. However, at 15.8 lbs, I don’t think it would be a bad thing to lose a pound or two after removing the kibbles. Thoughts?

5. In order to keep him from losing too much weight (0.8 lb loss in 4 days), how many ounces of wet food should he be eating a day?

Lucky for us, Howie loves Fancy Feast Classics, so the removal of the kibbles has not been an issue. I love this cat more than words, so I look forward to any and all suggestions and comments.

Thank you,
Jennifer
dancing_cat

 

First of all, welcome Jennifer to you and Howie. I will give you my opinions, but others will chime in and you can decide how you want to process the information we give you.

If you can manage it, wet food is better than dry. Info on how to transition Howie to wet food can be found at www.catinfo.org - just to let you know I know how hard this can be, it took me a month to get Trouble to eat wet food at all, and longer to make the full transition.

How long to wait before you start insulin? Talk to your vet - they seem very up to date. Are you willing to hometest? If you do, you can see what is going on with Howie's blood sugar as you transition - always a good idea. But you may not want to wait. Diabetes is a mean disease - it is, essentially, starving in the midst of plenty - lots of food/fuel for metabolism, but Howie's body will not be able to use that fuel because he can no longer produce enough insulin to take full advantage. Insulin is the substance that tells cells to take up and use the food - in its absence, the cells just throw everything away. Imagine if you cooked a full meal and tossed it into the garbage - that's a crude analogy for what the cells are doing when Howie eats right now.

Another thing to consider: Some cats go into ketoacidosis sooner than others. Although Howie doesn't seem to have really high blood sugar levels, I can't predict whether he would be one of those who would have complications earlier rather than later. If you do wait, please use ketodiastix to test Howie's urine for ketones so you can take him for treatment immediately if they begin to show up. You should also know that sooner support by giving insulin can help Howie's pancreas which might help him go into remission - Trouble was lucky enough to do that because this group helped me realize we should start early rather than wait.

I hope this information is useful - each cat is different, and you know Howie better than any of us. I wish you and Howie all the best. Laura

 

Hi Jennifer and sugarkitty Howie and welcome to the FDMB! Lots of experience here to help you with managing your diabetic cat.

Roughly one week for the dry food to get out of Howie's system.

I would not go longer than the 2 weeks if this were my cat. Better to start the insulin and give a little support to help the pancreas heal.

It depends. I suggest you test for ketones, to make sure Howie does not develop DKA. Two weeks to give the low carb food change a chance to work is plenty in my opinion.

Did he have an infection/inflammation, steroid shot, anything else to cause the BG numbers to be high?

Where does he fall on this body condition score chart? How hungry is he? Knocking the food out of your hands? Gobbling the food in minutes? Or more laid back about getting food?

15-20 calories per pound. He may still lose weight simply from the switch from dry to wet food. My Wink lost about 2 pounds fairly quickly.

Also, weight loss will occur when there is not enough insulin in his body to process the food. You may need to start insulin for a short time, sooner than you would like to if this is the case.

 

Hello and welcome to the board!

Its great your vet recommended us to you, sounds like he is a good vet! But with all forums its up to you to consider the advice here, and what your vet says, and of course how you and your cat feel and think about the advice.

Saying that I agree with what Deb is saying. I wouldn't wait more than 2 weeks of nothing but those fancy feast classic pates - not even dry treats! Thats assuming no ketones are present so you want to go and buy a pack of urine test strips and start testing his pee. Once you get the strips we can give advice on how to collect the pee.

For now I would also monitor his weight. My cats lost weight moving to wet food too so weigh him every couple of weeks and see and alter the food intake if necessary. BTW a can of FF is around 85 calories so you can work out how much he needs. Based on 15-20 calories per pound and aiming for a 14lb cat I reckon - maybe 250 calories - 3 cans FF a day to start?

Wendy

 

Hi Jennifer. I have a lot of similarities with your situation. My Hairy is also a 15 year old male who was diagnosed just over a month ago with similar BG levels. We tried managing with diet for about 3 weeks but it didn't make a significant difference in his BG so we started the insulin. But in our case, Hairy was already pretty much on a low carb diet, so in your case, I would give it 2-3 weeks and you might see a difference. I don't recommend switching diet and starting glucose at the same time because then you have no way of knowing which is contributing what to lowering his BG.

Hairy also lost weight in spite of eating ravenously. .8lbs in 4 days is a lot. The problem Hairy had is that even though he was eating well, the high BG kept him from metabolizing the food well so he lost weight, and worse, most of the weight lost was in muscle mass. I let him eat as much as he wants but make sure it is high protein/low carb. I feed all of my cats Friskies pate with cooked meat (chicken, liver, or gizzards) added to increase the protein content without increasing the carb content.

 

Thank you all for your input! I would not say that Howie is ravenous but he is a healthy eater! He is currently eating about 2-3 cans of FF Classic a day. Last night, I cooked some chicken for him and he gobbled it right up. He doesn't seem to be starving, so I hope he's alright. I'll keep monitoring his weight to make sure he's not losing too much.

Any suggestions on treats? I want to give him something after the BG tests and thought of some cooked chicken. Are there treats out there that won't mess with the BG? I see jerky's and things for dogs that are just dried meat....don't see anything for cats in the stores. Maybe online?

I will continue to monitor the BG levels and see where we are on Friday. That will have been one week that he has not had the kibbles. I don't want to wait too long to start insulin, even a low dose. I want what's best for him. I will do the pee test as soon as I can. I have the ketodiastix and just need to get him to go in the box with the nosorb pellets...he's going to love that!

Any additional advise or tips are greatly appreciated. Thank you all so much for your quick responses. I was so worried that we wouldn't be able to get Howie to the point of blood tests but he's been such a trooper!

Thanks again,
Jennifer flip_cat

 

I feed mine Friskie's Pate but add some additional protein to it like boiled chicken or I make my own pate with cooked gizzards or liver. That adds additional protein without adding any additional carbs, making it equivalent to the higher priced specialty canned foods but at a lower cost. I feed Hairy several small meal per day so I usually feed him one of these meals right after I test him and don't really use treats. They do make some freeze dried chicken treats for cats, but they are pretty expensive and not all cats like them.

 

Thanks Nancy. I will be sure to add the extra meat to the canned food to give him the extra protein.

 

Cat info has a lovely chart with the percent of calories from carbohydrates on it, which they don't put on the cans.

Select any with under 10% calories from carbohydrates.

If/When you start insulin, you'll want a few cans of the gravied, high carb foods to have on hand in case he should have low numbers that need steering.

 

I do have a few of those gravy cans on hand as well as the treats that he shouldn't get. I read something about that last night...having hi-carb foods/treats just in case. This site has been a blessing! I have been reading and re-reading the posts and information...I even started printing out some of the information and highlighting things I did not want to forget! I am keeping a log book of the BG levels, test times, food, weight, etc. There is just so much information to try to remember, so I have to keep it all somewhere easily accessable.

Thanks to all!

 

What are considered "normal" levels for BG? I have seen a few ranges and want to get a good guide....75-120....60-130? I believe my vet is looking for 70-110.

 

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.

 

Only 2-3 cans of Fancy Feast a day for Howie? My foster Wink was eating 4 cans a day of those little 3 ounce cans. He's cut back considerably now that he is OTJ (in remission, off the juice). He eats about 6-7 ounces a day, down from his high of 11-12 ounces.

I've read of cats here that have eaten 15-20 ounces of food a day. :shock:

Keep an eye on his weight.

 

Deb - that's what I'm worried about. I took the kibbles away at first and then read about the side effects, so I put some back down (just a little bit). He didn't want them. He only wants the wet food now. I give him a can in the morning, one mid morning/lunch, one between 530 and 6 and one at night. He will only eat about half of what he's given, so approximately 2-3 cans a day (or 6-9 ozs). I added fresh cooked chicken last night in addition to all of that. I think that addition will be key to getting more food in him. He was always kibbling all day long....a few here, a few here, etc. I think that's where he piled on the weight.

At 9-10 years old, he was 10-11 lbs. I changed his diet (thinking he wasn't getting enough food) and he shot up to 15-16 lbs. I would assume that he will lose a few of those over the next couple of months but doubt he will get that low again. I will keep an eye on his weight and consult the vet if it seems to be dropping too fast.

Thank you for your reply Deb!

 

Heres some tips on how to test the urine https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

And here are some low carb treats - many of us feed the freeze dried chicken you can get in most pet stores : http://www.felinediabetes.com/FDMB/viewtopic.php?f=14&t=9172

What are his BG levels like right now? You might want to use our spreadsheet to track his trends - with the added bonus that you can share it with us and your vet if you want added input - let us know if you need help with it: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207



Wendy

 

I pulled a log off of this site and have been tracking successfully. I cooked up some chicken to give as "treats" which is working out great! His numbers were low 300's in the morning to 275 tonight. I have all of yhe stuff to test the urine now, so I hope to get that done tomorrow.

Thanks for the links and all of the information Deb! How is Tiggy doing?

 

the 300 and 275 is that pre shot?

I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

 

Right now I am testing 4 times a day (once before food, once after, morning/night). I have yet to get a urine sample but I WILL GET IT TONIGHT.

The numbers before Howie eats are usually 237-300 and after he eats are usually around 350-375. I've had one go up to 414. I think that the changes to his diet have brought the numbers down a bit but depending on the urine test, we will probably begin insulin soon. I'll post again with an update on the urine test.

Have a great weekend!!

 

The most important numbers are between shots, around the expected nadir, or lowest point between shots. This si to make sure he doesn't go too low.

For Lantus, that is from about +5 to +7 hours after a shot.
For ProZinc, that is from about +5 to +6 hours after a shot.
For Levemir, that is from about +7 to +9 hours after a shot.

 

Yep but I forgot she isnt on insulin right now but with those numbers he will be soon. How long has he been off the kibble?
Wendy

 

Howie's levels are staying in the high 200's to high 300's, negative keytones in the urine. However, the urine sugar was very high, which was expected. The doc said it's time to start insulin, so that will begin tonight. I'm a little nervous and doubt I will sleep much tonight. nailbite_smile

I have watched and read a lot about injection sites. With that being said, one place I read about was on the belly. Is that an ok area to inject? It said to be careful of nipple areas and things like that (which to me is a no-brainer). I'm worried that if I start on his back (shoulder/hip) area, that I might not get it. Maybe I'm overthinking?

Any advice is greatly appreciated.

 

I gave it around the shoulders, where there is some loose skin to easily pull up and inject.

 

I think belly shots are intended more as an injection site for humans rather than cats. I would suggest his scruff between his shoulders. The skin is loose there and you can pull it up into a "tent" Then inject through the pulled up skin. That way you don't have to worry about hitting a vein or muscle or nipple. If he is on two shots/day, and you are home during the day, you want to consider waiting until the morning for his first shot.

 

Hi Nancy,

My vet said to start right away (tonight). What would be the reasoning behing waiting until the morning? I have not read anything that said one way or the other, so I would love to have some backup on that to discuss with the vet.

We will be doing shots 2x per day, so I will take your advise of tenting the shoulder area instead of the belly.

I appreciate your quick response!!

 

Mostly so you can be awake to monitor!!! Staying up all night with a cat going unexpectedly low, or rushing to a vet ER is not how you want to spend your night.

I'm hoping you are starting with a low dose, such as 0.5 to 1.0 units. Some cats can be really sensitive to insulin and have an unexpected response.

 

You can also inject insulin into the flank area of the cat. Here is a link that shows you where this is:

http://www.bd.com/ca/diabetes/english/p ... 1&id=14874

You can also watch their video on how to inject insulin - using the tenting method:

http://www.bd.com/ca/diabetes/english/p ... 1&id=19057

 

Jennifer,
When I first started my Hairy on insulin, I started with a morning dose so that I could watch him carefully that day for any adverse reaction like allergic reaction or hypoglycemia. If I had started with a night time dose, I would have either had to stay up all night or could have possibly slept through a bad reaction. Hairy had been diagnosed a month before he began insulin and had probably been diabetic for some time longer than that, so in the grand scheme of things, a 12 hour delay in beginning his insulin is not likely to make any difference.

 

We are starting with a 1.0 dose. Now I'm scared, so I'll start tomorrow and take off from work. I want to make sure there are no adverse reactions for sure! My vet said it was no big deal and that you will see in the first 3 hours if there are going to be issues. Maybe he's a little too relaxed about this. I'm picking up the prescription tonight and will begin at 6am!

Thanks everyone! I'll let you know how it goes.

 

Don't be scared - be prepared. Have on hand some high carb gravied foods, Karo/syrup, and an oral syringe in case he should ever go uncomfortably low.

You are starting at what appears to be a reasonable dose for most long-acting insulins.

What insulin will you be using? It makes a difference.

To double check, here's a formula for estimating a starting Lantus dose:
What does he weigh?
What should he weigh?
Which is lower?
Convert the lower weight into kilograms by dividing by 2.2.
Multiply by 0.25.
Round down.

 

What kind of insulin is it? Did I miss that (sorry).

We can help prepare you more on what to expect if we know what kind it is.

Wendy

 

I will be using Lantus. There was a mix up at the pharmacy, so I will be picking it up tonight and will start tomorrow morning bright and early!

 

Did he prescribe the solostar pens? If so, there is a coupon http://www.lantus.com/considering/save-on-lantus/default.aspx . You use syringes with them - not the needle tips they can be sold with. When you fill out the lantus coupon card - be sure to put your cat's name and your last name and list the cat's age as 18 (otherwise you won't get the coupon).

let me know

Wendy

 

Not knowing anything about this, I assume this is not the regular glass bottle and syringe but a prefilled pen and you adjust the dosage amount?? I am filling this at Costco because it’s the cheapest and then you get a member discount on top of that.

 

Its a prefilled pen. It has a dial on it to "dial a dose" in combination with pen syringe tups but that doesnt work well with cats as the dosing that way is inaccurate for small cat doses. So you withdraw the insulin the same way as for a vial using normal syringes - see pic below. You might need to ask the vet to write "pen" on your prescription. Costco Canada sells the pens and vials.





Wendy

 

So I've picked up the Lantus and needles and am ready for the first dose first thing tomorrow morning. Howie's readings tonight were 350 before food and 383 after. This morning they were in the low 300's.

Should I expect to see the numbers going down while testing throughout the day? I assume the charts I have been looking at to get the "nadir" are what I should expect but will the numbers go down in the 100's almost immediately?

 

Lantus will start working immediately. However since you are just starting out, it could take up to a week to settle in which is why we say to hold the dose for a week to let it settle... Unless the blood sugar drops under 50 in which case you reduce dose immediately.

A few things to note..

1. Test before you shoot. As a newbie don't shoot under 200 for now as we don't know how he will behave.

2. I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

3. Lantus works in a slow curve, the third link below includes information on the typical curve, how long lantus takes to kick in etc.

Also read the below links when you get a chance and let me know if /when you have questions!
Wendy

- How to store and handle lantus (keep in fridge, no roll or shake, should last up to 6 months): http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=151

- Tight regulation protocol : http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

- New to the group info http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

 

Wendy, you are awesome!! A sincere thank you to you and all of you that have commented here. I will post tomorrow and let you know how things are going!

 

Keep asking questions. It's a lot to take in at first.

Also we need to get you set up in a spreadsheet. But my iPad is running out of charge. Remind me tomorrow.

Let me know how the tests are. If he starts to drop suddenly come on and post 911 for help

Wendy

 

After Hairy's first dose (1 unit) his BG went from over 400 to 89 at 7 hours after than first shot. But that is the lowest it has ever been, I't been all over the place since then.

 

Thanks Nancy and Wendy.

 

So we were successful this morning with the first dose! Before he ate, Howie's BG was 278, after 258. By noon, we were at 118 and at 4 we were at 79. I just tested at 6:10 and he was up to 82. I am waiting on a call from the vet to confirm...common sense says not to do the 2nd shot. If this is the way his numbers are going, maybe only one injection a day? Thoughts, comments?

Thanks all!!!

 

No shot tonight!!!

What was the dose you gave? If 1 unit, tomorrow morning, take it down to 0.5 units if he is over 200 mg/dL.

 

Here are some glucose reference ranges used for decision making using glucometers. Human glucometer numbers are given first. Numbers in parentheses are for non-US meters. Numbers in curly braces are estimates for an AlphaTrak.

< 40 mg/dL (2.2 mmol/L) {< 70 mg/dL for an AlphaTrak}
- Treat as if HYPO if on insulin
- At nadir (lowest point between shots) in a long term diabetic (more than a year), may earn a reduction.

< 50 mg/dL (2.8 mmol/L) {< 80 mg/dL for an AlphaTrak}
- If before nadir, steer with food, ie, give modest amounts of medium carb food to keep from going below 50 (2.8).
- At nadir, often indicates dose reduction is earned.

50 - 130 mg/dL (2.8 - 7.2 mmol/L) {80 - 160 mg/dL for an AlphaTrak}
- On insulin - great control when following a tight regulation protocol.
- Off insulin - normal numbers. (May even go as low as the upper 30s (1.7 mmol/L){60s for an AlphaTrak}; if not on insulin, this can be safe.

> 150 mg/dL (8.3 mmol/L) {> 180 mg/dL for an AlphaTrak}
- At nadir, indicates a dose increase may be needed when following a tight regulation protocol.

200 mg/dL (11.1 mmol/L) {230 mg/dL for an AlphaTrak}
- no shot level for beginners; may slowly reduce to 150 mg/dL (8.3 mmol/L) {180 mg/dL} for long-acting insulins (Lantus, Levemir, and ProZinc) as data collection shows it is safe

180 - 280 mg/dL (10 - 15.6 mmol/L) {may be 210 - 310 mg/dL for an AlphaTrak}
- Any time - The renal threshold (depending on data source and cat's renal function) where glucose spills into the urine.
- Test for ketones, glucose is too high.

>= 280 mg/dL (15.6 mmol/L) {may be >=310 mf/dL for an AlphaTrak}, if for most of the cycle between shots
- Uncontrolled diabetes and thus at risk for diabetic ketoacidosis and hepatic lipidosis
- Follow your insulin protocol for dose adjustments
- Test for ketones; if more than a trace level of ketones, go to vet ASAP.

 

BJM,

You had posted that information before and I looked it over and said...this is common sense. There is no way that I should be giving another dose when he's in the normal range. I will continue to check him tonight to see how the levels are when I go to bed. I was pleasantly surprised at how well things have gone today. I will follow your advise of 0.5 tomorrow morning and see how he does. In this instance, if I do 0.5 tomorrow morning and the BGL goes back up (like I've seen in graphs) later in the day, it would warrant another shot of 0.5 12 hours later, right? Either way, I will post tomorrow afternoon with the stats to see what everyone thinks.

Thanks for the quick response. I guess this really isn't a big deal....I was so nervous when Howie was diagnosed and I'm so glad to have found this site! You guys ROCK!

Jennifer

 

It's better if we can find a dose for Howie that you can give twice a day. Even's out the amount of insulin available for a 24 hour period.

BJM's suggestion to reduce to 0.5U is a good one.

 

Good job of managing today - since he was low and you couldnt shoot - definately reduce to 0.5 and try that for a few days (unless he drops under 50) - as Deb said, you want a dose you can shoot consistently. And as Lantus is a depot insulin , it hasnt even properly built up in his system yet!

Any chance of a the spreadsheet ( let us know if you need help with it) : http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy

 

Good morning,

So Mr. Howie was still in the normal range when I went to bed last night (91). This morning, he was at 188 fasting and 200 after breakfast. We gave him a 0.5 dose. He was at 212 when I left for work (2 hours later). We will check in on him at lunch time, since it took about 6-8 hours to get to the lowest point yesterday. I will post his progress with the lower dose tonight.

As far as logs, I have been keeping hand written notes for the last 2 weeks. I created a new log a few days ago to track BG, insulin dose, food, etc., that I hand write in every day. I will try to remember to bring it with me to work tomorrow so I can scan it in and upload it for you guys to see.

I have to tell you guys....Howie has been a sleepy head for months, kinda curious with the goings on in the house. Yesterday, with the low BG, he was like a kitten again! I couldn't be happier right now.

Thanks,
Jennifer

 

Ideally, the insulin kicks in about 2-3 hours after being given, so there may be a slight increase from feeding until then, after which the glucose goes down and back up in a smile shape.

 

Acting like a kitten again! There is nothing better than hearing words to that effect from a member. It means their cat is feeling better and showing their caregiver that the insulin is helping to make that happen.

Hoping for continued progress with Howie.

 

My Hairy is over 15 so I wouldn't say he is acting like a kitten, but he did become more active pretty much right away when he started on insulin. He has improved symptomatically in every way even though his blood glucose levels are still pretty high.

 

He was playing with toys and following me around the house like he used to do. It's amazing to see that he "feels good" again. I had no idea how slow he had gotten. I thought that maybe he was just getting old. Boy, I was wrong. His frisky spirit is back!

 

Now you know why one of the mantras we have is, "A cat is more than a bunch of numbers." The 5 P's, peeing, pooping, purring, preening, and playing in combination with the appetite tells us a lot about how a cat is doing. From what you have said, he's doing much better. Congrats!

 

Just a quick note on Howie. He's maintaining a pretty good level and receiving 2 shots a day. It has been difficult to find that happy medium but I think we have finally done it. Thanks to all in helping me understand this disease and all of the tips and recommendations offered.

Jennifer

 

So how is Howie doing with all the 5 P's and his appetite now?

 

Howie is doing great! He eats and drinks like normal, activity seems to be better and he hasn't needed a shot since Friday morning. We were doing shots every 12 hours, with him not going over 200 for a week. Last week we were able to keep it between 55 and 160. Friday morning he was around 150, he got a shot and by evening, was still at 90. He's been staying between 70 and 120 since. Is it too premature to be excited? We are obviously still testing his BG levels but think we will start testing only once in the morning and once in the evening to keep things in check. I am just shocked at how quickly he responded to the insulin (less than 3 weeks of injections).

 

If you get 14 days with glucose between 40-130 mg/dL and no insulin, he'll be officially off the juice (OTJ).

 

He might well be going into remission, to help him you want to give frequent mini meals through the day instead of a few large ones. That way it will help support and not overwhelm the pancreas.

Keep us updated!

Wendy

 

Thanks guys. That's what I'm trying to do is many frequent small meals and keeping a close eye on his numbers. Cautiously optimistic.

 

Paws crossed. We want 14 days of 40-130 or so. No dry food or dry HC treats either. After 14 days we can give tips to keep him OTJ if he gets there. If he doesnt, he might need a small amount of insulin to help support the pancreas a little longer. But lets see!

Wendy

 

We have no dry food in the house. We do keep the snacks just in case he dropped and gave them once (45). He and his sister got 2 each last night. I am trying not to give any of that stuff. His daily intake is Fancy Feast classics, which were his favorites to begin with (so we were lucky there). He's been fine with just the wet food for a month now. Weight is good, food/water is good. I will keep a close eye on him.

Thanks again everyone! I will post an update in a week or so!

 

Hows things going now?
Wendy

 

He's staying around 55-75 every day. Seems to be doing really good!!!

 

Great! How many days has he been in the 50-130 range with no insulin now?

 

The last dose was 9/27. He did get to 150 on tuesday night but immediately went down to 105 by the time I went to bed. He's been under 130 since Wed and still no shots.

 

Ok then count today as day 5. Also it will help his pancreas if you give frequent mini meals instead of big ones. And no high carb foods at all including treats. If he can stay 50-130 for 2 weeks then we consider him in remission.

 

My little guy, Kitten, was 15 when he was diagnosed (it was steroid induced) and he went into remission rather quickly as well. This board and its wonderful people was indeed a Godsend.

From Kitten and I...fingers and paws crossed....GO HOWIE!!!!

 

Just wanted to post and say Pasquale and I have our paws / fingers crossed for you and Howie too.

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Thanks! You guys are awesome! Howie's doing great. He's still staying between 55-120 every day. I couldn't be happier!

 

Just a quick note to say hi and post an update on Howie. He has continued to stay in the normal range (60-80) since my last post. I am continuing to feed the same foods (FF Classics) and his weight is stable. Is there anything else I should be doing?

 

There are a number of things on my signature link Secondary Monitoring Tools that may be helpful - regular weight checks, keeping track of water consumption and output, how to check for dehydration (any time you see vomiting or diarrhea!), and so on.

 

Wow its been 2 weeks already.... so CONGRATULATIONS!!! :mrgreen: :mrgreen: :mrgreen: :mrgreen:

Tips to stay OTJ

We say a cat is in remission if the cat can maintain BG levels for 14 days between 40-120 with most of that spent under 100. However, please keep in mind that once a diabetic always a diabetic.

1. Never feed dry - not even treats. If you change wet food types, be 100% sure the new food is also low carb and same low carb % as your current food. Some cats are very carb sensitive and an increase from 3-6% to 8-10% can spike the BG’s. Don’t feed if you aren’t sure!
2. Weigh every 2 weeks to 1 month to watch for weight changes. Too much of a weight gain can cause loss of remission.
3. Measure blood once a week, indefinitely. You want to catch a relapse quickly.
4. No steroids or oral meds with sugar - remind your vet whenever giving you any medication. Always double check.
5. Monitor food intake, peeing and drinking. If increasing, a sign of losing remission.
6. Regular vet checks for infection such as dental , ear or UTI. And get them treated quick!

If he does fall out of remission you need to be more aggressive and resolve issues/ back on insulin as soon as possible as the window for a second remission is tight if any.


Wendy

 

I guess I'm a little overkill....I still test once a day. If you say once a week, maybe I can ease up a bit. The funny thing is he doesn't mind the tests at all. I did notice that he has a harder time jumping on the couch and beds. So I got him a set of stairs and my dad built a ramp for him. He loves it. I have been monitoring the water/urination and it seems to be normal. Nothing close to what it was before diagnosis.

Needless to say, he looks and feels much better. His coat couldn't be more clean and silky. I had noticed that he was starting to get scruffy looking...even with me cleaning him and all. Now, he's cleaning himself more often and is a lot more playful. I think we caught this just in time.

I will be out of town for 4-5 days in a few weeks, so I will continue testing daily and then let it go while I'm gone. That's a lot to ask of someone taking care of them while I'm gone. SOOOOOO glad we are off the insulin. It was going to be tricky for someone else to do it.

Very thankful for everyone on this site. All of the support and advice has been a life saver. My vet really thought this would escalate to me having to make the choice of putting him down. Now, he's a very happy boy!!

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