Newly Diagnosed Diabetes Ketocidosis

Hi there,

I have a very much loved cat called Caz. He's an active little fella with a lot of spirit. For the last two weeks, he had been going off his food, which given he is a faddy eater is quite normal. But I noticed he seemed grumpier than normal, as he is a really affectionate little fella. Then within a spate of a few days, the weight dropped off him, I couldn't get him to eat anything. I took him to the vets, who sent me off with antibiotics. Unfortunately it was over a weekend, as after a day I began to get really worried as he didn't want to move and wouldn't let me touch him. I took him back and despite the vet writing him off because of his age, I insisted on a blood test.

The white cell counts were ok, but his blood glucose was at 26.5 and his kidney test read 17. His blood sample, looked weird because there was all this clear liquid. The vet said it was ok, that all cats had fat in their blood, he just had a lot of it. she gave him a shot of insulin and sent me home, to return 6 hours later for a glucose reading. The next reading for glucose was 17. She diagnosed Diabetes Ketoacidosis. She sent me home with a bunch of needles and some insulin telling me to give him 3 units, 6 hours apart, but just twice a day.

I feel overwhelmed, scared and confused. I have been on so many sites to try and read up to make sure I give him every chance of getting better.

I have been hand feeding him since he started looking really poorly and with perseverance, he has been eating a little. The insulin seems to be working, along with the hand feeding, I think he has started putting weight back on.

He ha always been a grazer throughout the day eating little and often and has always been lean. Never over weight. I have been feeding him Gourmet Gold pate, as it's the only thing he would eat when he was really bad. But since then I have moved him on to tinned salmon, tuna and turkey, with the gourmet gold pate food in addition. He always had a mixture each week of all these anyway. I think the tinned fish helped because somehow he couldn't seem to sense the food otherwise.

My questions are;

1. websites indicate if two injections are to be given, they should be 12 hours apart. My vet insists on 6 hours apart, which is incredibly difficult for me as I live alone and work long hours (some of which I can do at home) but I will struggle to get him an injection 6 hours later. I'll be honest, I wasn't totally comfortable with me vet. She seemed young, inexperienced and at one look at Caz because his weight was dropping wanted to write him off because of his age. Who is correct on the timing of the injections?

2. Is a diet of tuna, cooked turkey / chicken, tinned salmon, tinned mackerel, tinned pilchards ok for him? I have seen on a lot of sites Friskies is recommended. My local supermarket doesn't sell this but I am going to try and locate it. I also need to chuck out anything in sauces, as these have high sugars? Can he carry on having watered down Whiskas cat milk? He doesn't really like water. I know I need a secondary mortgage for all these types of foods, but I'd do anything to make sure he gets better. Can I let him eat when he is hungry or do I have to give him two meals a day only. 1/3 in the morning and 2/3 at night like the vet has instructed? he is a nibbler, eats a bit, sleeps a bit, gets some more, then goes out to play normally.

3. I don't have a home testing kit yet. I am looking at buying one, although it's very confusing to know where to get it from, as there are so many sites on the net and I live in the UK.
He never showed any signs of excessive hunger or thirst. The first sign he looked poorly was turning up at meal times, but refusing to eat anything. Then all of a sudden, he deteriorated very quickly.

I am very lucky, because in the few days I have been at home with him, monitoring him and encouraging him to eat .. he has picked up and put on some weight and I even had a purr out of him. So I know I need to be very patient with this when he doesn't want to be touched or picked up. It's so hard standing back when you love them so much and just want them to be well.

I was wondering, if there were any other signs I can look out for? Do mood swings, grumpiness, not wanting to be picked up indicate he has high blood sugar? How do I know if the insulin is enough? The vet only wanted to see him a week later. Which seems a long time, after diagnosing something that I have been reading about is very serious. Should I get another visit sooner?

4. can I buy the insulin on the net. I looked up to see what the insulin was and saw some companies advertising it at £25 less than my vet charged me, which given I will need a bottle a month, is quite a lot of money.


I am so sorry for this long essay .. I just feel very scared in case I hurt him somehow through my lack of knowledge in all this. I really appreciate any advice. xx

 

Angie, I am trying to get some UK members in touch with you but in the meantime can you please tell us what insulin the vet has started Caz on? As you have already read, shots are given 12 hrs. apart and if Caz has ketones in his urine I am amazed your vet didn't do more for him. Please, please...get a meter ASAP so you can monitor his blood glucose at home. Also, not sure what they are called in the UK but here in the States they are called either Ketostix or Keto-Diastix. First one measures ketones in the urine, second one measures both ketones and glucose. Is there any chance of finding a different vet? If Caz is spilling ketones, he needs medical treatment and I just don't think this vet is up-to-date enough to give the care needed. Please, check back and hopefully Steve or Simon will respond or someone from the UK.

 

Hello, thank you for getting back to me ..

I was concerned about the vet too. I was cross with her attitude about his age as he seemed to get poorly really quickly. I was wondering if he had something happened to him that caused him to be really stressed as I read somewhere this can bring it on.

He is on Insuvet Protamine, 3 units on the syringe, twice daily.

It's been three days since his diagnosis and he has shown a drastic improvement in his behaviour and weight in the last two days. I have been trying him with food to build him back up and get some nutrients in him and he has responded well I think mostly because he trusts me and the insulin must be working. But I am worried in case it is not enough, as I also read, the brain takes some of the glucose, even though the body doesn't which means their organs overload even though the cat can appear to have perked up.

 

Sorry, I forgot to mention. The vet diagnosed it, but I am not sure how apart from the high glucose measurement as they never took a urine sample. She decided given how poorly he was, he would be less stressed at home with me, taking care of him. I have been off work since Wednesday taking care of him. I guess it could have been from the blood test, which had some red blood at the bottom and then a large amount of white liquid sat on top.

 

Angie, did she also test the urine for glucose and ketones? Please do not increase the dose.....he is feeling a little better but adding more insulin without knowing what the 3 units are doing could be dangerous. This is why hometesting is so important. They go to the vet, stress can raise the numbers, vet sees higher numbers, increases the dose, you go home, numbers decrease and suddenly you find out he is getting too much. Usual starting dose is 1 unit 2x a day so he is already at a good dose for a newbie. You do not want to hypo him. A meter will tell you all you need to know when it comes to his blood glucose. As for the diet, I may be wrong but it seems to me it is mostly fish. Fish is high in phosphorous....not the best as a steady diet because it can affect the kidneys. Any chance of some chicken or beef for him? Also, when dealing ketones, part of the treatment consists of getting sub-Q fluids to help flush them out. DKA is where the ketones have maxed out and the blood becomes acidic. If that happens, he would need to be at a 24/7 ER clinic to have all his electrolytes monitored, especially his potassium.

I am hoping someone will see my PM's to them that live in the UK so they can tell you under what name the urine testing strips for ketones is sold and also what meter to buy.

At least he is feeling better which is a good sign but please...more insulin is not always the way to go. Please do not increase his dose right now.

How old is Caz?

 

There is a lot to address with Caz's situation.

I see you're in the UK - we have members from around the world. Some terminology is different though, such as how blood glucose is measured. So I will try to be clear. And I will try to round up some UK/European members who can help guide you with getting things.

You should be able to get ketone test strips from the local pharmacy/chemist to test his urine with. Try to get those as soon as possible. Even moderate ketones need critical care in a veterinary hospital. He needs more care than you can provide at home.

Ketones usually develop due to not enough insulin, not enough food and some type of infection. Did they try to determine if he has any infections? He should be getting some type of antibiotic if he does. They said his white count was OK? Did they get a urine draw and test it for infection, which would be from a urinary tract infection? You can read more about ketones here: http://petdiabetes.wikia.com/wiki/Ketones

Addressing your questions:
1. Every 6 hours insulin dosing is possibly what they would do if he were monitored in a critical care facility, but you should not be doing that at home. At the very least, get the ketone test strips - we can help you figure out how to test his pee easily. Moderate ketones needs critical care - they are life threatening, especially because they can worsen very quickly.

2. Tinned turkey or chicken would be better than so much fish but at this point let him eat all he will. We can worry about the affect food has on blood glucose later. Right now he needs to eat, as not eating exacerbates the ketones. Watered down Whiskas milk? Is that for kittens? Yes, that would be fine. He needs as much water as possible. He is surely dehydrated from the higher BGs, another reason he should be in a care facility.

3. You should be able to get a human blood glucose monitor from the chemist. I'm not familiar with what brands are available in the UK. The human monitor is fine, it does not need anything special to be used on a cat's blood. Only testing his blood glucose at home is going to tell you if the insulin is "enough." More than likely it's too much and that's what I'm worried about too. Please read about hypoglycemia here: viewtopic.php?f=3&t=12626

4. I'm not sure about the UK, but you probably can't get the insulin from the internet without a prescription. Some of us in the States order different insulins from Canada. We used to not need a prescriptions for insulin, but now we do.

I see that Hope has given you some wonderful advice and is trying to help find other members closer to you to help. Hang in there - you are doing an amazing job helping Caz!! Many people would not be up for this challenge. It sounds like you are doing very well for Caz - getting him to eat and here you are asking strangers on the internet if these things seem right and what else can you do!! Amazing! Keep your chin up. We can help. Keep reading and asking questions! Many people here have been through these complications of feline diabetes. Please don't feel so overwhelmed, OK?
:YMHUG:

 

He loves fish, but has a mixed diet of canned meat / fish and lots of turkey / chicken. I've always tried to vary it. He won't touch rabbit or beef.

I would never attempt to give him anything other than what is prescribed, as I work on the principle the vet knows more than I do.

I've been researching meters online and will try and locate one for tomorrow.

I am going to ring the vets tomorrow, because if they have diagnosed this, then I need them to take him in and monitor him by the sounds of things, despite him seeming much brighter in himself. And no, they didn't do a urine test. Doesn't sound like he got the best treatment I paid for (
I am wondering if I need to get a different vet. I go to that one because he is the closest for travelling as I don't like stressing him in the car.
He's about 15 years old.

I just want to say a HUGE thank you for taking the time to read and get back to me on all this xx

 

Sorry, I just noticed your reply.

The vet thought he had infections originally as his temperature went in to the 40's when she took it. So her original treatment was dosing up with antibiotics. But I took him back because gut feel said it was something more. She then did the blood tests.

She gave him an injection on Thursday, which was meant to last in his system for two weeks, which was antibiotics on top of the original one and the tablets I had been giving him. (Wasn't the best giving me ones to sprinkle on his food, when I had told her he wasn't eating, but managed it through using the pate cat food by gourmet).

I am really worried now that him showing signs of improvement is misleading. He's gone from not moving to being up and about more and going to his bowl. Admittedly he doesn't eat much when he goes there, he takes food from me rather than eat for some reason.

I feel really confused .. have I been given bad / misleading advice from the vet?

 

Well, it depends on how serious the ketones are. But I don't think any of us here with all of our years of experience would be comfortable giving our own cats 3U of insulin every 6 hours, no matter how serious the ketones were! At the very least, despite the stress, Caz probably should have been or be on IV fluids with blood glucose testing every hour to make sure he wasn't going too low. Since you are not doing that, giving so much insulin is dangerous.

How much insulin and how often are you giving now? Since he appears to be feeling better, hopefully you went back to giving insulin only every 12 hours. That is certainly safer. But we need to see what level the ketones are. Do you think you can do that? Or have vet do that tomorrow?

From what you describe, they seemed a bit blasé about the ketones.

 

Re: Newly Diagnosed Diabetes Ketocidosis Hullo from Hastings

Hullo from Hastings

Try to get Butchers CLASSIC tins, they are some of the best.

Any other tinned food IN JELLY is OK . The jelly ones have less carbs.

Almost any meat on your plate will do nicely (except bacon and ham, because of the salt in them)

Having said that, ANY food, even fish is better than NO food

Get rid of any dry food and dont be conned by the vet into buying "Diabetic dry" food. Most dry food is 50% carbohydrate. If the ideal food is a mouse, that is only 4% carbs

You can buy glucometers and supplies cheaply at ebay, just look for diabetic supplies.

If you let us know which town you are in, we may find a member who lives close by who can help you with testing.

I will try to get you a Private Message with my tel number, in case you want to talk


Mary, Hastings (UK)

 

Hi Angie ... and greetings from Essex!

We know how you feel at the moment. The initial diagnosis of Feline Diabetes is a very tough time for owners. We have all travelled that path and we know the feelings of anxiety and uncertainty that you are currently going through. You have found the best place to be to get the support and encouragement that you need to help Caz and yourself. There is an active network of FDMB members in the UK and they are a fantastic and knowledgable group. They will be happy to help you, particularly with hometesting. If you could post your location it would help. Please do not post your address ... Just the rough location (Maybe the county) in which you and Caz live.

I would suggest that you get a testing meter from Boots the Chemist. I have a One Touch Ultra and it works fine. You can also get testing strips from the chemist and there are also some cheap deals to be had on eBay but watch out for expired testing strips (Testing strips are the things that you put into your testing meter each time you do a test)

I gave Sweepy two shots of insulin each day and they were twelve hours apart. It didn't cause a problem with my daily routine and it just became a part of everyday life for me, as it will for you and Caz.

Mary has given you some good diet advice. Butchers Classic Cat Food is really good and it is free from sugar and chemicals. It is fairly hard to get but is stocked by all Sainsburys supermarkets.

Home testing really is essential. It can be a life saver as it enables you to make an informed decision about how much insulin Caz needs. I hope that it will be possible for one of our UK members to visit you to help you to get started with hometesting. The home visit was certainly invaluable for me!

I will send you my contact details by personal message. Please call me if there is anything I can do to help or if you just want to share your thoughts.

Feline diabetes is treatable and you and Caz will be OK. I can see how much you care for him from your post and commitment from an owner is the biggest asset that the FD diagnosed kitty can have.

Love

 

If your vet has diagnosed Ketoacidosis and not taken Caz in for emergency care, then you need a new vet right now. Ketoacidosis is a diabetic emergency and needs round-the-clock vet care until it's fixed, or you're looking at a pretty high mortality rate.

Either your cat's fine and your vet's wrong, or your cat is in DKA and needs an emergency vet now. Either way you do need a new vet.

Please read up a bit on DKA and you'll know what to say to the next vet:

http://petdiabetes.wikia.com/wiki/Ketoacidosis
http://en.wikipedia.org/wiki/Diabetic_ketoacidosis


As for the long-term care, your vet seems to know about the first problem of diabetes (getting glucose into the cells) but not the second problem (keeping blood sugar low and level). (Hence I don't agree with you that the vet knows a lot.) You need to do both to keep your cat healthy, and the second requires knowing the behaviour over time of your insulin. And food. For that we'll help you get monitoring blood sugar as you would with any human diabetic, and keeping blood sugar level.

Stay in touch, plenty of us in the UK can help!

Steve

 

Thank you everyone for the wonderful support, private pm's and great advice.

An update is, I took Caz to a new vet first thing this morning.

She looked at the blood test the other vet had taken and told me she didn't think Caz had Ketocidosis, given no urine samples had been taken and the results of his other blood stats (potassium I think) which were ok.

She took his temp and that is back to normal so the antibiotics are working and also took his blood glucose, which was 24.5. I found this worrying, because he had his injection about an hour before and wouldn't eat this morning. But the vet said the insulin is slow release reaching a max in 5 hours, which coincides with what I have been reading up on the Insuvet.

He is going in on Friday for the day to the new vet, she is going to do his glucose curve for me. She checked him over and said that given it had only been three days, he seemed like he was doing well. The vet also confirmed that 3 units, was ok for initial treatment to get the glucose levels down.

My Dad is a diabetic and has a one touch meter, so he is going to come over and help me until I get one sorted.

I think my initial vet, needs a letter from me, firstly pointing out that just because a cat is older, doesn't mean she should write him off and to study a bit harder on diabetes, given she knows bugger all about it

So far they charged me £350, out of it I got a load of stress and heartache from thinking he had the Ketocidosis and that me not insisting he stayed in could be killing him. I felt wretched last night when I was reading the feedback.

Thank you for the tip on butchers classic, I shall be locating some tomorrow as I have a Sainsbury's in a local town.

Caz is grumpy today, but poor little fella has been prodded, poked, long car ride .. and high blood glucose, and a thermometer in an undignified place, so I am lucky he is still talking to me I guess.

Thank you all so much for you advice and help. xx

 

Thank you to the UK contingent for hopping aboard! You're in good hands, Angie.

I'm sorry if anything we explained last night scared you. Ketones are scary and the vet just didn't seem to be on top of things for you. As you now realize. Good for you for getting Caz to a different vet who is more helpful.

About the glucose curve - if you get a monitor, there is no reason you can't conduct it yourself at home! Friday, as they have scheduled, would be a good day as that's after a week on insulin. But if your schedule would permit you to do it on Saturday, no reason it couldn't wait another day.

The reason we recommend doing curves at home is because the stress from being at the vet's will raise their results. Hence, the dose they arrive at could be based on inaccurate numbers (meaning he won't be that high when at home) and too high. Does that make sense?

If you go through with the vet curve, please keep that fact in mind. Good luck! You've done a great job so far and will get the hang of everything soon enough, though I'm sure it's upsetting now.

 

Hi Angie,

I'm British, though presently live in Germany.
I'd suggest reading up on the insulin your getting-not sure if it's a new one? Steve/Jock may be wise on that.
You need to know if it is definitely a slow acting insulin, then you work out when it starts working in Caz (called onset), when it has most effect on bg (nadir-the lowest bg number you will get in 12 hours)

Insulin is given every 12 hours if slowacting. Don't want to confuse you but some people do dose more frequently than 12 hours (like tid,3x a day) but not very common and as you've said not compatible with someone who works.

A note on the food.
A lot of cats aren't massively fond of Butchers. I would suggest (and your lucky, you get Sunday shopping! :mrgreen: )get 1 or 2 tins of butchers.
Felix 'as good as it looks' pouches (3.4% carbs so nice and low)
Tesco's do an own brand (I'm not at home so haven't got my list but will post later)that is also low.
Even the Felix tins in jelly (gravy foods are much higher in carbs) are just over 8%

The only thing with this. What food are you giving Caz at this moment in time?
Sorry, you've listed. Can you list the ingredients-ash, meat etc. Can then work out roughly for you what % carbs is in the food your giving Caz right now.

Your giving 3u twice. The insulin works on these carbs.

If your giving say 20% carbs in his present food, and then switch to say Felix, 3.4% his carbs is significantly less and bg would be lower. You then have the concern that you could give him too much insulin and drop his bg too low.

Sorry it's hhard to explain this.

Example.
Lucky was on dry food. This is usually around 40%+
She was 457 (US numbers so would divide by 18 for UK equivalent)
I took her home. Switched to Felix in the tin jelly. One week later (no insulin at all) her bg was 254

So you can see just by switching food her bg came down significantly.

I used one touch. Great if you can use your dads.Ask if your not sure on how to test Caz (we tested Lucky's ear)

Then as someone else said, Ebay is cheapest for strips. If your dad hasn't got a spare meter he can lend you, then Boots or any pharmacy will sell them, but can be quite expensive. I paid around £30. Yet got another one touch off ebay for £5. I don't think you want to wait for one.

Lucky was 15 when diagnosed and we had the same response to treating her. Lot of cats I've seen on here have lived up until their 20!
Sadly I had not very good vet source, but did at least have an extra year, so definbitely worth it if your willing to get yourself into a routine and make the effort. I'll nevr regret doing it.

This board was definitely a lifesaver as 1st vet o'd on 1st shot of 5u!
Everyone from all over world will help you.
Brill thing is it means someone is around 24/7 :mrgreen:

Keep asking questions and no q is a dumb one.
Have you said what county your in?
Good luck :mrgreen

I'm quite happy to ring you from here, though I see you've had offers. Let me know if you do.

 

D'oh! just seen your in Lincs.
Shame I'm not in Uk would have been down the road! Sos.
It will be ok, honest. I had no-one and we did just fine with the power of the net! :mrgreen:

 

Via a Google search, Insuvet Protamine insulin is a 100% bovine, protamine zinc insulin of U100 strength. Like others, I consider three units twice daily is too high.

 

Thank you Simon, Steve and Mary....

for responding so quickly to Angie.

Angie, I was so glad to see your post and to know you took Caz into another vet so quickly and relieved to know Caz does not have ketones. As to a curve, as Vicky wrote, you can do one at home on Saturday and save some money and avoid vet stress. If you do bring Caz in for that curve, please ask the vet how she gets the blood for each test. We all do a little stick on the edge of the ear for a small drop of blood for our meters. I would really want to know what the vet does. What truly makes me annoyed at that first vet, aside from the lack of advice and help, was basically just doing the minimum for Caz because he is "old" cat(2)_steam

You are doing great and please rely on others to help you when needed. Looking forward to updates from you and Caz.

 

Hometesting links........

viewtopic.php?f=14&t=287 Everything you need to help you hometest, Angie. Remember one thing....it DOES NOT hurt the cat. It is just the edge of the ear but cats are great actors and there are times that fear from the human affects the cat. Watch some of the videos and you will see for yourself.

 

As promised info on the other UK cat foods:

Tesco premium cuts in jelly pouches (chicken, tuna, salmon and prawn, rabbit and turkey) 8.2%
Tesco finest succulent chicken breast collection pouches 1.1%
Sainsbury's pouches in jelly 10.5%
Kitekat and rabbit in jelly 14.3% if you start hometesting it's good to have some higer carb foods if kitty's bg drops too low for comfort. This is like a mid carb food)
Oh so meaty chicken pouches 4.4%
Butchers classic fish and meat selection is around 8.8%

If you say what:
protein
moisture
fat
fiber
ash (if listed, sometimes it's not)
amounts are on the food your giving, I can tell you roughly what the % carbs that food is.

Whiskas MMM was around 1% too but they seem to have stopped making it.

One easy treat to give after testing and/or giving shot is just a couple of shreds of fresh boiled chicken (carbs pretty much non-existent)

 

Thank you everyone for your amazing replies and lots of info .. Caz sends a big furry hug to you all too!

I am struggling enticing him with food at the moment, I have opened Pruina pouches which are 60% meat apparently but the one thing he will eat is strong smelling fish, or Gourmet Gold Pate cat food; which to be honest when I first read about carbs, I thought I had been feeding him the wrong stuff, but it's 80% moisture so maybe in a way, it helped him when he was at his poorliest (Is that a real word!?!)

The composition of gourmet gold, his main thing he wants to eat at the moment is;
8.6% protein
4.3% oil
2.5% ash
0.1% fibre
80% moisture
3mg / kg copper.

Can someone tell me if this is safe for him to keep eating this? He won't eat Felix, never has liked biscuits. He's really funny, he will eat only if I hand feed him, which as a vegetarian is a real treat for me having pate smeared all over me I'd do anything for him though.

I know some of you are still saying 3 units is too high .. I don't know what to say to that except the vet has told me it is a suitable dose given him reading was still in the 20's today, 24.5 original diagnosis 26.5 and they need to get it to a more manageable level. At the moment, the vet has assured me he is not in danger of going too low and he is having injections 12 hours apart to the second. (I have glucose / syrup / honey and evaporated milk on standby, my Dad has his meter if I see any signs that I make me think he is slipping down .. he's probably quite fed up with me watching him every time he moves).

I understand what you say about the vets and stress, but I want them to keep him for a day, because I am going to get them to check his ketone levels and give him another thorough examination. Because all of this has come on really quickly and I am worried in case something else is going on, the other vet missed, although I guess his blood stats would have shown that.

Thank you again everyone, you really are an amazing bunch of people, but then I already knew that because you are all crazy about animals and cats xx

 

Re: Newly Diagnosed Diabetes Ketocidosis Oh and I forgot

Oh and I forgot

HYPER is too high blood glucose

HYPO is too low b/gs and is much more dangerous

Sometimes a HYPO can be spotted by changes in behaviour. Jazz Cat had to sniff his way around as he didnt recognise his home.
Katy tried to climb up the wall shelves for no reason. Both were confirmed by blood tests and recovered quickly when given glucose.

The best "first aid" to keep in your cupboard is a box of glucose powder (cost about £1 lasts forever) You can rub it on the gums or dissolve it in water and squirt it minto the mouth with a feeding syringe, but I expect your Father has told you already!

Also ask Cats Protection for their diabetic list You may find someone quite near you. However not everyone on their list has the knowledge we have accumulated on this board

Mary

 

Something else you might try to help get him to eat is warming his food a bit. You said "strong smelling fish" is one thing he loves, so maybe he really needs the smell to whet his appetite or something? Anyway, warming up non-fishy foods might get him to eat something other than fish. Can you get tuna flakes there? They stink pretty bad, maybe a sprinkle of that over regular low carb food? It sometimes works on my picky civvie girl when she's being a princess about food offerings. It's been a long time since I've used baby food but I wonder if it smells (the all meat kind) when warmed up? I use hot tap water to warm up food for our crew, I like the extra hydration for them and I like it better than microwaving. Micro will do if I'm in a hurry though, just a few seconds at a time in mine does the trick (stir well to avoid hot spots.) My cats will drink hot water from a bowl (or used to when they drank water from bowls) or from the bathtub as it's filling for my bath though so maybe they are just freaks. :lol:

 

Re: Beware baby food!

BEWARE BABY FOOD

Although we recommend it for cats that wont eat, you MUST check the ingredients!

IN UK the baby food manufactures have taken salt out of their recipes and substituted ONION powder instead

ONION is poisonous to cats and can cause severe aneamia

It is now nearly 11pm, so goodnight!

Mary

 

Hi again,

I'm basing the oil as being the fat content.
The bad news is this food is approximately 23%-this would be classed as a High carb food that you might use if needed to get kitty's numbers up to stop them crashing.



The composition of gourmet gold, his main thing he wants to eat at the moment is;
8.6% protein
4.3% oil
2.5% ash
0.1% fibre
80% moisture
3mg / kg copper.

Can you try any of the other foods I mentioned? (Other than Felix)
Warming food for about 10secs in microwave is something I did sometimes.
You can also try sprinkling a smidge of parmesan on top.


I see what you have said about Caz's numbers but a 22 is 396 in US numbers.If a cat is given too high a dose it can cause something called somygi rebound. If there is too much insulin in a cats system, a life saving response kicks in.The body releases glucagon to get the bg's up. Next time you do a reading, get a high number and so again administer the same dose and the cycle continues. Cats body could go on like this for a short/long time and then suddenly will give up. As every cat is different, you can't know which one your cat is.
I understand you want to take Caz to the vets for a curve. It may give you something, but the only way to test for Somygi is by cutting the dose and monitoring.
You shouldn't do this iuntil you have tested for keytones and know there are no other underlying health issues.

As for keytones, you just need a chemist (Boots/Llloyds) and ask for 'Keto diastix'. There just strips. You then pop them under kitty whjen having a pee for so many seconds. Compare the colour on the strip to that printed on the chart of the bottle.


If you want to wait,you could look at trying to win a meter off ebay as much cheaper than pharmacy.
It is more work hometesting but definitely better for overall diabetes management.
Good luck :mrgreen:

 

Welcome AngieB & Caz! It's very nice to meet new folks across the pond.

 

Hi there Kate,

Oh blimey that's really high. I am struggling getting Butchers classic, but have found that Pets at Home sell it online so will order some from there.

Caz has never liked Felix .. so I guess I'll have to mix chicken or tuna with it to get him to eat it.

Could you tell me how to calculate the carb content. I have been searching online tonight for new food and none of them give the carbs.

Thank you so much for your support
x

 

Hi Angie,

did you see the other UK brands I listed? Tesco/Whiskas?
You could just try 1 pouch of the Felix'as good as it looks' Is meaty chunks. Lucky preferred it to the Felix in a tin.

To work out carb content (quite entertaining on the cat food aisle-Being there with my calculator and getting some very funny looks :lol: Just smile away....

This is only approximate as I think pretty mush all UK brands give approximate values as they can vary slightly from batch to batch.

Want under 10% (under 5 even better, but bear in mind your giving 3u twice a day and using a cat food that is around the 20% mark which will mean Caz is starting out with a higher bg for the insulin to work on-don't suppose there's been any change there?)

Get values for:
Protein
Moisture
Fat
Fibre
Ash (if listed)

add up, then subtract from 100

This is your wet matter carbs. However, when comparing foods need to do on a dry matter basis.

So eg

78%, 11.0% 5.%, 2.0% and 1.5%=97.50%. Remainder 2.5%. That's your wet matter

to get dry .Take 78% (%moisture in this example) from 100=22.take your wet matter number (2.5in this example) and divide by the moisture subtracted from 100. In this case 22
2.50 divided by 22=11% carbs on a dry matter basis. (so slightly too high)
Hope this isn't too confusing for you!

Your initial aim is to get Caz under 250 for as much of the 24hr day as possible. This is generally considered the renal threshold. (the number at which kidneys are being over worked)
Then from that point your trying to get Caz into non-diabetic numbers for as much of the day as possible (this is where your tweaking and monitoring of dose comes in and gets kitty what we call 'tightly regulated')

Just ask away if anything else.
Good luck and happy hunting :mrgreen:

 

Thank you .... :-S I think I got it

I've just put an order in for cat food, that you have suggested .. the delivery man will think I have 400 cats lol as I have ordered a few of everything to make sure there is something I can tempt him with that is good for him.

I've also bought some chicken breasts to give it a go cooking and shredding, that should be fun eek! Amy my other little cat, she is loving it, it's like a banquet of different things to try each night lol.

I am sure he'll get used to the other varieties, he's a fuss pot and has a strong determined nature, but tuna always wins him round so a few flakes on healthy stuff should do the trick

I had a few purrs out of him tonight

Thank you again

 

Update. Today went badly for Caz and I feel really let down again by the new vets.

I dropped him off this morning at 9pm with his food / insulin etc. At 11am I called to see how he was. They said he hadn't eaten and was quite stressed. So I told them I was coming to get him. They insisted he would be ok, that they needed to carry on the tests and said to call back in 2 hours. When I went to fetch him, I found out they had only managed one blood test throughout the whole day! Apparently they couldnt draw it from his front paw. He was in a terrible mess when I got there. He looked really poorly. He hadn't eaten all day and his blood glucose was at 3.5 The seemed scared of him because he swore at them and was grouchy (normal behaviour I would have thought, after being prodded and poked!) and also I would have thought they would have been trained in managing this?

I talked to him all the way home because I was really worried about him and didnt want him falling asleep, he kind of likes it when I talk soppy to him. As soon as I got him home, he happily ate when I gave him some food and seemed to transform before me back in to Caz.

I feel so guilty that I trusted the vets to look out for them. But I am wondering if any of them know diabetes and how to manage it. The advice I have been given today again has left me loosing the will to live. Apparently it doesn't matter about the carb content, as long as his food is consistent. ie, feed him just cat food, not chicken or tuna etc. She said the important thing was for him to eat. That otherwise cats would starve themselves. I said, no, they would probably hunt for food, at which point she said, precisely and you can't tell if they bird they eat will have high carbs/fat content... I get they shouldnt have foods that give them big swings in their glucose levels.

It seems to me, vets give random, dangerous observations not based on fact. I have a meter, so I am going to attempt a glucose curve on Monday.

Caz is sleeping at the side of me peacefully and I am so relieved to have him home.

 

Sorry forgot to say, the vet tested his blood today for Keytones and they were negative.

I also have to take him back in two weeks for a glucose test that tests stored levels in the body, less invasive.

 

Yeah, you'll probably find more useful information on what food to feed by simply testing blood sugar yourself (from the ear, much easier than from the paw). Vets don't usually have nearly the day-to-day experience with diabetic cats to know what foods make blood sugar swing round and which don't.

We do, though!

 

Well I find that amazing! Because we are paying them for professional advice and trusting them.

If people don't have access to the net due to funding etc, they are harming their animals.

I admit, I am not happy about pricking his ears for blood, as he has always been sensitive there. Usually Caz is ok at the vets, but I won't be leaving him there again.

 

I thought my Yittle was going to be a terror and a half about home-testing. But no.. as long as I remained calm, or at least faked it, he was fine. I started out by spending a good couple hours just clicking the lancet pen around his ears without pricking him and while petting him and feeding him treats. Then I would press it against his ear with a bit of tissue held underneath just like I would if I was lancing his ear and click it (again minus the needle). And then we went for it - and he was fine. By the time he went into diet-controlled remission he was asking for his blood tests, running in advance of me to wait for me to give them (and his shots) and was even known to fall asleep during testing time, while I was doing it. I can safely say that it doesn't hurt them nearly as much as it hurts you if/when you miss and lance your own finger. And we won't talk about the couple of times I ended up with a partial dose of insulin myself (blush).

If nobody else has suggested it - you can try the warm rice sock massage method. You take a sock and fill it with a fist-full of rice and then knot the top. You microwave it in 15 second spurts (I flip it between nukes) until its warm to the touch but not hot. Then you use it to massage your cats ears to a. help relax them and b. make the blood flow easier when you test them. Yittle loved his rice-sock ear massages. He's been known to ask me to test him now that he's off insulin just to get them. If you make testing time a time full of love, cuddles, positive reenforcement and special treats it will hopefully go easier. That being said, some cats always hate it - but its usually more about being told to hold still and do something then the act itself. Also - if you can get a little petrolium jelly (Vaseline here in the states - not sure about UK), it helps to wipe a small smear on the ear you're going to test and then wipe most of it off. It makes the blood bead up better to get a sample and it helps keep the ears happy.

 

I'm sorry that Caz had such a rough day. It sounds like they were trying to draw blood the usual way, through the leg, which is unnecessarily stressful for blood glucose testing.

You can also test via the paw pad. See these pictures and explanations: http://www.uq.edu.au/ccah/ppt/homemngmntslides.pdf

It is a 6.2MB pdf file so takes a little while to load. It includes both ear and paw pad testing, so may help you with either location! My only comment about the ear testing is the explanations and pictures don't stress using this particular area:


After you're practiced at it, you can do areas further up or down the ear, but the "sweet spot" is preferred for beginners. And warming the ear really helps too.

 

Hello,

Thank you for the posts on blood testing .. I am going to give it a try tonight and the post has really helped. I have downloaded some instructions also. Although not sure I can manage every 2 hours, but I am giving it a go next weekend. Until then I will try for morning and evening. I've been trying to get him used to the sound of the pen, before I actually attempt a reading.

He seems to be okish, wanting to be held a lot thought lately and a few purrs, although my other cat Amy seems hell bent on annoying him. I was hand feeding him after he didn't have an appetite this morning and she jumped on him. I guess cats get green eyes too.

I have been researching all the various cat foods I have bought lately to see if they are ok for him to eat as I realise even though he likes fish and chicken, he needs cat food too. I can't get him too interested in any other types of food at the moment and believe me I am trying with this. I liquidised some tinned mackerel in with some felix and he still wouldn't eat it.

I am not sure I picked up the calculation properly, as some of the analysis shows compositions of >100%

Example;
Gourmet Gold Ocean Pate Fish
Protein 11.0
Oil 7.0
Ash 3.0
Fibre 0.1
Moisture 77.0
98.1
Total 100.0
Carbs 1.9
23.0
Carbs % 8.3%


This is the food I mentioned earlier he loves, I know it's not under 5% but would it be ok for him to have a little to stimulate his appetite?


He really likes this next one, but I am confused because the numbers are negative?!!
Gourmet Solitaire Tuna with shrimp in Jelly
Protein 15.0
Oil 0.5
Ash 1.5
Fibre 0.5
Moisture 84.0
101.5
Total 100.0
Carbs -1.5
16.0
Carbs % -9.4%

I have some coming out at zero, example Tesco Finest Succulent Chicken Selection and 4% for felix as Good as it Looks, Chicken in Jelly and Tesco Kitten Premium Cuts in Jelly at 2.6%. I have a few others to analyse .. but I won't until I know if I have the wrong end of the stick .. the negatives have thrown me.

Thank you for anyone that can help.

 

Hi Angie,

sorry I have been in the UK for the w/e! with no internet access (rare but does happen! :lol: )

It's a bit late here so not a good time for me to do the maths but I will as soon as I get to work tomorrow.
The 8.3% (think thats the no you gave) is fine. Under 10% is a good starting point.

My offer still stands if you'd like me to ring and talk anything through (I'd give you mine but be expensive unless you get free calls?! )
If you think it might help just pm me your number. I am coming back to UK (near you) but not till end of July and think that's a tad too long.

Some people do test their cats paw pads, but I've picked up these seem to be particularly placid cats (also one who tests her feerets paws!).
The ear is the best way I think. Clicking the lancet around Caz is a great idea and what I had to do. Lucky was a particularly fractious cat, but once she understood what I was doing made her feel better it becae extra loving time :mrgreen: (there was the odd moment of Satan like behaviour for various reasons, especially if I was doing a lot of testing or she was having a particualrly nice sleep :roll: )

The vets in the UK seem even less educated than the American ones (sadly) The only other thing you could try is ringing around any other vets within the radius your happy to travel and throw some test q's at them to see if they have any knowledge/ It's not their fault really. If you think how many species of animal and then the inherent diseases, your talking thousands of things they need to know.
This site was indeed the only place we got real help and I educated the vets we ended up working with (no. 4! and still they didn't take everything on board)

Get some fresh boiled chicken down Caz if you can, that's lots of protein. 3.5 is way low (x18) and that is what peeps are saying about testing-don't know how long this was after the shot?
Caz will feel that bit more crappy as well if his?/her? bg is swinging from high to low.
Don't worry your on the right track and so much you can learn here.

 

H Angie,

thought there was something missing in your figures.

Have you got the fat content for each one? That I think is why your numbers are out.

 

HI there,

I took the oil content to being the fat content?!??? Is that right?

I did his first reading today, 6.3 when I got home from work (managed to shoot it in my finger first because he twitched his ear ). He didn't seem to want to each much this morning, so was worrying about him all day as he seemed moody yesterday. But tonight, he is wanting to be out watching all the birds in my front garden .. so I am guessing he is coping ok.

About to do his second reading today in a moment, to see what his level is before his injection and about 2 hours after food ..

I guess I am frustrated with the vets for giving inaccurate advice, not for not knowing .. and also because I want them to help me give Caz a good quality of life and for my own selfish reasons so I have fur face around for longer, because I love him so much. Sure is a rollercoaster of emotions this diabetes diagnosis.
Thank you for all the advice. xx

 

Just took another reading (finally after naffing him off with my bumbled attempts) and his reading was 8.0

I am using a Freestyle meter, the vets say this isn't as accurate as a feline one, but a lot of websites say these are ok. Does anyone know what the tolerance level might be?

 

Hi,

from my workings;

ocean gourmet (1st one) I make to 7%
The figures should not be above 100, so not sure how to work out the other one accurately.

Tesco finest chicken breast with duck=1.1%
Tesco premium cuts in jelly=10% (according to the pack I have here. Though I know I quoted 8.2% from the old figures I have)

If it only says oil then yes I guess this must be the fat (on the tesco it says fats and oils)

6.3-how many hours after shot was that? That is 113, pretty low and could mean Caz was much lower at peak/nadir.
Interested to hear what your pre shot is.

 

The > 100% had me confused too .. I wish they would just add it in to their analysis. I will re-check my calc, seeing as you get different results.

He has an injection about 8.45am and 8.45pm.

He grazes all day .. mainly about 4 times. Eats a little sleeps, eats a little.

At 6pm he was 6.14 he was 6.30, I then put some fresh food down and he had some. I then took another reading when I made the last post and he was 8.0. I was surprised his reading was low as I noticed that half his water bowl had gone, which is more than normal. But maybe he peaked during the day? Although his insuline Insuvet is slow release, max about 5 hours after injection.

I will do a full curve on Saturday, if he still loves me enough to come home after I have perforated his ears this week ..

Be really interested to know your thoughts..

 

Hi again,

great job with the hometesting.
You have an ally in Sally Brighton, she too is UK and using same insulin. It's sounding like PZI but I'm not positive and not an insulin I'm familiar with so you could educate me and others if you have any more info about it (uploading a pic of the box could help)

If peak is around 5 hours that's pretty good and close to Lantus and Levemir.

This is the glucose conversion for mmol to mgdl (for the benefit of Americans/Canadians and me as I'm so used to these numbers now)
http://www.felinediabetes.com/bg-convert.htm

8.0=144 that's still low and a non-diabetic number
6.3=113 a very low number-was this your preshot? Without having a lot of data, you would delay shot and consider giving a reduced dose. Anything under 50 is too close for comfort with hypo.
Doesn't match with the water, that would suggest still excreting a lot of glucose in his urine.

Can you post any numbers you have, when they were taken in relation to shot time and food being given.
I'm unlikely to be on the board tomorrow. Maybe start a new thread and ask for people's thoughts on the numbers you have.

Are you still giving more than 2u twice a day? This may be too high-hard to say without the info requested above.

Reemmber lots of cuches and he'll come back for more pokes+ :mrgreen: treats!

 

I only started doing home testing yesterday,

8.30am in the morning I gave him his first injection of the day, 3u of insuvet protamine zinc slow release, left lots of different food out to see if he would be temped. He didn't eat much before I left for work.

In from work, 6.14pm tested 6.3 then fresh food, which he ate. Noticed on changing water, quite a bit had gone, but not an awful lot of food had disappeared. Was a bit aloof, which is how he was when first diagnosed.

Further test around 8.45pm when I gave him his 3u and his test was 8.0 (reading done prior to injection), fresh food put down before I went to bed. Not much water had gone and a lot of the food was still therein the morning.

Tested 8.30am this morning, result was 7.0 Gave him his 3u and left lots of food down. He is grumpy, although he is being an Angel, at my prodding him with needles, I think he is fed up. He went out with only eating a few teaspoon fulls of food. I left lots of different types down for him to try during the day.

I know his habbits, he grazes throughout the day, never gorges his food. So this doens't unduly worry me, although i would have liked to see him eat more before I left.

His results are surprising me, given on diagnosis he was 26.5, which he then went to 17.5 I think, need to look at my diary on the same day diagnosed. Two days later he was at 24.5 at the new vets and now these results. I am actually a little relieved that his results are low but not sure it stacks up with his moods as he is normally so affectionate or the water drinking yesterday. I guess I'll know more on Saturday when he has a day of me taking the tests. Also wondering if the resutls are because he is not eating as much as in the last few days.

 

Angie

Please note I have not been following your thread closely, but giving 3 units of PZI at such low numbers when first starting out is very dangerous. Yes, you have to make sure that you don't invite ketones back, but now you have to worry about overdosing and rebound. Usually the cutoff is 11.0 for dose/no dose/reduced dose....

 

If I could add, this general rule is for PZI insulins. Lantus and Levemir can be given at lower BG levels.

 

Yes, thank you. Better still, this cutoff is for beginners who don't have testing data

 

It's the dose the vets told me to keep giving him .. I feel a bit confused about all this. Is the insulin just balancing him out as it's slow steady release during the day? so that his blood sugar returns to normal levels, which I understand is between 4-9.

The other thing is, how accurate is my freestyle meter? the vets tell me it can be up to points out because its not specifically for a cat.

I'll call the vets tomorrow .. I feel really worried about all this, I don't want to harm him. The vet told me the 3units is a small dose, but everyone on here tells me it's a big dose.

I am going to take his next test around 8.30pm when he should have his next injection. Do I give him less? 1 unit ? 2 units? none?

He hasn't eaten as much in the last few days, he wants to be outside watching the birds, so I am wondering if this is bringing his glucose levels down, he also seems to me like he is loosing a bit of weight again. I am wondering if he needs another full blood test. It's another week before he has that test that determines his average glucose level. Not much of his water had gone today when I got home from work.

 

Your vet's advice doesn't help if his blood glucose levels are close to normal. 3 units may be too much at these lower levels, which is why we push hometesting so much! Section 4.9 of the faq discusses what to do with a lower than usual preshot number...you can give the same dose, reduce or skip. With a cat who has a history of ketones, it is a delicate line to walk. If you are injecting and then leaving for a long period of time, giving a very small dose at 7.0 would have been a better idea (very small meaning 0.5 units).

It is also important to test inbetween shots whenever you can in the beginning, as you need to know how low that insulin is taking him. Idealy you would have data to tell you whether injecting at 9.0 is safe or not...

I know this is scary and confusing, and conflicting advice doesn't help, but we're trying to help you balance everything...

Jen

 

Sorry, to address your questions

1. freestyle is fine. It tends to underestimate at higher numbers but that doesn't apply here
2. next preshot test and shot - I'd suggest giving a reduced dose if at 11.0, and skipping or giving 0.5 if 7.0. You can always retest in an hour and see where things are.
3. you do not need a fructosamine, you need to test at home and see where things have gone on a daily basis....

Does this make sense?

 

Hi Jen,

I am testing at home for the last two days. About to do his next test now. I am going to do a full curve on Saturday.

His insulin is slow release, onset 2 hours, max 5 hours, so it won't be until much later I will know if it's too much or too little.

Thank you for taking the time to give me some advice, when i said I was confused and worried, it's not I don't appreciate your advice I am just terrified of doing the wrong thing and harming him.

He is off colour again today. Grouchy and not wanting to be picked up, so it will be interesting to see what his reading is.

Not sure what fructosamine is, will google it.

Thank you x

 

I just tested him and he was 6.1

 

how many hours post shot? If you can do some more spot checks to see how things go......

 

That would be 12 hours since his last insulin dose this morning.

Last night he was 8.0 at this time, this morning 7.0 and tonight 6.1

Is it the insulin is working and keeping him at the right levels?

 

Please do not give him 3 units!

Yes, the insulin is working well! But 6 is a nondiabetic number (108 in us measurements), and you do not want him going lower than 2.2 and since you do not know how low he is going inbetween shots, I would hold off. I honestly think that a big dose reduction is in order, and that you need to consider a cutoff if somewhere around 7...and that is just a guess.

how about testing again in an hour and seeing what happens?

 

Hi - I can emphathise with where you are at with a newly diagnosed cat, my vet advised only on injection of 2 units a day to begin with, use observations on mood, urination, drinking and eating and then review in a week, no testing. Reading all the information and with high anxiety as to will there be a hypo or hyper event is enough without learning more, I am hoping to start some home testing myself at the weekend when i visit the vets (not with the cat) meanwhile I have been advised here that the insulin I am using will not last 24hrs as suggested and not really understanding all the different types and their benefits, but.....it seems it us unclear whether Insuvet Protamine Zinc is a PZI insulin (I think this is the same one you have?) So for the benefit of those helping us learn I am going to try and add some photos of the packaging of mine.

Good Luck

 

Angie,

not sure where your up to.
Did you ring the vets today?

All human meters have about a 20% variance. The difference between them and the animal one (if that is indeed one your vet uses) isn't huge either.
What you do, is be consistent with the meter you use (you should do a control test about once a month to check the meter and strips work within the range. This is stated on the side of your strip vial). As long as it is, your fine using that meter.

Do you have any numbers you can post?

What you would do is something like this:

amps (morning pre shot) 300
+2 280
+4 200
+5
+6 (you do them closer together around the time you think the insulin is working it's hardest, so you can work out when nadir/peak is in your cat. On Caninsulin, Luckys was around +4. On Levemir it was almost bang on +6) These numbers and your pre shots will be your guide on dose.

I don't remember you saying kitty has had keytones? Has he? This is important to know. As others have said it means you need to be more careful with your dosing.


I note you say kitty is on and off grouchy. This sounds like swings in his glucose levels. Can make kitty very grouchy and crappy. Same goes for human diabetic. Can't remember if it is yourself whose dad is diabetic? If so ask him.

The insulin builds up in the system, probably why the reduction in numbers.What you can get is symogyi rebound.Too much insulin, bg drops like a bomb. Life saving response of kitty dumps glucose into it's system to raise bg. Next time you test, high bg, 'oh ok this dose is ok' and so the cycle goes on, or worse still, keep increasing the dose. In actual fact what should be doing is reducing it.
Are you still feeding dry or have you changed it?
The spot checks really will help beans advise you and hopefully give you some peace of mind.
The pics from Sally do make it look like PZI-Gonna try and check.

 

Hi,

not seen anything fro you guys in a few days.
All ok?