Newly Diagnosed

Hi I'm Brandi and my 10 year old male, Kingston, was diagnosed on 5/17/20. On 5/13/20, I had taken him to the vet due to a skin issue. He had dermatitis possibly from a flea bite. He was given a steroid shot and antibiotic to help it. Well on 5/17, he was very lathargic and would hardly move. I took him to the emergency vet because it was a sunday. After a blood panel, I found out he was diabetic. They then did a urine analysis and found glucose and ketones in his urine. He was given IV fluids and stayed overnight. The next day he was transferred to my vet and stayed for a total of 5 nights trying to get regulated. He just came home yesterday. I've started home testing, changed his food to a wet canned food, Fancey Feast classic pate. The vet perscribbed him the Hills m/d food and 7u of vetsulin insulin. I'm being told that is way to large of a dose and I havn't been giving that much. I've only been giving 4u and then 3.5 this morning. This evening, his numbers were low. So I didn't give him the insulin this evening for fear it would be to low. After 3 hours post eating, his numbers are at 259. I'm second guessing my choices of not giving him insulin but I was told it was better to be high for a cycle than low for a moment...

This is my first full day with him at home post diagnosis so I''m nervous taking care of him. Any advice is greatly appreciated!

 

HOLY COW 7 UNITS IS AN INSANE DOSE for a newly diagnosed cat. RUN, DON'T WALK away from this vet. The recommended starting dose is 1 unit twice a day!!!! I'm not being dramatic when I say this vet is going to kill your cat. If you had just kept shooting 7 units blindly without testing I can pretty much guarantee you would be back in the vet with either a dead, or almost dead, cat.

What meter are you using, human or pet meter?
FF Classic is a perfect food choice. I'm so so so glad you are testing at home. you literally saved his life. OK so here's what you do. IN the morning, when you would normally be giving his shot.... test him. If he's over 250 give 1 unit of insulin. then test him about 3 hours later and see if it's going down. Then test again at 5 hours. Vetsulin can start working pretty quickly, but usually the lowest point is between 4-7 hours after the injection.

In the meantime, please read our info about using vetsulin: http://www.felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.186099/

I'm so glad you found us. Yikes

 

Two things you can do to help us help you. When you get a chance: 1. set up a signature like the one you see below most of our posts. To do that click on your name on the top right, choose signature. Add info such as your pets name, date diagnosed, insulin type, food you are feeding, the meter you are using, and any other health concerns or medicine's given.

2. set up a spreadsheet... you can put the link into your signature once you do. Here's info on how to do that. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

Welcome! I’m so glad you are home testing. Janet has given you some great advice. Testing is especially important as the steroid shot wears off, usually 3-4 weeks, some cats can go into remission

 

OH, one more thing... since he has a history of ketones, you will want to monitor for them. There are two ways of doing this... you could get some ketone sticks at the pharmacy which you put in fresh urine... or you can get a ketone blood meter, which works just like a glucose meter. I do the meter because it's so much easier then getting a urine sample, although more expensive.

 

ok I will work on getting my signature set up! I have the spreadsheet going! I started it today because today was the first full day of having him home and I was able to enter my data!

 

I do really like this vet! I honestly don't know how to feel about this because I swear he's good. I really do trust him but I agree, if I didn't find this forum and the FB page that goes with it, he would be dead. I most defiitely HAVE NOT given him 7u. I gave less than that.

So what do I give if it is higher than 250 tomorrow morning? This morning it was over 400 before breakfast and insulin.

 

I would do 1 unit. that 400 could have been a bounce from going too low the cycle before. The best way to find the right dose is to start at 1 unit for a few days. If it is not enough then you gradually raise the dose in 0. 25-0.5 unit increments until you get the dose you need. Most cats never need more then 3 units.

Even wonderful vets don't know everything about all diseases. It's clear this is an area he doesn't have much experience in, or perhaps is more used to dealing with diabetes in dogs. Most vets only get a few hours of instruction on diabetes in vet. school. they also tend to raise doses too quickly in whole units which is dangerous.

 

My cat was recently diagnosed with diabetes and did an 5 day vet stay. They did a urine test and found glucose and ketones in urine. They did IV fluids with nausea meds and started insulin.

my questions now are how long do ketones last?
He’s eating great and drinking normally from what I can tell. Made a complete 180 turnaround from when I brought him in.
How often do I test for ketones?
He was given a steroid shot a few days prior to diagnosis and UTI was discovered with diabetes and now on antibiotic.

the vet wants to see him Tuesday after Memorial Day as a check up.

 

You can buy urine ketone test strips, such as Ketostix, at most pharmacies. Try to test him every day if you can. Anything above trace ketones needs to be handled by the vet. Fluids are good to help flush out the ketones. If you can, add some water to his food. There is lots of information about ketones, and how to test for them in this post. Click on the blue link.

What is your kitty's name? And which insulin type and dose are you giving now?

 

His name is Kingston. He’s on Vetsulin. Dosage is what I’m trying to figure out too. I’ve read that page already and don’t feel like my questions were answered.

He was handled by my vet so what do I do now?.

How long do Ketones last?

 

I agree that 7 units is too much!!
However I’m concerned you have skipped a dose with ketones in the picture.
It is really important that you give the insulin each 12 hours and Kingston gets plenty of food.
Ketones form when there is not enough insulin and not enough food.
It can quickly turn into keto acidosis (DKA) especially if there is an infection present as well. I’m glad the UTI is being treated.

So feed Kingston up to 1 1/2 times what he would normally eat. To get rid of ketones feed more.
Also if you can get the spreadsheet up and running so we can see it, that will help..
We need to find out the dose of vetsulin you can safely give that will keep the ketones at bay.
It is very good he is eating. A lot of cats who have ketones won’t eat.

Do you have plenty of high carb food and some honey or karo in case of low numbers.
Are you testing before every shot and again during the cycles?

There is no set time ketones last. Some cats don’t get them again and some cats seem to be very prone to them.
The way to keep them at bay at the moment is to feed Kingston plenty of food, give him his insulin, test the BG, and test for ketones at least once a day and given extra fluids.

 

Ketones last until whatever caused them is taken care of. The only way to know if the ketones are gone is to test for them. Since he is eating, drinking and acting normal, he may be fine but the only way to know is to test. Also, cats that have had ketones often seem prone to getting them again, so if you are testing you can catch them early and often avoid that big vet bill.

 

Some cats get over ketones quickly, others take a while. Some cats never get ketones, some get them frequently. The easiest way to check for ketones for me is to use a ketone meter (I use the keto mojo which I got off amazon). Ketostix are much cheaper, and you can get them in the pharmacy... but you have to use them with fresh urine. As far as the dose, what did your vet say? Most cats start at 1 unit twice a day.

 

Yes, I have high carb dry food and I do have honey in case of low numbers. Yes, I am testing before each shot and I test about every 3-4 hours after to monitor his BG. This makes sense about them lasting. So I gave him a full cane of Fancy Feast pate after I took his morning BG. I'm going to wait about 20 min and then give him 1u of vetsulin and monitor how he does. How do you think that sounds?

 

Well his vet said 7 u 2x a day. But I know that is way to high. He was also on dry food during his stay so obviously his numbers were high because the dry has too many carbs. So someone on here suggested 1 u for a few days since I switched him to the canned. What do you think?

 

perfect. what was his number today?

SO here's some things you can do to help us help you. First set up a signature like you see below our posts. to do that click on your name at the top right and go to signature. Add info such as your cat's name, date diagnosed, insulin you are using, meter you are using, food you are feeding, and if there's any other health concerns.

Now that you are testing at home (awesome job, btw!) you can also set up a spreadsheet that can be added to your signature. Here's the template and directions. If you need any help setting it up just ask. http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

 

ah yes. that was me that suggested it. hahahahahaha. I saw your other post. You are doing great. Fantastic that you are home testing already. Eliminating dry food makes a big difference.

 

His AMPS was high. It was 446. Too high for my liking. In time will that start to lower?

yes, I will work on my signature. I’ve got my spreadsheet started and I’ll work on adding that too. Sorry. Still new to this!

 

haha thank you for your advice! You’ve been so kind and helpful!

 

Happy to help. I've been on this ride for 4 years now, but I vividly remember how scary those first weeks are. It will all be routine very quickly, and before you know it you will be helping other new scared, stressed people just starting out.

 

If after a few days 1 unit proves not enough we can try 1.5 for a few days and gradually raise it until we start seeing lower numbers mid cycle. With prozinc we are more concerned with how low it takes him rather then what the starting number was. Eventually that starting number will come down.

 

Can you set up a spreadsheet if you are home testing? Here's the link to the instructions.

 

Welcome and you’ve got some great advice already!

7 units holy crap that does sound like a dog dose urghhh

yes, in time with the right dose the numbers will go down to the 200’s at the pre shots. It’s a bit of trial and error until you get there but home testing is key. And the numbers at the vet will always be elevated because of stress. Here’s a link for the signature instructions:

http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

 

And the signature please so you don’t have to repeat his history to us every time because the info will be in your signature and we can all see it

 

over time it will come down, yes

 

Normally with cats showing ketones, we are reluctant to drop the dose down a lot. Since 1 unit has been suggested to you, it's even more important to test for ketones. Ketones can go from trace to high in a few hours.

 

Yes but her vet told her to give her newly diagnosed cat 7 units! Can't do that. 2 units would probably be ok... but 7 was scary high.

 

He has also had a steroid shot. Here’s the link to her first post http://www.felinediabetes.com/FDMB/threads/newly-diagnosed.230020/

 

Yes that is what the vet said and he did have a steroid. I think I’m going to keep it at 1 for now. That steroid needs time to leave his system. That’s probably why he’s high. I changed his diet to a low carb wet food so I am only giving 1. I hope this helps. I don’t want him to get anymore ketones so I’m making sure he eats well and gets plenty of fluids.

 

I updated my signature and added my spreadsheet! Any more advice would be greatly appreciated! Thanks!

 

http://www.felinediabetes.com/FDMB/threads/newly-diagnosed.230020/#post-2575012
Here is your other thread on the same subject
@Wendy&Neko Is it possible to merge these two threads please?
Looking at the SS I am concerned 1 unit may not be enough insulin, given there are ketones in the picture. @bgiff420 Have you tested for ketones since reducing the dose of insulin?
I have no experience with vetsulin dosing @JanetNJ @Deb & Wink what are your thoughts on increasing the dose?

 

I would be onboard with 2 units to start.

 

Thanks @Wendy&Neko for merging threads.

 

Thanks everyone! So do you recommend I start that tomorrow then?

His +2 number is 364. Is this slow lowering?

 

Let’s see what @Deb & Wink thinks as well.
Have you tested for ketones yet? It is really importamt you do as that helps determine if we need to increase the dose of insulin.

 

I'd be good with trying 2.5 based on the numbers on the spreadsheet so far.

 

I went ahead and tried 2 because I wasn’t sure and wasn’t able to see this before it was time to give it. His AMPS was 383. That’s the lowest AMPS since I’ve brought him home! This gives me hope.

Now I’ve got another question. So I was supposed to check, feed, shoot at 6:00 am CST this morning... well my stupid self set my alarm wrong and I didn’t do it until 7:30. So now he’s off by an hr and a half. I feel terrible. How bad is this? Should I go back normal this evening and do 6:00 or do I need to wait until 7:30 again? What’s the best way to go about adjusting back?

 

oh good! Nice to see that number lower.
No biggie. Vetsulin is not a deposit insulin. One of its pros is that it's more flexible with shot time. I'd check the number at 6:30 tonight. Then tomorrow you could move back to 6. Don't forget to update your spreadsheet.

 

Has anyone ever experienced numbers stalling? I checked him just now and his numbers were the exact same as they were 2 hours ago. Is this normal? They were 253. As of now he's about 2 and a half hours from more insulin and dinner.

 

Nice! You are getting longer duration, but it's not so low that you have to be afraid to shoot!

 

What Janet said.

 

So you think I should try 2.5?

 

I tried but he doesn’t like me messing around back there and won’t go when I tried to get back there. I’m going to get puppy pads and try that.

So what do I do if there are ketones again? What am I supposed to do? I’m giving insulin, he’s eating great, drinking water. Not sure what there is to do.

 

The reason it is important to test for ketones after your kitty has had them is to monitor the situation to ensure they won’t come back, especially since the dose of insulin was reduced a lot.(and it needed to be reduced because 7 units was much too high) The only way to do this is to either test the urine or buy a ketone blood meter and test like you test for Glucose in the blood.
If ketones do show up that means that food needs to be increased and/or the dose of insulin needs to be increased
Try putting a small container in his favourite spot to pee. Or put some crumpled plastic in the LB to catch some pee.
You are doing really well with him and hopefully ketones won’t reappear, but there is no guarantee.. monitoring is the only way to be sure.

 

That's what Janet said.

LINK >>>>>>> Catching and Testing Urine Tips.