Newly Diagnosed 4 units vetsulin BID

Hi all. Found your board when one of my cats was diagnosed with diabetes. It didn't come as any great shock as I noticed food and water being consumed with great speed along with someone peeing in the wrong place - my bedroom carpet. As I have two cats I wasn't sure which one it was until I caught Taz as he was peeing on my carpet. :cry:

Off to the vets we went on 12/18/09 and his glucose was 530. I knew it wasn't good when both the vet and his wife said "WHOA!" loudly at the same time. Subsequent readings have been 500 and 481 (12/23/09). My vet is not opposed to home testing and in fact is encouraging me to do so, which is a relief. It's too expensive to go every other week, not to mention the time it takes to get there - half-hour each way- and the stress it puts on Taz. I work 2 jobs, so time is tight anyway. A blood panel indicated that everything else is fine with Taz. He has a cataract in his left eye, which I'm assuming is from the diabetes. Diabetes runs on both sides of my human family.

Taz is 11 yo, and my other cat Tigger is his littermate. Tigger was also tested and his level is 91, which is surprising since he's 24 pounds. Tigger is healthy, he's part coon cat so he was even large as a kitten. Taz was 15.9 pounds when he was diagnosed, down 4 pounds from a year ago, and on his last visit was 15.4 pounds. I adopted both of them from a shelter. They are both neutered males. I have always free-fed them because I have found that when I leave wet food out, or pick up any food after a certain time, usually only one of them will hog whatever is put out. I am feeding them Hill's W/D which as I'm sure you know is a dry food - amd $$$. I would love to put them on wet food, but don't want to starve Tigger because Taz is inhaling the food and water. Any ideas on how best to do that?

The vet has me injecting Taz 2x/day with 4 units each. The insulin is vetsulin (I know; I've read the boards and need to have the insulin changed.) Since I started him on 4 units, he seems much happier - more energy. He's back to grooming himself.

 

Re: Newly Diagnosed

Welcome... do us a favour and change your subject line to Newly diagnosed - 4 units vetsulin BID. We don't, at this point have any other way of bringing that kind of attention to the thread and you need some attention. That is a relatively high dose of an insulin about which there has been warnings - as you know. Keep in mind that some cats do indeed need a lot of insulin but those are cats with conditions that are discussed in the high dose group of the Insulin support groups... Please check out that forum if you think that might be an issue.


Just click on your post and click edit... then you can edit the title so that others will zoom in for a peek.

So to recap... that's a lot of insulin and more people will comment on that.

Switching them both to a low carb wet food will be good for them overall. You can free feed or do meals... Taz won't be inhaling so much once he's better regulated.


Good for you for considering home testing. Please get yourself a meter as soon as possible. You should test before each shot and in between.

 

Thanks! That will help...

 

Hi and welcome!

Unfortunately, despite your vet's willingness to have you hometest, he's got you on the wrong track in every other way. WD is a horrible food that is high in fibre and no nutrition, and it is like putting fuel on a fire (to quote Dr Lisa). Now, giving 4 units to start is a HUGE beginner dose, but in some ways will counteract the food you are feeding. A better approach is to feed a canned food that is high in moisture and low in carbohydrates, and cut the dose to 1-2 units twice a day. Does this make sense?

Jen

 

One of my cats inhales food and the other munches slowly. I've had to meal-feed them (breakfast, dinner, and bedtime) so that the muncher gets his food. I also sort-of stand guard while they eat - wash the dishes then or something that needs doing but can be done while keeping an eye on the cats.

It works. They are pretty used to it now. The one who inhales the food will hunch down and stare at the muncher while he eats. She has learned that I stop her if she tries to go get his food, though, so she seldom does. I don't think they are "trained" to the point that I could let them eat unsupervised, but as long as I am there, they both get their meals.

 

LOL Jean.......same thing here.......we cater to our kitties like kids.....they can sure be sneaky snakes :lol:
Neither of mine hoard food.....but of course if I leave two plates out..one will always want to be the first to touch her tongue to the freshness & .... I stand by to ensure they both get fresh!

 

Cataracts can come from diabetes, but generally that is thought to be more of a long term poor treatment result, rather than instantly showing up along with the diabetes.

The other posters are right on the money. Just give them both wet food and everything will be fine as far as diets. In the beginning, worry less about who is consuming what in regard to someone overeating, as Taz will be so hungry that it's unlikely Tigger will get much of his food You can stand guard, or just keep putting food down until they are both sated. That's not the most practical advice for long term, but it'll work for now. Check out http://www.catinfo.org for TONS of great diet info. I feed all 3 (2 are diabetic) of mine Friskies canned as I am laid off and they are all doing just fine. Initially, as you get them onto wet food, they will both seem hungry often, but as their stomachs adjust to the lower fiber food and become familiar with the higher protein content, they WILL stop being Starving To Death all the time. Cats can get used to just about anything, including new feeding schedules. When my first cat was diagnosed, I was shocked that a lifetime "grazer" could learn to eat on schedule, but they do. I feed mine 3 times a day and sometimes a snack too

Big Important Note: Do not switch them to wet food without reducing that dose. The dry food is keeping Taz safe right now.

Ahhh Awesome that he is feeling better but I caution you that the dose is very high. We do not know that he needs to be that high, so you will absolutely need to start over with your dosing as you switch to wet food. Standard advice here is start back at 1u and work your way up if necessary, using testing and the insulin support group as your guide. I don't know how your vet calculated that dose, but I suspect it was due to his size. We have found that size has nothing to do with dosing, with small cats on large doses and large cats on small doses being equally treated on this board. I do find it interesting that he is getting a dose as high as 4u and not showing any ill effects, however we know WD to be extremely high in calories from carbohydrates and we know Taz is very hungry as he's still in early stages of dx. I'm very curious to see a curve on your boy, and will look forward to seeing the results as you begin testing him.

Glad to meet you and welcome to FDMB

 

Hi and thanks everyone. I haven't been able to get back here as I'm working 7 days a week. I have an appointment with my vet tonite, so I'll will be telling him I want to change Taz's insulin (and dosage) and put him on a wet food feeding plan. I saw the post about changing from dry to wet and will read it before I go and make sure I understand it. I also saw the list of wet food that is acceptable.

While Taz is definitely feeling better - he's back to parking himself on my keyboard when I'm on the computer - he is still laying in front of his waterbowl and drinking, so I'm sure his numbers are not down by much.

I can't wait to make the change; I feel like such a bad mother. I just want him to feel better.

Lisa and Taz

 

Lisa, you are not a bad mom... Do you understand how and why the 4 units is too much in the beginning and why it may be keeping the BG up? That will be important in your discussion with the vet. Let him know you want to work with him but that you have done your homework and the latest treatment in FD is a low starting dose and hometesting along with a low carb wet diet.


Please do not change the diet until you are hometesting and have lowered that dose.


And please do keep us posted.

 

Hi Lisa

Just to clarify one thing; he may have high numbers due to rebound. I reiterate that 4 units BID even on dry food is too high and could be causing rebound.

Jen

 

Victoria,

I had originally found the answer to your question about BG and units, but I guess it was on the old site and I'll have to dig through the archives to find it again along with the lingo guide!

So, I need to continue with the dry food diet, lower the dose and hometest, then I can transition him to wet food. is there a certain "number" I have to hit with his BG when I hometest before transitioning to wet food, or do I just do it and test him before his meals and adjust the dose accordingly?

It's all a little overwhelming!

Thanks!

Lisa

 

In general, once you are home testing and have lowered the dose, you can start to transition the food by mixing the wet with the dry and slowly putting in more wet and less dry... You can start this right away if you are home testing and you have lowered the dose. This will help lower the BG - insulin alone does not always work. And what we like to see is that the food changes reduces the BGs and therefore the required dose of insulin.

The transition can take between a few days and a few weeks, depending on the cat and if they refuse the wet. Some do but some love it. The thing is, once you are home testing you'll be able to know if it's safe to give insulin. What you WANT to happen is that the transition of the food and the low dose of insulin help the pancreas heal and the BG become too low to give insulin... and the cat becomes diet controlled - like a type 2 diabetic in humans... But we can get to that when we get to it.

You will want to set up a log or spreadsheet for tracking the BGs and can feel free to post your numbers as you go to get input from people here.

You do not have to slowly lower the dose. (When increasing dosage, it must be done slowly, but decreasing can be done in one shot). You can safely lower to 1 unit instead of 4 units - if you know there are no ketones. To check for ketones, you use ketostix from the pharmacy and dip them in the urine puddle or stream of urine. Ketones develop for a number of reasons, including not enough insulin... So when lowering a dose, you should check for them. It's not hard and they are inexpensive. But sticking to a dose that is too high is not safe either.

 

Hi Lisa.....

You sound like you are being really proactive with a limited amount of info from your vet.

The info you have already been given in this thread is great and I just want to add a couple of things.

Before you make the switch to another insulin, it is still important that your Taz is being kept safe.
4 units is a really big starting dose.

I am concerned and all I can encourage you to do is learn to hometest today, test before the shot and about 3 and 5 hours after the shot in the next 24 hours, to see what is happening.

Some cats need a bigger dose for sure, but they get to that dose by starting with a relatively safe dose -about 1 unit, and then testing and increasing or decreasing, as is needed to balance the blood glucose, while vigilantly testing for ketones.

I suspect that dry food is keeping Taz from dropping too low, but he still may be having wild swings and that will leave him hanging in front of the water bowl.

Please have a look at this vetsulin user guide if you have not yet..
viewtopic.php?f=19&t=302 and fel free to join us in insulin support group here viewforum.php?f=19

Having a read through others experience with this may help you also.

Please keep asking lots of questions and let us know how you are doing.

It gets easier

Kimmee

 

Hi Lisa welcome to FDMB :thumbup Best place to be

I echo what others have said.

Just in case your asking 'what are keytones?' here's some info:
http://petdiabetes.wikia.com/wiki/Ketoacidosis

The production of ketones is the result of inadequate insulin.

 

Oh brother. grumpy_cat cat(2)_steam

Just came back from the vets and he is totally resistant to changing the insulin and its dosage. Taz had a BG of 432 tonite and he is down a pound to 14.4 pounds. The vet wants me to up the dose to 6 BID 2x/day and once the BG gets to the 200's he wants it upped to 7 BID 2x/day. He told me that he thought a weekly BG test at home was sufficient. Diabetes runs in my family so I know once a week certainly isn't enough. While he was curious about what the websites have to say - and I told him - he pretty much pooh-poohed everything; he wasn't listening and I'm totally frustrated.

He is going away for the next month, so I've decided that I will do what has been suggested here: transition to wet food and drop the dose once I get my glucometer (I ordered a newbie kit) so I'm hoping to have it by the end of the week. I am planning on taking Taz for a second opinion as well. Maybe someone whom is neutral would be at least willing to listen to my concerns. The vet did ask for the websites I've gone to and I told him. I have no idea where this is coming from! He has always been open to alternatives in the past.

If anyone knows a vet that perhaps specializes in diabetes in the Middleboro, MA area, I'd be happy to contact them. I'm thinking of taking Taz into Angell Memorial, but I think it may be out of my price range.

Lisa and Taz

 

Wow... I'm sorry to read this.... Please do not up the dose at all. This is completely contrary to any proper FD treatment.

Please drop the dose before transitioning to wet. You can drop the dose any time. Then start testing as soon as you get the meter. In the meantime, check regularly for ketones.

Well, we see this a lot... and it's a shame. He's resistant to learning and what he has prescribed above could kill a cat. I hope he finds this thread and reads it. No offence... but any doctor or scientist should keep up with developments and if they do not, they should be open to learning. Giving 50% more insulin without running a curve or knowing a nadir (low point in the cycle) is crazy... then to increase the dose again once the BG gets lower... well, it really is crazy. AND DANGEROUS.

You have a good head... if he won't work with you, find someone who will. But please let him know this so that he knows that his treatment is dangerous.

 

Echo Vic. Don't change the food unless you lower the dose. And check regularly for ketones. This is the right approach, but a little scary if you are not hometesting. You really don't know what differences your changes are making.

If money is not an issue, I would go down to Walmart and get a ReliOn Micro glucometer. They are inexpensive as are the strips. The meter you are getting can serve as a backup. We can take you through the steps; many people have learned to hometest over the internet.

 

Thanks Vic and Sue.

I'm planning on lowering the dose and starting him on wet food when I can get my hands on a glucometer. I will check out Walmart for the glucometer and the strips you have suggested tomorrow on my way home from work. I wouldn't change anything until I can get a handle on the BG readings, which hopefully will be lower since Taz is at home. Taz gets soooo stressed going to the vet's - he hyperventilates, pees, poops, vomits. Poor thing; I feel so bad.

How hard is to check for ketones because I have two cats and it is hard to find either one of them peeing in their boxes.

I feel better knowing that I've made a decision that I'm comfortable with for Taz. I'm still shocked about my vet.

Lisa and Taz

 

It always feels good to have a plan. People with two cats usually resort to putting one inside a bathroom with the box and waiting until he goes. (If he is like mine, that will be right after you change the litter) Sometimes people stalk the box with a ladle and put it in his stream. Or if desperate, you can get some aquarium gravel so it isn't absorbed.

 

I don't want to sound pushy... but really, there is NO reason to wait to lower the dose. The dose you are giving now and the resulting BGs really don't tell you much because he could be in rebound and that could be why the BG are high, if they are. And even if the BG is low, that doesn't mean this is the right dose. The only way to ensure one has the correct dose is to work up from the starting dose. So you can start at that lower dose - to ensure the kitty is safe from a hypo - then start measuring from there. You are essentially starting over with all the new information you have now. More shots at the higher dose only put off getting his BG sorted.


As for the ketones... well, we all become little stalkers and have to wait on them when they are peeing... either getting behind them with the stick, or scaring them out of the box before they have a chance to cover the puddle. Sounds exciting, right? ;-)

 

Not being pushy at all. I'll roll back my dose with his next shot which is in the morning as soon as I roll out of bed.

My cats are not big on covering up their stuff; I just need to make sure it's Taz and not Tigger leaving the puddle. Great, stalking my cats in their litterboxes. Hope someone doesn't call the MSCPA . . . . .

Lisa and Taz

 

Lisa,

I live as you do in Middleboro, MA. I foster diabetic cats. Because I am a human diabetic of 30+ years, the vets in the area have begun to listen to me about insulin and food management for the diabetic cats I've handled in the past 3 years.

Send me a Private Message and maybe I can help you with a vet in the area.

 

Hi Lisa, and welcome to FDMB! I am sorry you are going through all that with your vet. He has given you some crazy advice, particularly about increasing the dose after the BG levels decrease. :shock: It sounds like you have a great handle on things and what you need to do, and you've gotten some good advice here already.

We have all been where you are and we're here to help. Ask any questions you have and continue to read like you have been. You've done awesome so far. Keep up the good work.

 

If you've requested a newbie kit, it should arrive soon

 

Or you just test the blood for ketones.... :roll:

 

Any updates from Lisa and Taz today?????

 

Ella, not all meters test for ketones. The majority of people use the stalking method. :twisted:

 

Sorry! I've had problems logging in. I rolled Taz back to 2 units 2x/day and they are both on wet food and LOVING it. I thought they were going to knock me over when they saw the can in my hand. Taz hasn't been seeking out attention like he did last week, so I'm a little worried by that.

I feel much better about finally making some decisions. I'll give a shout out when I get the glucometer for help on that. I've been reading the posts on it. Nervous, but I'm sure I'll be fine. I'll also start posting a spread sheet once I figure it out!

Thanks for all your support, I truly appreciate it and so does Taz in his own cat-way.

Lisa and Taz

 

Puttz also was initially on 7 BID Vetsulin when he was diagnosed with FD...After watching him look soooo sad, and running under the bed before his massive dose, I convinced myself to home-test, self-taught myself all about it here, and have successfully gotten him down to 1U BID with diet and monitoring. The benefits of this Board helped me through tough times.

 

So far so good with the wet food and going down to 2 units 2x/day. Taz seems much perkier bcatrun_gif and is back to driving me insane, which I never thought I'd be happy about! I owe Cjleo a call and will do so. I got my glucometer in the mail on Saturday and now I just need to sit down and read the directions on how everything works so I can start the hometesting asap.

I should probabaly add that water consumption is down. I keep looking at the water bowl (it hold up to a gallon) and thinking, "WOW, I don't need to put in more water yet?", so that's good. They're inhaling the wet food!

Lisa and Taz

 

Great news. Start a new thread asking for help with home testing if you need some pointers. I found that working it out on myself was a good way to learn... and didn't make me feel so guilty about poking Sundance. Added benefit - you'll know you're not diabetic.

 

You are doing a great job. Now to the most vital part hometesting.

Try the meter out on yourself so you know exactly how it works (before trying on a wiggly ear.)
Make a rice sack: thinnish sock filled with rice, heated in microwave until very warm but not hot
Get a flashlight and put it behind Taz's ear. The vein that runs down the edge has capilliaries running off it toward the edge. You are aiming for the capilliaries. When you find the right spot, put a dab of vaseline there. It will give you a place to poke and will help the blood bead up.
Pick something to put behind his ear when you poke - a small make up sponge, folded kleenix or the rice sack

Have all your supplies ready in the place you are going to do this: meter, lancets, rice sack, thing to poke against.

Here is the video that shows how: http://www.youtube.com/watch?v=_zE12-4fVn8

Don't be discouraged if you don't get blood on the first try. Very few of us did. Three tries and then treats for kitty and bean. Come back on and we will bombard you with hints and tips that worked for us.

 

I started to test on myself and my hubby as well. Good way to learn and experience what I was going to do to my cat.
Oh.. and don't be worried or upset when those ears won't bleed easily. Here sometimes it goes/flows very well and the last day's again it just wont.
I still have all of my 10 fingers though. :mrgreen:

 

That wouldn't work at all here. :lol:

 

I think there is only one meter that tests for ketones in the blood - and the test strips were so expensive that I didn't get it.

Most use the Ketodiastix for testing urine for ketones -- where-in you stalk the kitty in the litter box for fresh pee.

 

This video will show you how easy it is to test a cat:

http://www.youtube.com/watch?v=_zE12-4fVn8

Keep in mind that the meter he's using requires a tremendous drop of blood compared to most modern ones. You can use much less with most meters.

 

Lisa,

Glad to hear you have the meter. I can help you get started testing if you'd like. Sometimes it just helps to walk you through it the first couple of times.

You're making great progress if both cats are happy to eat wet food. Less water consumption is a good sign. Bet the litter box is easier to deal with as well.

I'm close enough, so give me a call on the cell.

Claudia

 

Just another little hint that helped me when I first started testing. Trying to coordinate everything got me all confused and made me nuts. I'd have a hand doing one thing and realize I need that hand for something else, etc. Felt like a pretzel.

So what I finally did (after doing this to myself) was sit down and think through the steps, and where I needed what, and when I would do what. Did a trial run with no cat. Then I grabbed the cat and did a trial run with the cat, like pretending to do each step, except I didn't actually poke him - just went through all the motions. Did this several times til I didn't feel like a pretzel anymore. I also let my cat smell everything and let him listen to the beep of the meter and such, trying to get him used to the stuff. You know how cats have to smell everything (in case the smell changed from 3 seconds ago).

Too bad about the vet. I haven't had to deal with the diabetes in years so I feel behind on some of the current junk, but your vet is more behind than I was 8 years ago! Sheesh. My first clue that he wasn't keeping up with stuff was doing the W/D. That's actually for weight loss. My vet claimed they used it for diabetes when they didn't have a diabetic food, cause most diabetics were overweight. (Except sometimes they've lost a lot of weight and vets were using it anyway.) Most vets can't let go of their precious prescription foods, but "at least" they use M/D these days, which was made for diabetes. (I say "at least" lightly cause it's still terrible food.) He's obviously never heard of carbs.

That 2 unit increase at once is just ludicrous. That whole paragraph from your most recent visit just had me shaking my head. And if your vet won't listen and be willing to go research it himself, he's doing this to his other clients as well.

 

Wow, your experience sounds pretty similar to mine.

If Taz is looking perkier that's a good sign. As well as checking bg's it's good to monitor weight,peeing, pooping, purring, playfulness.

Checking for keytones is important because you have reduced the dose-happy stalking

I hope you can take up Cjleo up on the offer of a phone call. Having someone show you how to hometest takes an awful lot of stress out of the equation and finding a good vet to.

Good luck :smile:

 

WOW. Lot has happened since my last post - I got hit by a car (while Iwas in the crosswalk with the walk light mind you), then got into a car accident. I'm fine and evidently so is Taz.

I took him to my vet when he returned. He wanted to know what I had been doing for treatment and Itold him to just take Taz's BG and then I'd tell him. Needless to say ,the vet was stunned when the BG read 66. I Then informed the vet that I was feeding Taz wet food and had dropped his dosage to 2 units 2x/day. My vet couldn't believe Taz had gone from 471 to 66 in less than a month. I basically responded that the people on this site know what they are talking about because they deal with this everyday so for me it was a no-brainer to follow their advice. I'm very glad that I did and will continue to do so. I'm so thankful to have my happy, playful, pain in the a** cat back.

I have been testing Taz and while 66 was the lowest he's been, Taz has been hovering btw 100 - 110.

Thanks to Claire for speaking with me and offering sound advice as well and providing me with the names of vets.

Thanks again to all of you for your help and wisdom and for this site.

Lisa and Taz

 

So sorry about the accidents, but I'm glad you are both doing well, and congrats on those great numbers! One quick question - are you still giving insulin or no??

 

Yes, I've taken him off for now and I'm monitoring his BG as much as before. I'm still in panic mode when I'm at work.

Lisa and Taz