Newly diagnosed in Australia

Discussion in 'Welcome to the Group - Post an Introduction Here' started by CarolynE, Jul 21, 2015.

  1. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Hi folks, my name is Carolyn, and my cat Martian has just been diagnosed with diabetes. He's nearly 15 years old and otherwise healthy. He has high glucose but no ketones in his urine.
    We live in Victoria Australia, and I'd be particularly keen to link up with other Aussies here.
    We will be starting on insulin next week and I'm very keen to switch to a high protein low carb diet before we do, since from what I've read that's better than waiting in terms of figuring out dosage and reducing the possibility of hypoglycaemia. But Australian pet food brands and labelling are quite different to the US and I'm having trouble figuring out what to do.
    My vets don't have a lot of experience with diabetic cats, so the more info I have the better. (I will post this stuff to the relevant boards too).
     
  2. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn and Martian and welcome to FDMB.

    I live in Sydney. You will find this board very helpful with loads of good info and guidance with how to manage diabetes.
    Here is the link for some of the food in Australia. Just scroll down the page until you come to the food in Australia bit.
    http://www.felinediabetes.com/FDMB/threads/food-links.133016/

    Also if you could set up a spread sheet for Martian it will help people see how he is responding to the insulin.
    http://www.felinediabetes.com/FDMB/...te-a-ss-and-link-it-in-your-signature.130337/
    If you run into trouble setting it up just let us know and someone will help with it.:)

    If you can tell us what Martian weighs, and the insulin he is going to have that would be very helpful thanks. The best insulins here in Australia are Glargine (Lantus) or Levemir.

    If you are not going to start insulin until next week it would be really good if you could swap over Martian gradually to the low carb, high protein diet before starting the insulin, as you said. It is much safe that way. Canned food only . No dry food at all. It is not necessary to give the prescription diets from the vet. They are expensive and many of the over the counter ones are just as good.
    Ask lots of questions, we are here to help.
    If you can test the blood sugars your self, it will be much cheaper and you will be able to keep Martian safe. I have an Abbott Optium glucose monitor which I bought from the chemist. It was about 40 $ I think, I can't remember exactly how much. The strips are expensive from the chemist but they are much cheaper on EBay....I can help you with that ...just let me know. If you want help buying a monitor just send me an alert.
    Here are two other Aussies, I will send them alerts . They may be able to give you more info. Welcome!
    @Voula
    @Vyktors Mum
     
    Last edited: Jul 21, 2015
    Heldon likes this.
  3. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks. I've had a quick look at the food info you linked to, I'll look properly later.
    We currently use a combo of wet and dry foods. Is it better to reduce the amount of dry food gradually or go straight to wet food only?
    My lot have also been used to free feeding, so they're going to have to get used to specific supervised mealtimes (I have two other cats, Dash and Daring, sisters nearly 5yo). I'll switch the diet for all of them, but Martian likes his food (and everyone else's), and Daring doesn't like to join the others for mealtimes, so it will be a challenge :)
    Martian weighs about 5.5kg. I'm not sure which insulin (the vet didn't seem to sure either), but I'll be speaking with her tomorrow afternoon so I'll find out then. I'll put his details into my profile as I get them.
    I'm sure we'll get there, there's just so much to take in at first.
    Thanks again.
    Carolyn
     
  4. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    With any change of food, do it gradually over a week or more, maybe changing 25 % each day or two if there are no issues.
    I feed at preshot time and +2 or +3 with both cycles each day. You might like to fiddle with those times a bit to suit you. But always feed at preshot time. We test, feed then shoot. Because Sheba is a good eater, I give her the insulin as she is eating and she doesn't even notice it.

    I use an automatic feeder for Sheba for times when I am not here and at night. I can't get the site to show you the feeder at the moment as I am in the middle of feeding kids their dinner but I will look it up later and post it here. They are really worthwhile to get.
    Good idea to change all the cats food then you won't have to worry about Martian getting into forbidden food.

    Try and get the vet to use the glargine or Levemir insulin. And you will need to start on a low dose. If the vet is inexperienced, post here and ask and someone will help you with the dose.

    Sounds like you have a pretty good handle on things...it is a lot at first.
    If you read the sticky notes at the top of the pages, you will get lots of info.
     
  5. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn,

    Here is the auto feeder I use. I put wet food in there and fluids also. Once you master the clock setup it is easy to use. I've had mine over a year and it has been completely reliable so far. I use the 24 hour clock set up and just never turn it off on the base. That way you don't have to reset the clock each time which would be a real pain. I am still using the same batteries as I started with.
    Many in the US use one called Petsafe I think it is called but I am not sure if it can be bought out here.

    http://www.ebay.com.au/itm/AUTO-Dog...l-Automatic-Program-Digital-LCD-/111237001846

    Some people free feed their cats if they are grazers. I can't because Sheba wants to eat it all at once, no matter how much. I find with the auto feeder I can space out the meals if I am not here.
    Sounds like Martian is a bit like Sheba as far as food goes!
    We don't give any food for the two hours preshot so that the blood sugar level will not be influenced by food.
     
  6. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Welcome to the best place you never wanted to be :)

    Free feeding is fine for diabetic kitties as long as you remove the food for the two hours prior to shooting. This is so you get a blood glucose test that isn't food influenced.

    Not only are the low carb options on the supermarket (or pet barn) shelves cheaper than the vet prescription diets they are better because they are lower in carbs. The diabetic prescription foods are based on some ancient tests that found, I think it was higher (or lower) fibre and higher protein diets were better than standard. Coincidentally the foods are lower carb than some varieties but that isn't the way they were designed. It is now widely recognised that it's the carbs that are a problem for cats (hardly surprising given they are obligate carnivores) but the prescription foods haven't caught up :mad:

    I'm not sure that levemir is available in Oz so lantus is the way you'll want to go. Canninsulin is often prescribed in Oz but it's not well suited to cats because of their fast metabolism - it tends to be very harsh in dragging the BG down but then peters out well before the twelve hour cycle is done so the kitty ends up spending far too much time in higher numbers.

    I highly recommend you take a look at the stickies (posts stuck to the top) in the lantus/levemir support group forum for the basics on how to handle and store lantus, dealing with low numbers and the protocols we follow. I'm a big fan of tight regulation for the high rates of remission in newly diagnosed cats (Vyktor being one of them). There is a document in the tight regulation protocol sticky you can take to your vet about the tight regulation protocol based on a study undertaken at the University of QLD.

    I think it's great that your vets acknowledge their lack of knowledge on FD. We see so many cats arrive having been treated really inappropriately by a vet that doesn't know what they're doing but doesn't want to say so. It will be good for you and your vets to learn together :cat:

    I also use the optium exceed and have found it to be an excellent meter, it has the added benefit of being able to test for ketones but you can also use ketodiastix (only about $10-15 from the chemist) to test the urine for those. My mum uses an accucheck performer which also seems to be a very good meter and requires very little blood. I would recommend you avoid the freestyle lite. Many of us have found problems with it reading much lower than other meters would in higher numbers which can have a devastating impact - Vyktor got ketoacidosis not long after he was first diagnosed, turned out his BG was much higher than the freestyle lite meter had led me to believe.

    There is a post on food in the FAQ forum with a link to a spreadsheet specifying carb and other values. Although it is American some of the foods mentioned, e.g. Wellness (not all varieties are low carb) are now available here so it is of some use to us.

    The cheapest options are Dine - check the labels some contain cereals so you want to avoid those and the whiskas loaf varieties.

    You can start preparing Martian for home testing now by rubbing the edges of his ears as often as you think of it and telling him how good he is so he starts to get used to you messing with them.
     
  7. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    @Vyktors Mum

    hi Serryn, thanks for looking in here....yes you can get Levemir here...I use it for Sheba.:)

    Lovely photo of Martian Carolyn.....he is very handsome
     
  8. Voula

    Voula Well-Known Member

    Joined:
    Sep 15, 2014
    Hi Carolyn. Welcome to you and Martian too. Some low carb non prescription foods are the Whiskas loaf varieties and some of the fancy feast classics such as savoury salmon, whitefish and tuna, and cod, sole and shrimp too. I find the Whiskas loaf in the pouches very good. Some of the Dine Desire range are okay too but they are not complete diets so they are only suitable as a treat. The Ultimates are pretty good too. As Serryn said look for foods without cereal in them. My Lucy is on lantus insulin and it is a good insulin for cats and levemir is good too.
     
  9. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Another option for the scarfers is to freeze part of the meal so it is nibbled as it thaws.
    See my signature links Glucometer Notes for feline-specific reference numbers and Secondary Monitoring Tools for additional assessments you can make to evaluate your cat.
     
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  10. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks for the advice everyone.
    Thanks @Bron and Sheba I think he's pretty handsome too :) This is his "feed me" pose (he's not a nagger, he just sits and LOOKS at me).
    I've made a start on changing over their food. As I said, they've been having a mix of wet and dry, and the dry was a mix of Whiskas and VIP grainfree. Today I've left out the Whiskas dry and reduced the overall amount I put down. If free feeding is OK I might stick to that (noting what @Vyktors Mum said about witholding pre-shot). Martian likes his food but the only thing he really scarfs down is raw mince when I give it to him, so he already gets that in two smaller serves about an hour apart (currently about twice a week, which I might put up a bit - I use the VIP one with added taurine). Sounds like they're going to have to learn to like loaf varieties, which I might manage to convince them of if I mix in enough water "gravy" :)
    As far as all of your insulin suggestions go, I'll mention them to the vet. Because they don't have a lot of diabetic cats in the practice she looked up what they gave the last one on the computer system, so that may not be the best current option. Also, does anyone have a suggestion of where I can buy syringes relatively cheaply? The ones from the vet seem to be really expensive. I'll have to talk to the vet about home testing too, as it doesn't seem to be on their radar at all (other than occasional urine tests). Then all I have to do is get over my needle phobia. I think I'm making progress - I can talk about them without shuddering now; next I'll spend time looking at some photos... the things we do!
     
  11. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn,

    Martian looks like he is saying feed me! Good job with the transition to wet food.!!

    I buy my syringes from the local chemist. Cost about 30$ for 100 syringes. I use BD Ultra-fine 11 short needle, 0.3 ml, 31G x8mm. Use with U-100 insulin only. You would use these with Glargine or Levemir insulin. There are two different types of syringes so you need to make sure you get the right ones that go with whatever insulin you get. Post here if you are not sure. It makes a difference! We can only get syringes marked in 1 units here, NOT 1/2 unit markings like in the US, so don't waste time looking for them! You could try ebay...I just haven't done that but I should, they might be cheaper, but first you need to make sure you get the right syringes for the insulin you are going to give.
    I hope the vet doesn't give you the Canninsulin as it is not suitable for cats. If she is unsure, say you want glargine or levemir.

    You don't need the vets permission to do the home testing of the blood sugars. Lots of vets don't like it but it is much safer for the cats and you are much more likely to ultimately get off the juice if you can see where you are going.
     
    Last edited: Jul 22, 2015
  12. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Some vets really love the home testing too, my replacement vet nearly fell over himself with glee when I showed him Vyktors spreadsheet. I imagine that yours won't be against it given that they are learning too. The vets that are against it usually say that your cat will end up hating you for it. Not true at all, they might hate it at the vets but at home with a treat and loving they usually come around very quickly, the pain is negligeable. The other reason some vets don't like it I because they don't understand the numbers if they're using pet specific meters. This doesn't seem to be as much of an issue here as in the US as a lot of Oz vets use human meters too. I can't see it being an issue with your vets as they will be learning what the numbers mean with you.

    I also buy my insulin and my needles (same type as Bron uses) from the chemist with a prescription from the vet - it is heaps cheaper but ring around before you buy, the prices vary a lot between chemists. Doesn't sound like your vet will have insulin in stock anyway so it will be just as easy for them to write a prescription as order it in. The only thing is - from your vet you may be able to buy a single cartridge whereas this would be unlikely from the chemist where they come in boxes of five (this is for lantus I'm not sure how levemir comes as it wasn't available in Oz when Vyktor was on the juice). If per chance you get lucky and get Martian into remission quickly you're going to have a lot of left over insulin.

    You won't be the first one to have to conquer a needle phobia for testing - it's amazing what we can achieve for the love of our kitties :) I recall some people singing while they are doing it to keep themselves calm. You really have to get your head in the right calm space or Martian will pick up on your stress and start stressing too. Post on health for tips if you find yourself having real problems.

    If you've been rubbing the edges of his ears without concern on his part you can now introduce clicking a pen near his ear while you do it to get him used to the noise of the lancet device. Next step test! No need to wait until he's on insulin it's better if you can have that part down pat (or part way there) before the insulin starts when it's possible.
     
  13. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    The vet is planning to use Glargine insulin.

    But then she freaked out a bit when I mentioned that I'd been researching online and talking about diet and so on, and I got really upset, so now I need to email her with my questions/plans before she'll schedule Martian to start the insulin. And I didn't get anywhere near the home testing question.

    It's all got a bit much for me tonight. Going to deal with the email tomorrow.
     
  14. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    :bighug::bighug: It can be upsetting when you have a disagreement with the vet....most of us have been there at one time or another. But remember Martian is your cat and you are paying the vet. Martian is not her cat and you are Martian's advocate. You have every right to question things or look up things online.

    If I were you, I wouldn't mention home testing just yet. You don't need her permission to do it and you can start now and she needn't know until you are ready. I would get the insulin and feeding sorted out and then when all that's settled and Martian has started the insulin, you can mention you have started testing. I go to a vet practice where my vet thinks home testing is great but his collegue who I sometimes go to thinks I test far too often. I just accept that we disagree and don't bring up the subject. You can always just smile and nod and then go and do what you think is right.

    That is great she is going to use Glargine insulin.
    Good luck. You have done everything right, so don't be put off by someone who is probably feeling a bit insecure about it all.
     
    CarolynE likes this.
  15. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks @Bron and Sheba. The vet conversation came on top of some other stuff this afternoon and it was all too much for me.
    I will leave the home testing out of it for now as you suggest. I'm still trying to figure that out myself.
    I will put together an email about the food tomorrow. She wants to use Hills MD wet food, so any arguments for or against would be handy. Cost is a big issue for me at the moment too.
    I get the impression that she wants to stick with what's familiar in terms of treatment, which I understand. I just want to do what will be best for Martian, and get it happening as soon as possible.
    Thanks for the support and the place to vent.
    Carolyn
     
  16. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    The three best arguments against Hills could be
    1) it's too expensive. There are no "prescription" ingredients in it, just the same or not as good as supermarket foods and it is way too expensive for what it is, or isn't.

    2) too high in carbs. In the food chart we use, done by a vet, Hills md is 14% carbs. We suggest staying under 8%. Her food chart is here: www.catinfo.org. Go to the protein/ fats/carbs chart and then scroll down to vet prescribed foods to see Hills.

    3) your cat won't eat it. This is a little sneaky but can't fail. Buy one can from her and try it along with the foods you want to feed. Then report back that he snubbed the Hills but is eating _________.

    Good luck! And remember, she can suggest a food for your kitty, but you are his advocate and you get to decide.
     
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  17. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Most people when they first start out have a few differences of opinion with the vet, so don't let it bother you too much of you can.
    Once you get the meter and strips post here and someone will help you. There are clips on utube which are very good and take you through it. It is hard for the first few times but as long as you can remain relaxed and give Martian a treat every time you test, whether you are successful or not, you will get there I promise. I remember the first few
    times I tried it was a disaster and I was sure I would never get it. The ears learn to bleed very easily after a few weeks and it becomes much easier. Now if I get up during the night to test when Sheba is running low, I am up for less than a minute and I am half asleep....it becomes very easy.

    With the food.....vets only spend a couple of days if that in their training on cat diets and that is sponsored by thethe big companies like Hills and they are taught that Hills is the only way to go with diabetes. But we all know different.
    You can tell the vet that you simply can't afford the prescription food. It is not cheap. I used to use it and it costs $3.25 I think it was a can. Sheba used two cans a day and that was 6$. She went back to 1 1/2 cans when her sugars lowered and she was less hungry but that is still a lot of money. Also a lot of cats don't like that food. And I believe it is higher on carbs than many other foods. So you could tell her 1. you simply cannot afford that much money on food.
    2. You want to feed all the cats the same diet so you can leave it out during the day and you certainly can't afford to feed three cats on that. 3. If she absolutely insists, you can say you will take one to see if Martian will eat it, then say he refused to eat it. Only say number 3 if you get stuck though!
    Good luck. Let us know how you go. Hang in there
     
  18. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    The biggest disagreement I had with my vet was over food. He also tried to insist on the prescription diet. In the end I bought in a tin of what I was feeding and got him to compare the ingredients in mine to the ingredients in his and asked him to tell me which one contained ingredients unsuitable for a cat ;) he did then admit that it's a liabilty thing for them, they can't really recommend anything other than prescription food.

    You might like to take some reputable articles on diabetes and low carb foods in for your vet to read at her leisure. There are plenty around if you google.

    My vet was also a bit concerned about following Internet advice to start off with but it didn't take him long to realise that we know what we're talking about. I would have been concerned about it myself except that what I was seeing here backed up all the research I'd done on my own.

    :bighug::bighug::bighug: It is all really difficult and stressful to start off with but hang in there, I promise it will get easier.
     
  19. Julia Rae

    Julia Rae Well-Known Member

    Joined:
    Jun 11, 2015
    Hugs, I too had conflict with my vet in treating Magellan, the vet initially wanted Magellan on Novalin N and was flat against home testing. I went with my guts on dosage amounts and I am soo very glad I had, because if I had followed the vets instructions at 3 units bid and no testing. I would have a very dead cat or if I was lucky a very, very sick cat. Go with you guts and instincts you know your cat far better than any vet out there. I am not saying they are useless just that they have so many other animals and see your cat at best an hour a year???
    I finally told my vet what I was doing, my results and he grudgingly admitted that I had been right and now he is on the band wagon with what I am doing. My advise is to trust your guts, hear all the advise out and do what your heart and your cat says is right and you should not go wrong. :bighug: :bighug: :bighug: :bighug:
     
  20. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks everyone.
    I was in a bit of a state last night. There were lots of reasons for it, but this was certainly a major factor. I gave myself the day off dealing with it today (along with the rest of my Real Life problems) and went birdwatching in the sunshine. I'm feeling a lot calmer now, but still a bit mentally fuzzy, so I'm going to write the email tomorrow morning. I know that's delaying when Martian starts on the insulin, but I'd rather make sure we get it right. It should still be next week sometime. In the meantime I'm phasing the cats off the dry food and considering which supermarket brand(s) I'll go with.
    I've also identified a couple of potential syringe sources that may not cost me anything (though I'll probably still have to buy some). I'll go with whatever the vet supplies for the first lot so I know what I need, then we'll see...
     
  21. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn,
    Am glad you are feeling better today. We all feel overwelmed at times. I think it is a good idea to transition the cats to wet food before you start the insulin anyway, so a day here or there shouldn't make a difference.

    I don't know if you have a pet barn near you, but they have a lot of good and suitable canned food for cats. I feed Sheba mostly raw home prepared food but I always have some canned in case I need it and for when I need higher carb food for when she drops low. I buy the Weruva brand. We can get the 'cats in the kitchen' ones here and most of them are low carb, high protein. I usually buy online and get kitty litter at the same time. If you get $50 worth there is free shipping. The kitty litter bumps it up easily to $50 I find.
    A lot of people use Fancy Feast but just be aware it is high phosphorus which is no good if any of your cats have any kidney issues. Otherwise it is OK.
    Sounds like you are pretty organised and know where you are heading with everything.
    Good luck with the email
     
  22. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Watch out for fancy feast you only want the pate styles for low carb but you can use the grilled for your high carb when you need to manage low numbers.

    I always find there's nothing like a bit of nature time to sort my head out :)
     
  23. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    I like the look of Cats in the Kitchen @Bron and Sheba. My nearest PetBarn is about half an hour's drive from here, so home delivery looks like a good option. If I'm buying for three cats I don't think I'll have any trouble getting to $50 ;) I might drive down there this weekend and buy one of each flavour to see which ones they prefer, then order online in bulk. I might go down the homemade raw route eventually, but I think we can leave that for the time being.
    I give a great impression of someone who's organised, but I'm often better on theory than practice, so we'll see.
    @Vyktors Mum I probably won't buy Fancy Feast anyway, because I try not to buy Nestle products, and if you follow the company chain they own Purina, which makes Fancy Feast. But thanks for the heads-up on the varieties to avoid. Nature time is the best (well, at least equal to snuggling the cats :))
     
  24. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn,
    Good idea to drive to the Petbarn and check out the canned food. I would write a list of the ones that are suitable, because once you get there you can easily get confused with the range to choose from. I did! If you go online you will be able to see what they have to offer. Some of the other brands are quite good too.

    In Aus we only have the 90 gram cans of Weruva and the pouches. Another of their ones is BFF pouches..available here. Not sure now of the carb value of them, but you could look them up under www.weruva.com
    I have the added problem of kidney issues with Sheba so you should have a bigger range to choose from than I do.
    I pay $1 a 90 gram can of cats in the kitchen. I buy the 24 pack, it is sometimes cheaper.
    If you find it expensive with 3 cats you could add ....I think it is up to 20%.........but I will stand corrected on that if wrong......cooked or raw chicken or raw meat to bulk up the diet without having to add extra supplements. Also the odd cooked egg and chicken hearts.
    I started out that way when I changed to home prepared.

    You will also need a medium carb and high carb food to have for when Martian drops low.
    For medium carb I use Weruva Pumpkin Lickin Chicken (pouch) 12.4 carbs
    For higher carb I use Mack, Jack and Sam 18 carb or Chick Magnet 16 carb. Both pouches.
    You just need a couple of pouches of each.....you might only need a bit and any left over I freeze in ice cube tray and label and use next time.
    Also have some honey in case Martian drops really low. I keep all these things in one place so can get quickly if needed.

    Hope things are looking better for you now. At least it is the weekend!
     
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  25. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    That explains a lot. ;)
     
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  26. Heldon

    Heldon New Member

    Joined:
    Jul 25, 2015
    Hi Caroline
    Hi Ladies
    I'm Helen and my cat Tzar 12yo (Russian Blue/Siamese cross) has just ben diagnosed with diabetes. It was great to hear your information as I wad feeling overwhelmed. I will do whatever needs doing to keep Tzar well. He was started on 2IU of Caninsulin last Friday twice a day. He is fine but I notice you suggest Lanus as the best insulin...tell me more please. I read an article by Dr Lisa A Pierson and she talked about daily blood testing, do you recommend this?
     
  27. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Hi Helen

    Home testing is really essential to keeping your kitty safe when using insulin, it will also save you a small fortune of having vet curves done and will be more accurate because the kitty won't be stressing. Testing before every shot is done to ensure that the number is safe to shoot and testing during the cycle is done to see how low the dose is taking the kitty. Most kitties adjust very well and very quickly to being tested as they are given a low carb treat after each test or attempted test. For example, the kitty I'm looking after now runs to his testing spot when he hears an alarm and purrs all the way through the procedure and Vyktor ended up sleeping through most of his tests.

    When you start home testing you will be able to see how the canninsulin is working in your kitty. Most people see that canninsulin doesn't work well it pulls the numbers down hard early in the cycle but then wears off too quickly so kitty ends up spending way too much time in high numbers.

    Longer lasting insulins like lantus usually work better in cats and a university of QLD study showed that 85-90% of cats who were put on tight regulation (see the stickies in the lantus/levemir insulin support group for the tight regulation protocol) using lantus within 6 months of dx were able to achieve remission.
     
  28. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    We've reached a compromise on the food. I can go with an alternative brand but I have to choose a single variety, at least while we're getting Martian's insulin dose figured out. There's been a mixed response to the new food so far and only one real "Yes Please!" so that will pprobably be the option we go with at first :)
    He is booked in next Monday to start on Glargine (Lantus) insulin. They're going to do the first insulin curve at the vet (and maybe a second or third one too). I'm ok with this because I'm still pretty nervous about the whole process.
     
  29. Heldon

    Heldon New Member

    Joined:
    Jul 25, 2015
    Thanks for your support.
    Tzar is from Rockhampton, Queensland and the vet is very keen to assist and is listening to my concerns...I asked about lantas and she did look it up there and then...I don't think she is really open to it but I pressed a little and asked her to look into it for me. She is supportive of daily blood testing and showed me the pet gluocometer. My husband is a Type 2 diabetic and has a One Touch Verio gluocometer but she said that human ones give higher readings...? I will look up the lantus studies ... I want to be well armed when I speak next. My vet has scheduled weekly blood tests following our meeting late this evening and she has given me urine test strips to do once a week. Good news is Tzar has no ketones.
    His glucose was very high in his initial blood test and I only noticed something was wrong because I had been away for two weeks and he had been in an enclosed area with my other two cats who all only tolerate each other. Tzar ran inside and started drinking lots of water and consequently lots of urine. This settled down over the next few days and seemed quite normal. He is a cat who stresses. When I took him to the vet last Friday to do a cycle his glucose was high again.
    Tzar is not obese and very lithe and active. His diet is fairly high in protein but he will eat up any dry food if it's left by the others as well as his own. So the dry food is off the menu. This is a photo of Tzar on the right and Blueboy his brother. 20150616_082841.jpg
     

    Attached Files:

  30. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    @Heldon They are twins for my mums diabetic - Purrdy! Look at those cute little wombat rumps!

    It's the other way around - the pet tester reads higher than a human meter. It's not really an issue which reads what as long as people know what you're using but the strips for the pet tester are very expensive so nearly everyone around here uses a human meter. Also a lot of Australian vets use human meters. Your vet probably won't like the idea if she doesn't as it will mean she needs to read the numbers differently than she's used to. Although, since she has no experience with lantus you'll probably end up getting all your dosing advice from the lantus/levemir support group forum anyway. Most of us rely on the vet for our prescriptions only as far as the diabetes is concerned.

    Once you're home testing, weekly blood tests at the vet will be unecessary but you might want a separate meter from your husbands so you know whose data belongs to who. I don't have experience with the type of meter your husband uses but if it needs a small enough amount of blood maybe you want to get the same type for the cat so you can use his strips. My mum uses accucheck performa which requires a tiny bit of blood and I use an optium exceed which is also capable of testing for ketones (not really necessary if you haven't had ketone issues and can check the urine). I would just avoid the freestyle lite as there have been issues with the readings of that one - Vyktor ended up on deaths door step with diabetic ketoacidosis thanks to me relying on that meter and others have had issues too.
     
  31. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    It wouldn't make sense to do a curve until he has been on Lantus for 5-7 days and has a chance to stabilize on his dose.
    The starting dose is generally calculated by the following steps:
    How much does he weigh?
    How much should he weigh?
    Take the lower weight (aka lean weight)
    If in pounds, convert to kilos (pounds / 2.2)
    Multiply by 0.25
    Round down to the nearest 0.25 units.
    Note: syringes will not measure 0.25 or 0.75 increments; they must be eyeballed or you can use calipers to measure this.
     
  32. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn
    Sounds like you have reached an agreement with the vet on the food. That is good she has agreed to an alternative brand. What did you decide on as far as food goes?
    Have you bought a glucometer yet to test the BSL? You could start doing some testing now to get in some practise while there is no pressure. It will be much safer to test before giving the insulin.
     
  33. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    @BJM I think for the vet the curve is mostly to make sure he doesn't have a hypo.
    Looking at your dosing instructions above I think he should be receiving 1.25 units (his weight hovers around the 5.5kg mark)

    @Bron and Sheba I'm going to go with Cats in the Kitchen for the time being. There are a couple of flavours that they seem to like that have very similar nutritional values, so I might even manage to sneak in a little variety :) Once we get into a proper routine with home testing and figure out how he responds to the insulin I might mix it up a bit more.
    I haven't started testing yet - I couldn't afford to buy the equipment. I've had a bit of income this week, so I'm hoping to pick a meter up over the weekend. I have been trying to get him used to me handling his ears in the meantime.
     
  34. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Cats in the Kitchen are a great choice and they have several good choices within that range. You could add a bit of fresh cooked chicken or raw meat to the cans to make it go further if you wanted to. As long as it is not more than 20% it will be fine.
    That is great you are getting him used to touching his ears. After you get the meter and the first lot of test strips, you will find it cheaper to buy the strips on eBay....bit hard to do that though until you have the meter and know what strips. Also if you get the first strips with the meter, you will know the correct strips to get next time. The strips are always dearer at the chemist.
     
  35. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    You can use an inexpensive human glucometer with feline-specific references (see my signature Glucometer Notes). You don't need a pricey pet meter.
     
  36. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    :mad::confused: Feeling frustrated! Bought a BG meter today (Accu-chek Performa, which is by far the most commonly available meter where I am). Read the instructions, watched the video, got it all set up to make my first attempt at testing Martian, and the darn lancing pen doesn't work (it's an Accu-chek FastClix). I followed all the instructions but the lancets don't, well, lance. Anyone have any idea what might be going on?

    On a more positive note, while he didn't enjoy it, Martian was very patient with my abortive attempts to poke a hole in his ear :)
     
  37. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Have you tried the lancet device on yourself, Carolyn?
     
  38. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn,
    You might have to adjust the depth of the jab. Is there something to adjust it on the side?
    Good idea for Aine to try it on yourself first or try it on a piece of fruit to see if it punctures the skin.
    Everyone has a bit of trouble starting out with testing one way or another so don't worry. It will soon be old hat to you!
    And good boy Martian for being such a patient boy for your mamabean while she figures it all out. Are you giving him a treat each time whether you are successful or not?
    Are you holding a piece of cotton wool or a tissue behind the ear when you use the lancet. It will support the ear and make it easier.
     
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  39. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Definitely practice on something like an apple or grape, and on yourself, to get a feel for it, literally, with the timing, the maneuvering of the meter and strip, and then blotting the lanced spot.
    Some of us free-hand the lancet, rather than using the device. For me, it was easier to see what I was doing without the device and since I have crappy vision anyway, that worked best for me.
     
  40. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Mum has that meter she hated the lancet device that came with it, she found it very difficult to align it properly with an ear. She ended up going back to the chemist and getting another type - the type that comes with the freestyle lite. Luckily the chemist had a spare one under the counter. If your chemist doesn't happen to have a spare lying around you could ring the manufacturer and ask them for a different type.
     
  41. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks folks. I managed to make myself bleed, so at least I know the device is working. I did have to put it on a fairly deep setting ( though I think the skin on my fingertips is tougher than Martian's ear). I suspect aligning it correctly was the big problem. I was using a folded tissue behind the ear and giving him lots of scritchings while I tried to do it. Martian didn't act like it was pricking him at all, more like he'd had enough of me holding his ear.
    I'll look into getting an alternative device (I know a couple of people who may be able to source one for me). I might try a handheld lancet too. I like the idea of having more control over the process.
     
  42. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Martian's ears will learn to bleed much easier after doing it for a few weeks. When I first started I found it hard to get blood but it soon became easier.
    Good luck with starting the glargine tomorrow.....let us know how it all goes.
     
    Critter Mom likes this.
  43. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    First successful blood test - yay! (BG 19.4 - less yay, but he's still not showing symptoms and the glargine starts tomorrow)
     
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  44. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Well done Carolyn!
    The BLSs are usually higher at the vets from the stress so it is good to know what Martian is at home. What time was the test? Was it before or after food?
    Can you get your SS up and running for tomorrow?

    I remember you said your vet did not know a lot about feline diabetes. Just make sure she does not give Martian too much insulin. We have just has a cat from Australia who was given far too much insulin by a vet who did not know what she was doing. Based on Martian's weight of 5.5 kgms and the equation that BJM has posted above, Martian should not get more than 5.5 x 0.25 = 1.375 units of glargine. Rounded down to the nearest 0.25 and that is 1.25 units of Glargine. Vets usually only like dealing in one, two three units etc, whereas we go up by 0.25 units at a time. So hopefully they will not go up to 2 units, but stay at 1 unit. This is just some information for you to have when you go in to get the insulin.
     
  45. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks :)
    I've set up the spreadsheet and added tonight's test to it. I'll try to do a home test in the morning before we head in to the vet to start the insulin. Because Martian free feeds he'd had a snack (but not a full meal) about an hour and a half before we did the test. They usually finish off dinner relatively early in the night, so he shouldn't have eaten for a while before tomorrow morning's test.

    I saw that other cat with the too-high dose. I'm prepared for that conversation in the morning if needed (hopefully it won't be). Apparently the clinic has had advice from a feline diabetes expert in the past (no idea who it was) and my vet was going to check in with them about the food, and that was who told them to use the glargine, so hopefully it will be OK.

    Fingers crossed!

    Carolyn
     
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  46. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Can see the SS and it looks good. Well done getting it up and running!

    I can see you have 18:22 in the U column, is that the time? That column is really for the number of insulin units so it might be an idea to put the 18:22 either with the PMPS in which case you could say 19.4@ 18:22 or just put a note in the remarks column as to the time taken. Once you get going you could put the time there after the number of units if you want. I would put 'nil' in the U column to show no insulin was given.

    Good luck tomorrow. You sound as if you are well prepared!
     
  47. Vyktors Mum

    Vyktors Mum Well-Known Member

    Joined:
    Nov 15, 2011
    Welcome to the vampire club :cat:

    You might like to start posting in the lantus/levemir support group forum once you're up and running on the lantus. You can post Martian's details daily and the experts will keep an eye on you and answer all your questions - even the ones you didn't realise you had ;)

    Don't forget to start picking up the food two hours prior to shot time now so that you get a BG number that isn't food influenced.

    Spreadsheet note - when you add something other than the number to the world page you need to adjust the U.S. page manually. Just multiply your number by 18 and then you can colour the cells in both sheets manually (the colour code is at the top of the spreadsheet pages) using the icon in the menu bar that looks like a paint tin being poured.
     
  48. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    I'm feeling very tired and emotional after today.
    I didn't actually get to talk to the vet this morning about Martian's dose, and I left him there feeling really upset and scared about what might happen.
    They texted me to let me know that his dose was going to be 2.5U. That's double what had been recommended here (but at least not completely insane).
    Perhaps not surprisingly given that dose and the fact that he barely ate today, he had a huge dip approaching a hypo (though the vet said he wasn't showing any symptoms).
    So he's had no insulin tonight, and I need to take him in again tomorrow so they can adjust the dose and monitor him again. The upside is that they're going to reduce the dose by at least a full unit, which will bring it a lot closer to the "right" dose.
    I'll definitely be using the lantus/levemir support group as a resource once I'm doing all the testing and dosing until we get his dosage figured out.
    Fingers crossed his BG levels are more even tomorrow.

    I'm slowly figuring out the spreadsheet thing. Let me know how today's notes look.
     
  49. tiffmaxee

    tiffmaxee Well-Known Member

    Joined:
    Nov 15, 2013

    Hi. It's going to probably be hard to stick to just one brand of food. If it works, great. If not I would just explore the various foods and just omit that from your discussions with your vet. Many around here do that, keep a current ss and show it to their vet as miraculous changes are seen in pretty blue/green colors. I LOVE my vet but have learned with each new challenge my cats have faced that sometimes he just doesn't get it right. With FD I wished I had realized it sooner.

    My vet also did a curve the day Max was started on lantus. After that he had me come back 5-7 days later at the +6-7 point just to check his nadir a couple times a week.
     
    Last edited: Aug 3, 2015
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  50. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Carolyn,
    I'm sorry you had such a stressful day yesterday. I can imagine you were upset not knowing what was going on and how much insulin was going to be given, especially after reading about Aston's experience. I am sure the vet was surprised at the dip too, and at least has said they are going to reduce the dose by at least a unit. And at least they kept him there and tested....just didn't send him home with you and say bring him back in a week which often happens.
    And Martian had a really good response to the glargine so once he gets onto the correct amount, he looks like he will settle down well with it......in my humble opinion FWIW.
    Try and get him to eat a good breakfast before he goes in to the vet today if you can.
    Let us know how you and he get on today:bighug:
     
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  51. CarolynE

    CarolynE Member

    Joined:
    Jul 21, 2015
    Thanks Bron.
    Today was better, as much because I had more idea what was going on than I did yesterday.
    Martian ate a really good dinner last night and a reasonable breakfast today, but they didn't feed him at all during the day. I think there were some crossed wires this morning. His usual vet, who knows he's a "grazer", wasn't there today, and even though I told the reception nurse that they should actively encourage him to eat, they didn't give him any of the food I brought in.
    They gave him 1.6 units this morning, and his curve was less scary, but his BG was still fairly low this evening, so we skipped the evening insulin dose again. He's booked in again next Monday.
    We practised injecting him with salt water too. It's still pretty scary, but I did it.
    So I get to do all the testing and injecting for the next few days. I'll be posting in the Lantus support forum for advice. And I'm staying home tomorrow so I can keep an eye on him. Hopefully things go a bit more evenly so I don't spend Thursday at work worrying about him!
    Carolyn
     
  52. Bron and Sheba

    Bron and Sheba Well-Known Member

    Joined:
    Feb 21, 2015
    Ho Carolyn,
    I'm glad today was better. It is a shame they did not give him some food during the day as you asked. It looks like still too much insulin as you were unable to give a dose tonight. That is good you can stay home tomorrow.
    Yes that is good you are going to move over to the Lantus forum. You will get good advice over there for the correct dose. Most of the experienced people for dosing come online from about 12 mn to 2am our time and then are there on and off until about 4 pm our time. So you could post anytime from about now and then you should have an answer by tomorrow morning.
    If you can link this condo to your new one over on Lantus Forum, it will give them an idea of what has been happening. To do that you copy and paste the URL from this condo over on the new condo.

    I always inject Sheba with the insulin when she is eating her food and she doesn't notice. You will get used to it quickly. I think you have done really well.
    I'll see you over on Lantus forum:)
     
  53. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    :banghead: :banghead: :banghead: :banghead: :banghead: :banghead: :banghead:


    .
     

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