Newly Diagnosed Sugarcat - Lots of Questions!

Good morning,

I hope that I am using the 911 correctly, if I am not I apologize. My Zoey was diagnosed with diabetes on Thursday but my vet cannot do a full day of monitoring until Monday so he has had no insulin or treatment. I tested his ketones with the urine strips just now and the level is between the two highest options: 1 (56) and 2 or more (111 or more). I am not sure what to do... is this an emergency? I do not want to over react as I am feeling very overwhelmed right now with how to help him, but I don't want to under react either. He is eating, drinking, peeing, and his temperment is the same as always. He is always cuddly even when sick so it makes it difficult to read him. He is walking around, grooming, etc but lays down frequently. He has lost weight and has some wasting in his back leg muscles. Is this an emergency?? How do I know? I have no idea how long his ketones have been elevated... Is there anything I can test at home before I take him to an emergency clinic? Please help, I am new to all this!

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Smell his breath. If it smells like acetone or nail polish remover, he needs to go to the vet immediately. High ketones can be deadly, and can't be dealt with at home.
Try to get another ketone test also.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

make sure you timed it properly also. the longer urine is on strip, the darker it gets.
otherwise carl is right.. if high ketones you need to get to a vet or ER ASAP. thisis life threatening

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Just checking to make sure you are using a ketone strip and not a glucose strip? Is there also a color level on your strip? Here in the US there are several different colors on the strip which go from faded beige all the way up to dark, dark purple. If it is definitely a ketone strip and he is almost at the highest point, then I would strongly suggest you get him into an ER asap. You cannot treat high readings at home and he also isn't even on insulin yet and will need it. His blood values will also need to be checked, his electrolytes, his blood pH, so many factors. He may also be or headed into DKA. He needs medical intervention now.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Thank you for your responses!!

Does behaviour factor into the need for medical attention? I only ask because I am very low on funds but if he needs to go, I will be taking him regardless, that's what credit cards on for. I know only a vet can tell me for sure how much danger he is in... He is not vomiting and is still eating and drinking. I will test his levels again once he heads to the litter box... I called the emergency clinic to ask for suggestions as well, just waiting for a call back. I tend to be a worried and I don't know if I'm overreacting...

I live in Canada and used Diastix Reagent Strips for Urinalysis that only tests Ketones, not glucose. It does have colours and goes from aqua green to dark brown, he is at the darkest colour...

 

Re: High Ketone Levels??? Newly diagnosed, help!!

The same thing happened with my cat, Bob. He was diagnosed diabetic, no ketones present. Three days later, while waiting for his insulin in the mail, he was diagnosed with DKA (ketoacidosis), and spent three days at the emergency vet. They saved his life. The smell of ketones on his breath was very obvious. The primary thing I noticed behavior wise was he was very lethargic and crying a whole lot, and he was very dehydrated. Can you check if he seems dehydrated? Pull up his fur at the scruff and see how fast it it returns to "normal"...

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Hi Emily,

I have no experience with ketones, but I saw your post and just wanted to offer you support. I hope everything is ok. Just remember to breathe and stay calm. I'm getting really good at it and it helps a lot. We all wish you and your sugarbaby a speedy recovery.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Carl & Bob, when I did the scruff test, it appears his skin returns to normal after about a second, but I will keep doing this test to see if anything changes, thank you for the suggestion!
I'm still waiting on the edge of my seat to hear back from the vet... I'm so tempted to just take him in, which I may end up doing anyway!!

Thank you everyone for your suggestions, help and support, I definitely need it right now!! I bought $20 worth of raffle tickets to show my gratitude to this site and the support it has given me in the last couple days! I'd be lost without all of this useful information provided here!!

THANK YOU!

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Ketones/DKA can kill and ketones, untreated, can quickly go into DKA. I would waste the time waiting for him to pee again or for the vet to call back. I would take him in now.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Hold on! Diastix only test urine glucose NOT ketones. Check the package.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Check the box and see if they say "keto-diastix"....

http://www.healthwarehouse.com/keto-diastix-urine-reagent-strips-100-urinalysis-strips.html

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Wendy&Tiggy you're right!!! The pharmacist gave me the wrong kind!! I asked for Ketone test and the box does indeed say glucose!!! I am heading out the door right now to go get some Ketone test strips!! THANK YOU!!!!!

 

Re: High Ketone Levels??? Newly diagnosed, help!!

That's why in my first post I asked and you stated it was for ketone testing. I don't know Canadian strips and wasn't sure if our Diastix and Keto-Diastix were called the same, marked the same, etc. Colors didn't make sense either. So glad you came on Wendy and cleared this up. Guess they are called the same in CA.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Having not started insulin yet his glucose values will show high on the urine strip. Don't panic over that and as for spending the day at the vet on Monday and starting insulin....waste of your money. Buy a meter, test strips for the meter and lancets and start hometesting. No vet stress involved and first day of insulin isn't going to give the vet all the much info. Post back and let us know what insulin vet will be using and hopefully it will be Lantus or Levemir or Prozinc and not Caninsulin.

 

Re: High Ketone Levels??? Newly diagnosed, help!!

Ok, so the color would indicate high glucose in his urine instead of high ketones. That would make sense if he isn't on insulin yet... but yes, get the ketone strips asap, if for no other reason than to rule out ketones for sure.

Nice catch, Wendy!

 

Re: High Ketone Levels??? Newly diagnosed, help!!

I'm sorry Hope + (((Baby)))GA! I should have looked closer, I read the box a million times but apparently wasn't observant enough! I was wrong to assume the pharmacy gave me the correct kind! I just called them and they realized their mistake AFTER I left yesterday!! They do have the proper ones, called to make sure, lol, and I'm going to grab them. I will update as soon as I am back and hopefully all is well!!! I'll take off the 911 icon!!!

Thank you everyone!!!

 

Re: High Ketone Levels??? Newly diagnosed, help!!

The bright side is that you learned a whole lot about ketones today ;-)

 

Re: High Ketone Levels??? Newly diagnosed, help!!

:lol: Love your humour, Carl.
Always check before using anything from a pharmacist...especially drugs/dose....and if in doubt, double check with the vet. When pulling up insulin, double check the dose in the syringe too. Mishka's been getting insulin for almost 9 1/2 yrs. and still, after I've pulled the dose up in the syringe, I double check to make sure. Same with MC.....I always hold the syringe up and look at what I've pulled up.

Happy to know that it is not ketones dancing_cat

 

Re: High Ketone Levels??? Newly diagnosed, help!!



Make sure you talk to your vet about lantus or levemir as they are the best insulin and have best chance of remission. What food are you feeding? Wet? Dry?


Wendy

 

Ketone Levels

I got the right kind this time! Now I just need to wait for him to use the litter box but I think, from what I read, he is ok as he is acting fairly normal! That pharmacist almost cost me $1200 in emergency vet clinic fees! But I am definitely much more aware of Ketones and symptoms of high levels! Phew! I feel so much better!

I did have Zoey on Blue Buffalo Freedom as he is allergic to gluten, etc and JUST got him to a place that his skin is not erupting in sores and his fur is growing back. From what I read, I am so glad I don't HAVE to put him on a vet prescribed diabetic formula! I've taken away his dry (still have it for the other two, although I'm contemplating making my own now) and give him only wet that I know he tolerates and feels good on. I'm feeding him Lick Your Chops Natural Healthy Pet Food Seafood and Brown Rice Dinner now. I checked the carb levels on http://www.scheyderweb.com/cats/catfood.html and it comes up as 3.5% carbs, although in Canada they only have to put the min/max amounts of fats, proteins, etc. so I'm not 100% sure how accurate that would be. Does anyone else have experience with feeding diabetic cats with allergies? I want to get him on the best food possible!! Does anyone know about the Lick Your Chops brand? The first ingredients are ocean fish, fish broth and chicken liver... He has never been on only the wet, so I'm hoping his skin doesn't have issues.

I don't know what insulin he will be on but my vet will let me know when I take him in for observation on Monday! I hope she has a lot of experience with diabetes in cats and will allow me to do home testing and put him on insulin slowly! So many questions at this point that I won't have any answers to until Monday! It's so stressful to wait!!!! My poor guy!

I am so thankful to you all, you've saved me so much stress, worry and money! Here's hoping when I test my Zoe Bear his ketones are all good!!!

 

Re: Ketone Levels

You do not need permission from your vet to hometest. Heck, over the years a lot of us have been teaching our vets You just do it and it saves having curves done at your vet, saves you money also....you can do them at home and no stress involved. We all test our cats before giving insulin, always......no matter how well the cat is doing, no matter how many years a cat has been getting insulin........always test before shooting insulin. I learned back in Fall of '98 and I have never once given a shot without testing. Call me chicken but it is so quick to do and very well may save a cat from a hypo.

 

Re: Ketone Levels

I agree with Hope. I tell my vet what I am doing (to help my cat), what tests I would like done, and what meds I would prefer. He can give me his opinion and I may change my mind, but I'm the one paying him to do a service.
I would start hometesting today or this weekend, and tell him what blood glucose numbers you've seen so far.
You will save a lot of money by hometesting yourself at home, as opposed to having the vet do curves at his office where the cat is stressed out anyway.
I would ask for one of the longer lasting insulins, like Lantus, or Levemir, or PZI. I hope your vet is experienced in diabetes care, too, but a lot of them have limited experience, so you have to forgive them.

I wrote a post earlier, but I must have posted at the same time as someone else and my post didn't submit.
I am so glad Zoey doesn't have ketones. J.D. is a DKA survivor, and I test him for ketones a lot.

 

Re: Ketone Levels

Ok, I will start testing this weekend. Does anyone have suggestions on what kind of BG tester I should buy? I've read a lot of posts and I'm still a little confused. It doesn't help that I live in Canada and am unsure if I can get the recommended testers here. What is the most accurate and easiest? Is there a website someone could suggest that has the most up to date info on what to get and how to test or a site that helped them the most? I appreciate all the help! I don't know what I'd do without all the support!

 

Re: Ketone Levels

Wendy can help you with meter info. I see she uses the Bayer Contour.http://felinediabetes.com/FDMB/viewtopic.php?f=14&t=287

 

Re: Ketone Levels

Hello!

Taking away his dry is a good idea but watch for diarrhea - if he has that for more than a day you may need to transition more gradually. I did read somewhere the Blue buffalo freedom was 3.5% so it might be ok - am not sure about lick your chops - but you could look at these charts and see if there is any other food under 10% calories from carbs you could feed. Or make your own is cool too. I would take the dry away from ALL cats - you dont want this problem developing with another cat and it means he cant steal any of theirs!!
Dr. pierson food chart
Binky food list

You can get a free bayer contour USB meter and 25 strips if you go to http://www.bayerdiabetes.ca/BDoffer and use code "BDS 11-14" And then if you register the meter you get a free USB wall charger. As with most meters, the strips are expensive in stores $75 for 100 in Shoppers for example but you can get them for half that price on eBay! Or buy them in Shoppers and collect points.

How to home test tips: https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Home testing kit:
1. Meter
2. Matching strips
3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool. Some of these may come with your meter.
4. Cotton balls to stem the blood
5. Polysporin ointment to heal the wound
6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against. I got mine on ebay for like $2.50 from China - search "mini usb flashlight"
7. Sharps container - to dispose of waste syringes and lancets. Get it free in Shoppers. They will give you one and replace free of charge when full if you get some supplies there.
8. Treats for the cat - like freeze dried chicken - if they like it get the Pure bites big dog size bag in Walmart.
9. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
10. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

In terms of insulin -pens last longer and are less easy to accidently break. You can get a pack of 5 lantus solo star pens from Costco for $99 and they should last over 6 months. You dont need a prescription. Lantus is a great insulin for possible remission! Dont let your vet recommend novalin/humalin - its too harsh on cats. You can also get the BD ultra fine short syringes 3/10CC in costco.. or walmart .. or shoppers..

Wendy

 

Re: Ketone Levels

You can order the free meter but if you want to go get one now - make sure you print your free coupon first - https://www.bayercare.ca/EN/coupons/ConNext_Coupon_EN.pdf. Its free when you buy 100 strips.

I would still apply for the free one in the link above though - its good to have a backup and you get free strips!!

 

FIRST Ever BG Test: Success!

Just wanted to provide an update for all those that helped me out so much today!

I went to Walmart (in Ontario, Canada) and purchased 100 Bayer Contour Next test strips (for $84) and received the BG monitor free. I got everything together that Wendy suggested and had Zoey purring on my lap. It was easy to prick his ear and he only flinched slightly, probably alarmed that I would do such a thing to him! He didn't run away though and I was able to get enough blood to test! He greatly enjoyed his freeze dried shrimp and salmon treat and then took off lol. His BG was 21.1 mmol/L. I times that by 18, correct? Making it 379.8? The vet told me that when his blood work was sent out on Tuesday it was 28 mmol/L (504?) so I'm glad it is down! I have been feeding mostly wet, with a little dry as he usually only got dry with a bit of wet. I've only been doing this for the last day and a bit, so maybe he will drop further.

Should I test again in a little while? He ate at 4:45 p.m. (forum time) and I tested around 5:00 p.m. Should I check again around 7:00 p.m. to give information to my vet? It will be his first visit on Monday to start treatment.

This has been a very stressful day and this Sugar Cat Mama needs a tea and some chocolate!

Thanks again for all the support to everyone out there!!!!

 

Re: Ketone Levels

A tea and some chocolate, sound good for you :lol: :YMHUG: You have done a great job.

I would test again at +2 or +3 (that's 2 hours after the shot, and 3 hours after the shot, respectivily).

I'm glad you're starting to hometest, because you don't want to transition from some dry food to all wet food without testing as the change in carbs can lower his BGs.

Let us know how the next test goes.

Remember, always give a treat and some loves, whether the test is successful or not.

 

Re: Ketone Levels

Great job on the testing!!!

Now you are testing its good to get rid of the dry entirely. You will want to track his readings on a spreadsheet for your use, and so we can help advise you - here is the template and instructions. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207. Because most of the users here are American, I use the US template and just remember to multiply my readings by 18 (you are correct)

Hopefully he will drop further as the dry clears his system. I would take a few more tests randomly - like before he eats and then 3 hours after he eats, and first thing in the morning. Just to show your vet how he varies. You can also give your vet his Spreadsheet link once you have it and the vet can keep an eye on you too!!

I usually try and bid for strips from high rated ebay vendors - i like to to pay $40-$50 including shipping for 100. But when I need them and cant win a bid, I use these guys (shorefrontmedical) - they are reliable and better priced than walmart. Here is an ad from them for $60 for 100 strips including lancets, tax and shipping : http://www.ebay.ca/itm/Bayer-Contou...in_0&hash=item3a7b66579c&_uhb=1#ht_532wt_1076
The key thing is to make sure they are the right strips for your meter (next or next EZ), and that the expiry is good. Plus they are american so it takes a good 2 weeks for delivery by USPS so you need to bear that in mind when you start to run low.

Wendy

 

Re: Ketone Levels

I'm with Wendy, cutting out all the dry now will give you even lower numbers and not having started insulin it also makes it easier to stop the dry without worrying. Why not just relax for the evening, feed no more dry but give some more canned if he acts hungry, and then do a test in the a.m. before feeding and maybe one in the afternoon and tomorrow p.m. So glad Zoey is okay and being a good boy for the testing.

 

Ok, the dry has been removed from all three, we will see how that goes! Now my next question is, how much wet to give... Lick You Chops does not list the caloric amount in a can, just suggest 1 can per 6-8 lbs. I currently have 48lbs of cat (between the three, lol) meaning I would have to feed them 6-8 cans a day, at $2,14 a can... this cannot be right, can it? Can I figure out the calories based on the protein, fat, fibre, etc? I think I may have to keep Zoey on this food for his allergies but switch the other two to FF or another low carb type that is easier on the wallet but still good for my boys. Perhaps making my own is the right way to go, just makes me nervous that it will cost a lot and be difficult!

 

How big are these cans?

 

That would be a good thing to mention lol. They are 156 g or 5.5 oz.

 

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I'm looking for calorie info, but found you a cheaper price on my journey!

http://www.petfooddirect.com/Product/574/Lick-Your-Chops-Seafood-And-Brown-Rice-Dinner-For-Cats

I think that works out to $1.50 a can?

 

Deb, thanks for the info! I think Zoey is below weight now, but the other two might be a bit over. Gryffin is for sure! One can a day each seems like a much better amount and makes way more sense! I think I will have to switch the other two to a cheaper one though, as long as they are still viewed as good quality? Are the ingredients in FF and Friskies healthy for cats? I know there is a lot of garbage out there!

I did not have my settings on share, so I just changed them, can you view it now? I haven't put anything in as I'm trying to find a post on how to use it with no luck. Is there information on how to put everything in? Or is it fairly simple and I'm over thinking it? Lol.

Carl, $1.50 is cheaper, its $1.89 ($2.14) with tax where I get it. I will check out that link and see what shipping and everything comes to, maybe its cheaper! Thanks!!!!!

 

Your SS link works now
I emailed the company that makes lick your chops and asked for caloric data, including "% calories from carbs". Hopefully I will hear back soon.

 

I just tested Zoey again and he was 11.8 (212)? How could he drop that much with no insulin or anything? Could it have been an inaccurate read?? He was not so happy with me that time and I didn't do as well as I did the first time I had to poke him a lot!

Thank you for emailing them!! That is so kind!!!!

 

FF and Friskees are not high end foods, but they are fine. You want to stick with Classics flavors of FF and "Pates" with Friskees. Many of us feed those brands, and those are all my two kitties eat.

The SS is fairly simple. You put your AM and PM BG numbers in the AMPS & PMPS columns. The dosage of insulin given in the "U" columns. The +1 to +11 columns are for any BG numbers you get between shots, with the number corresponding to how many hours it's been since the shot. Then any comments you have go to the far right. Look at a few SS and you'll see what sort of info people make note of.

 

One thing that can cause a drop is his pancreas trying to do its job. In some sugarcats, the pancreas still works, just not 100%. Food is supposed to raise bg's, and insulin, from his pancreas or a syringe are supposed to bring bg's back down. Also, when you remove dry food completely from the equation, or switch to lower carb canned food, most cats show an immediate improvement in bg's.

 

Here's hoping a change in diet will help him tremendously! Maybe the Blue Buffalo Freedom dry is very high in carbs and sent his body into turmoil? He's all catnipped up just now and passed out on the floor beside Zukey (also content on catnip) so I think I will leave him be for the night lol. I'm sure he's sick of me following him around!! I'll test him again in the morning and see where he is at. I feel much better tonight then I did this morning!! What a help everyone has been!!

 

Hope you all have a quiet, restful, and peaceful night. Glad to see numbers dropping with removal of dry also and so glad Zoey is okay cat_pet_icon Just remember to test first in the a.m. before feeding canned.

 

Good morning all!

We had a good restful night Everyone was hungry this morning though as they didn't have dry food out overnight like usual! It will take them some time to get used to meal feeding I think.... poor guys...

Unfortunately Hope I feed Zoey before I got on the computer to see that I should have tested first... Should I feed him three times a day? I could test before I feed him the next time? Should I be letting him eat as much as he will right now as he's lost weight and hasn't started treatment yet? I'm worried he's not getting enough and is hungry.

Our testing went much better this morning as I was more relaxed then I had been the second test last night. He didn't like it but I only had to do one prick and he still ate his treat after without needing catnip to entice him. So much less angry with me lol.

I'm looking forward to having a good day today!! Got to keep calm for the kitties! Lol.

 

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I leave a can of fancy feast out overnight for my boys.

 

I could do three times a day when I'm working... is that enough? Breakfast 7:30ish, early dinner 4:45ish and late supper 10ish? Or should I be coming home at lunch or break? I do live close and could come home at noon or 3ish? If I leave some out I think my piggy Gryffin will steal it all! Lol.

Zoey was up to 358 again this morning I'll test again at about 12-1 before I feed him again, have to leave for a couple hours...

 

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What time are you thinking you will do your shots?

Assuming you use Lantus or Levemir which are the best insulins for remission, you shouldnt feed two hours before the shot so that the food doesnt spike the measurement. You will be shooting twice a day - every 12 hours give or take 15-30 mins. The idea is test, shoot and feed. So that might change your times.

I am wondering about the carb level in that food. Hope the company gets back soon.

 

I have one piggy and two grazers lol. I've just observed that the piggy finishes his bowl and then walks away and leaves the other two alone, so that's good at meal times! But for anything thats left out when they leave or over night, he will eat it all before the other two know it was even there lol.

Could I test, shoot and feed in the morning? Say 7:30 am, just feed when I'm home at 4:45 pm then test, shoot and feed again at 7:30 pm? Or should I come home at noon to just feed instead of at 4:30 pm? His levels definitely jump as soon as he eats, I test before he ate just now and he was 238 as opposed to 358 this morning right after he ate.

I'm anxious about tomorrow, I hope my vet is in support of Lantus or Levemir and home testing! If not, I will still be doing that, I would just rather have her on my team for Zoey's sake! She was AMAZING with Gryffin when he was blocked and his ensuing surgery and would allow me to bring him in anytime she was there and I was scared of a block just to check him, for no charge. She also was great with Zoey's skin issues when he had to have steroid shots, she would never charge me to see him, only for the $10 of insulin she gave him. I love her and I hope she's open to suggestions if she has not used Lantus or Levemir in the past!! Here's hoping!!

 

Ok doky hang on - when did she last have the steroid shots? Thats a good diabetes trigger...

You could do this
7.30am test shoot feed
feed any time during the day ie 4.45pm
5.30pm take food away if still there
7.30pm test shoot feed

Wendy

 

The last time he had a steroid shot was mid 2011. He still had horrible skin issues, he would twitch everywhere because he was so itchy and had sores on his back, the steroids helped it heal but it came right back. So I felt like the steroids were too risky and only a band aid solution. Turns out food was the answer, not what my vet had thought he might have. I hope that it wasn't the reason he has diabetes now I'm just glad food was the answer, wish I had figured that out earlier though. I hope being on the wet food only doesn't start his issues up again... I'm guessing gluten is the issue, but I really don't know, I just know that Blue Buffalo Freedom dry made everything all better for the first time in years.

I can do that schedule. I feel guilty saying this because I'd do anything for my kitty, but I feel a bit sad looking at the schedule, even though I know it has to be done... I've been separated just over a year and have wanted to date but it will be hard now. I do feel guilty feeling this but I'm sure someone on here has felt overwhelmed with the commitment this requires, even though I'm so glad that he will be around for me to be committed to! I just have no one to talk to about all this, most people I talk to think I'm crazy for not putting him down since he's 14, but he's not dying, he's just a bit sick and can have a good life Feel free to share open opinions and tell me I'm being stupid lol.

 

Emily,
You're still allowed to date ;-)
Diabetes doesn't mean your life gets put on hold. If there's a conflict with your plans, we can help you with working around it.

And any guy worth a damn will realize how important Zoey is to you, and if he's really special, you'll find you have a partner in this. And worth dating a second time!

 

2011? Nah that was too long ago then.

Dont worry about the schedule, it will get routine. And if you get a date, then as long as you know in advance you can move his shot time by 30minutes a day to say 11am and 11pm and then go on your date And if your date doesnt understand your diabetic kitty and those needs.. then he aint good enough lol.

You are totally right to not put him to sleep, he can easily have a good 6 years of healthy life - once he is regulated asides from the shots you will forget he is diabetic and noone will be able to tell. He will be the cat you had before all this happened.

But lets aim for remission / diet control for now. A good percentage of cats go into remission within the first 4-6 months if you change to a low carb wet food (very important!!) and get on a good insulin such as Lantus or Levemir - which is exactly what you are doing - and remission is why its important to test. But you also need to be strict on dosing and be willing to change the dose if its not working. Take a look at the two protocols we use and decide which you prefer to use. Personally I like to push kitties hard and fast with Tight Regulation. its more time intensive but theres no messing around and I think its your best chance to get him regulated or into remission.

Tight Regulation Protocol – get him regulated fast - more aggressive method. http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581
SLGS – Start Low go Slow – slow and steady towards regulation. http://binkyspage.tripod.com/SLGS.html

Wendy

 

(((hugs))) don't feel sad. You'll do fine, and you are doing fine. And you're not crazy. You're a very loving person.
And I agree, you want someone who is like you and will do anything for their pets and dependants. Hang in there.

 

Thank you for the support It's all very overwhelming right now but I will adjust! Tomorrow is a big day, I really hope my vet will be cooperative! Going to test once more tonight to have a few numbers to give her.

Thanks again for all the support this weekend! I'm sure I'll be posting tomorrow once he starts treatment and will have a new set of questions! So thankful that I found this wonderful site!!!!

 

Please test, feed and then shoot. You want to make sure he is eating before shooting. Bad news if you shoot before feeding and then Zoey decides he doesn't want to eat. Can't get the insulin back out of him nailbite_smile

As for his age, my Baby(GA) was dx at 13 and lived another great 5 1/2 years with shots every single day but you would never know she had anything wrong with her. Lost her to heart problem.

 

Test, feed then shoot? Wendy suggested not feeding for two hours before shooting? So test, feed, wait two hours or more, then shoot? Shouldn't I test right before I shoot? Sorry I'm so confused!!

 

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That makes more sense, lol. As I was driving Zoey to the vet I was thinking and realized that must be what everyone meant, lol. Sorry for my confusion! I'll blame it on the fact its Monday morning lol.

So the good news is that my vet support home testing! She uses the Bayer Contour to test as well, so that is good! Not so good news, they use Caninsulin there BUT the vet tech said to talk to the vet (she wasn't in yet when I dropped him off) because she has written presciptions for people to get a different kind if they choose. So that is good!!

Here's hoping Zoey does well today!! Thanks again everyone!

 

.

 

Tell your vet you want to use Lantus or Levemir. And remind them you dont need prescriptions for those in Canada - you can buy them freely from the pharmacy anywhere like Walmart shoppers costco etc etc. Maybe they want to give you a script cos they get $ or can charge you for that?

When you get him home, let us know what the dose is they recommend before you shoot. Some vets start at too high a dose - the cat is stressed at the vets all day and his BG is high cause of it and they base their insulin needs on that. But when the cat gets home the BG drops and now the insulin is too much!!

Wendy

 

I just spoke with my vet and she is pleased with his numbers this morning BUT he hasn't eaten all day(!) so is she is only getting low numbers (252) because he hasn't eaten? She feels that with the low numbers today and the numbers from my two of the tests I did after he ate (380 and 358) on the weekend, that we can try him on oral medication? What is the general idea feeling about doing that?? With his numbers being high after he eats, is the oral medication going to help regulate that enough for him?
She is very happy that I did home testing and said he won't have to go in for curves if I'm monitoring at home; so glad she is supportive of that!

 

oral medication??? Does she mean glipizide?? Thats not good at all!!! We dont recommend it as basically it tries to stimulate the pancreas to work,and given the pancreas is damaged, it stresses it even more and you can forget remission. I would absolutely not want that. I can get others to chip in on this but I know they will feel the same.

You want insulin, even if its a small amount.

Wendy

EDITED TO ADD: 252 isnt that low really. A normal cat is 50-130.

 

I just spoke with her again and she does want to try glipizide... I asked about during a small amount of insulin but she says she is worried about hypo for him due to low numbers? I don't know what to do! I would like to try insulin... but I don't think I'm going to have her support on that... How bad would it be if I did insulin anyways? I know its my cat and I pay her, I would just rather have her on my side with everything and not get her upset if I go against her advice. She already thinks I'm a huge worrier and probably thinks I research too much lol. Now I have new confusion! Lol.

 

Ditto what Wendy posted. Glip can also affect the liver and rarely ever works in cats...they still end up needing insulin.

 

This is from the board's FAQ -

.

I've seen other members who have come here in the past couple of years that tried glipizide, and can't recall any that found it successful. All eventually switched to insulin with much better results. Oral meds just don't seem to work well on cats.

 

FWIW, they can also hypo on Glip and there are helpful pics and info on how to give just a teeny, teeny drop of insulin. How about seeing how he does with the numbers once he is settled back home and you test?

 

Yes, thats right Hope we had another member recently whose cat had a hypo on Glipizide. It is not recommended for use in cats as it can cause liver failure as the others have said.
I would not use it in my cat for sure.

Terri

 

And we're probably all thinking she doesn't research enough :lol:

Does anyone have the link to the AAHA guidelines handy? I don't have it bookmarked on my tablet. Maybe Emily can share that with her vet?

 

Ok, so no to the oral medication. Can anyone give me a suggestion on how to get her to support this? It sounds like she has only ever treated diabetic animals with the oral medication and caninsulin. Caninsulin is a fast acting insulin, correct? Maybe her suggestion of oral medication is because she would be using the fast acting caninsulin which could cause hypo since it is harsh? I would really like her to be in support of my decision to do insulin in case something happens and I need her, but I don't want to insult her as she has ALWAYS been amazing... Any suggestions on how to approach this diplomatically?

 

Her numbers arent that low. He wont hypo because you are going to be testing him and you will start him on a low dose. Heres the thing, you dont know us from Adam but I find a lot of vets just arent specialized in this. They are great generalists but not specialized. And they make broad assumptions about your knowledge and what you are willing to do. And is so much easier for them and some owners to just give him a pill.

You could follow her advice, and it might be ok. But from our experience he would end up on insulin anyway and never have remission. And I disagree - these numbers arent that low.

Or you could follow our suggestions and he could go into remission! We see a good 30-40% of cats go into remission within 4-6 months with insulin and diet.
If you decide to try the insulin
1. we will be here to support you as much as you need - and then some.
2. Our experienced members have seen hundreds if not thousands of diabetic cats. They look at cat blood sugar levels all day long. WAY more experienced than the average vet.
3. He wont hypo because you are going to be following our advice and testing.
4. You will not shoot under 200 unless you talk to us first and a member will be sitting with you and coaching you the whole way. They will stay up with you all night if need be.
5.You will be updating your SS daily and posting on our Tight Regulation forum where we can look and advise on a daily basis.
Tell me - What vet would do all this??? For free!!

Its up to you. What do you want for your cat?

Wendy

 

If someone can link you to the guidelines I mentioned, share that info with her. If I'm not mistaken, you can get lantus in canada without a 'script. If she reads the guidelines, I think she'll support that choice of insulin. Caninsulin is okay for dogs, but doesn't work very well on cats. Cat's metabolize insulin twice as fast as dogs or humans do.

 

Lantus and Levemir are long lasting gentler insulins. Hopefully one of the the Lantus users will come on here and explain more about how they work. Cats are less likely to hypo on these insulins. They are also more likely to go into remission(not need insulin at some point)

Terri

 

hi Emily

its a real worry at first, not following the vet's advice but a lot of us here made that choice and pretty much everyone is happy they did.
I am, my cat has been in remission for 2 months - that would not have happened had I followed my vets advice.

Basically, I didn't tell the vet anything - just did my own testing, dosing based on advice from here and fed her based on Dr. Lisa's food charts.
And, as Wendy wrote, people will stay up with you all night to help if needed - that certainly happened with me.
You are in great hands \M/

 

Found them...

http://www.felinediabetes.com/AAHADiabetesGuidelines.pdf

Emily, share this link with your vet,

Edit to add- if you read "glargine" in there, that's" Lantus".

 

Your vet sounds like she is a bit out of date. And you pay her so she works for you - you are her boss so dont worry about insulting her!!

Caninsulin is fast and harsh on cats - it hits them hard and wears off fast - if there ever was an insulin that would cause hypos this would be it!!

So maybe tell her you really want to go on Lantus. And email her the following links as well as the ones provided above ( fyi glargine = lantus)

http://www.ncbi.nlm.nih.gov/pubmed/19592286
http://www.uq.edu.au/ccah/index.html?page=41544 - lots of good links - this Australian university is leading the way!!

Also maybe you want her to call Guelph and ask them about it. After all many vets use Lantus nowadays and if anyone supports it and is up to date that she would believe , it will be the University of Guelph.

Wendy

 

I am very willing to do what I have to do and insulin is what I will do based on all your wonderful information. I will try to talk to her but if she is not for it, I will still be doing it. Ok, so now the tough part. Where do I get insulin and syringes in Ontario, Canada? For the short term, I can just walk into any pharmacy and get them? Long term, any ideas on pricing or links to websites I can research? I'm just at work so I'm stealthily posting right now, but can't really do any real research, sorry for seeming to be lazy lol.

And now the BIG question. How on earth do I give my cat an insulin shot? Does anyone live near me at all that could help? I will definitely watch any video there is, but if by chance someone is close I'd much rather have a hands on lesson if possible. I think that is going to be a long shot though unfortunately Simcoe is about an hour and a half from Toronto but if anyone lives there I'd be willing to travel if need be.

 

You can get them in any pharmacy i.e. walmart, shoppers, Pharma plus , Costco (cheapest) , Sobeys ....wherever has a pharmacy.

Syringes: In walmart the syringes are in the pharmacy diabetic section. In shoppers and costco etc you have to ask from the pharmacist counter. Syringes: BD Ultra fine 3/10cc short.Its a purple and white box with a "short/court" label. $33 for a box of 100 in Costco. $39 at Walmart. I use each syringe twice. Shoppers gives points though so you need to do the math!

Insulin: You can get a Lantus 10ml vial or Solostar 5*3 pack of pens. The pens are bit more expensive but last longer since you only open one at a time. You have to ask the pharmacist as they keep it in the fridge. Costco the pens are $99 . Shoppers the vial is $75 but there is less in it. Should last 6 months if you keep them in the the fridge... not the door.

Sharps box : free at Shoppers if you buy supplies there. Once you fill it, they will replace the full one with a new one.


Wendy

 

Ok, so I need the pen and syringes? I feel so dumb with all this lol.

Do you think I can successfully learn to give him a shot just by watching videos?

 

Yep - here is how to use the pens:http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=151
You dont need to buy needle tips for the pens, they arent accurate enough for cats so we use syringes instead with 1/2 unit markings. On that page, there is a picture like this below that shows a syringe going into the pen . When you remove the pen cap there is a little purple rubber end you insert the syringe into.



Have you ever given any kind of shot before? Its really easy - the needles are short. I would suggest you come up here to Oshawa and I could show you but its a long way from Simcoe . I would come down there but I dont drive.

My vet showed me - same as watching a you tube video I guess - but you dont know what its like till you try it yourself! here are some shooting tips: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=85113

 

That makes more sense now! I thought you shot with the pen and was confused about the need for syringes lol. I get it now!

I am going to speak to my vet and show her some information and hope against hope that she will be in agreement... If she isn't and seems upset I will just not tell her I plan to do it anyways I suppose. In that case I may be making a trip to Oshawa, although it is a 2 hour drive unfortunately. If I start insuline should it be on a day I am home all day? I can't really take any time off work, I don't have back up right now... I do live 5 minutes from my house, leave for work at 7:45 and I could go home at 10, 12 and 3 and be home at 4:45... but should he be watched 24/7 for the first little while?

 

You could try giving your vet the links and ask her to look into it? "I found this stuff - can like you to ask around and look at your vet database to see what it says?"
My vets ( i have 2 cos I have rabbits) always refer to some vet database when they arent sure. This is a good test to see how good your vet really is Will she look at the research? Will she do the research herself on her vet sites? Will she support you? Or will she dismiss it out of hand?! Then its "Fine but I am doing this anyway and I would like your support."

He wont need to be watched 24/7. But for your own peace of mind you might want to start him on a Saturday when you can watch and test more often. Until we find the correct dose you will need to get a few more tests in - like say at 12.30pm (?5hours after morning shot) and before bed say at 10.00pm.

BTW Are you testing his urine for ketones? We recommend that twice a week or if they are over 360. You can get keto-diastix from any pharmacy.

Friday is pizza night if you want to come up then?

 

Ok, we are back from the vet. Zoey did not eat a single thing all day while he was there He did just eat about a 1/4 can and seems his normal sweet self.

So the discussion with my vet didn't go badly, but she would still like me to try him on the oral medication (Glipizide) for 2 weeks and she agreed to read the research I brought for her. She has never had someone that did home testing and has no experience with Lantus, except once or twice when she was at an office where the cats came in to the office because they were hypo. She didn't know though if they were doing home testing and adjusting the dose. I didn't fill the script for the medication, I'm not sure what to do. She knows I really want to try the Lantus, I think she's just nervous because she can't really advise me well on what to do... She is very happy with his numbers and thinks they are very low (at the lower level) for a cat with diabetes and feels the medication will bring them down. She would like him to be at 9-10 (162-180) all the time and thinks the meds will take him there. She has never had a cat go into remission but will be happy if I prove her wrong.

Now I don't know what is best for Zoey... Is there research someone has that says their numbers are supposed to be lower? I think she's really worried that he will go hypo. I love her as my vet and want her to be in support! His numbers at the vet today were 262 and 288 without any food and with a lot of stress most likely...

Should I try the meds or do insulin? I have severe issues making decisions and am lost on what to do...

 

I am not surprised he didnt eat - way too much stress.

I really would advise against the glipizide.. you dont want to damage his pancreas any more. I know you like her but just because she isnt experienced isnt a good excuse not to use it. She needs to do her research.

Now you are home testing. You arent going to get into that situation of hypos. I tihnk some vets prescribe too high doses of insulin and dont have their clients home test and then there is a hypo situation. You are going to start on a nice low dose and test and increase slowly. It will be fine.

Remember you can still have hypos on glipizide, i have seen that on here.. so I dont see the difference. It might well bring him into range but also might make him diabetic for life and have to go on insulin forever.

Starting insulin now is the best chance he has for remission. And the good thing is that I am only a call or short drive away.

Heres a thought. Test him for ketones and try low carb diet for a few more days. Lets see if moving to only low carb food will bring him down any further. That gives her time to read the research. And you to think about it. As long as he doesnt have ketones a few more days wont do any harm.

Wendy

 

Oh and I wanted to add that if you do go on glipizide, he could hypo anyway. And if/when it doesnt work you will still have to go on insulin, and there is a hypo possibility there if you didnt test... especially with the insulin your vet uses.

Cut to the point. Start the good insulin now and get Zoey regulated or into remission if he is lucky. I read today most cats go into remission in 4-6 weeks of starting the insulin.. do you want to waste two weeks and the short time frame for his best chance for remission? Sounds like your vet had a bad experience You can teach her something here.

Also have you looked at the food chart? Its key he is under 10% ( even better under 8%) calories from carbs.

Wendy

 

Oh ya, I forgot to answer you on the ketones. I did test him yesterday and he has no trace. The vet tested him again today and he still has no trace. I really think insulin is the best option for him... We will keep with the canned and wait to see how he does over the next few days then I will keep testing his ketones to make sure he is doing alright. I am not going to start the medication. I will probably start the insulin this weekend.

My civvies are trying to tell me they are starving to death lol. I took away their dry free feeding and am meal feeding a can of Friskies a day. Gryffin has desperately trying to convince me he will die if he doesn't get more food lol. Drama king!

Thank you again for all your support!! I feel better knowing you aren't far away Wendy

 

Great! So when you get Lantus we need to calculate a dose.

The formula is 0.25 unit per kg of the cat's ideal weight. What would that be for Zoey? But usually 1 unit every 12 hours if the math works out more than that.

Here is information on the protocol for you to read: http://felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

I am also going to suggest you start posting daily (if possible) on the tight regulation forum where there are some seriously experienced members who will help and advise every day but keep on here for now until you get the insulin.

How heavy are the civvies? 1 can doesnt seem like a lot but it depends on their ideal weight and we can do the math.

 

I'm not sure what their ideal weight is! Is there a way to calculate that? They are all strays so I'm not sure on their exact breeds. Zoey is similar to a Norwegian Forest cat maybe with Maine Coon, Zukey appears to be Maine Coon (probably both have domestic long haired also) and Gryffin is just a big short haired domestic. Does their body length come into play on ideal weight?

 

Well what do you think? Is she fat? Did the vet say she needed to lose weight? Or did the vet say she had lost too much? Do you think she is skinny? Judging by your response I suspect she is just fine - whats her weight right now?

 

He's 14 lbs and I can feel the bones in his back now, but he's so darn fluffy that its hard to tell lol. The vet said he's pretty good, could maybe lose a pound but she thinks he's alright. I know Gryffin is overweight at 18lbs(!) and Zukey is about 14 lbs. I think Gryffin could lose about 3-4 lbs at least, so I would say ideal for all might be around 14 lbs. How much would they get to eat based on that?

 

what flavour of friskies do they get?

The math is Required calories per day = [13.6 X ideal weight in lbs] + 70

Edited to add: So joey at 14lb = 6.4kg *0.25 would be at 1.6IU twice a day. I think 1 unit would be safe to start. I will ask a more experienced dosing member to comment.

 

I got the classic pate seafood mix: salmon dinner, seafood supreme and white fish and tuna dinner for Zukey and Gryffin, are those good ones? Zoey I still have on the Lick Your Chops one that his skin tolerates, not sure what the calories are on that one though. Maybe I should be feeding Zuke and Gryff a can and a half by looking at Lisa Pierson's food chart...

 

I hope Sugarcat gets better! My cat Shadow was just diagnosed on 3/4/13 and was put on insulin that day at the vets. I was shown how to do the injections and had to start him on 2 u of Prozinc. It's been stressful learning to give the shots and test his blood sugar, so if you need help I can certainly help you. When I took Shadow into the vet his blood sugar was over 600, and was spilling sugar in his urine. Don't wait too long to have his blood tested, Sugarcat can suffer from neuropathy from having sugars too high for too long.

 

Emily,
I haven't heard back from Lick Your Chops folks yet on the calories. But I'd guess it's somewhere in the 150-200 calories a can range. If Joey is 14 pounds right now, he could probably use 1 and a 1/2 cans a day? Less most likely once he's "better" but he'll need more than normal until then. Bob weighs 14 pounds (no longer on insulin) and he gets about 250 calories a day. It's not an exact science, because it can also depend on how active a cat is. 15-20 calories per pound per day is a nice ballpark number to use.