newly dx 12 years old Zoe

Hi all,
a few weeks has passed since my poor Zoe was diagnosed. I brought her to the vet after noticing she was losing a lot of weight (went from being an obese kitty to skin and bones), drinking LOTS of water, always hungry, she started leaking urine whenever she would sit or lay down and was constantly peeing just outside her litter. When I brought her to the vet and she was diagnosed, I was overwhelmed and didn't know the right questions to ask. The vet put Zoe on caninsulin 2 units BID and Medical diabetic kibble and asked to see us in a month to do a BG curve. But after much research on this wonderful forum, I feel like I can I will be able to manage Zoe's diabetes better on my own so I've canceled the BG curve at the vet next weeks, got myself a BG meter (one touch ultra) and started testing on my own. From Zoe's BG readings, I soon realized that the caninsulin isn't working well for Zoe (take a look at her spreadsheet). When I do the amps and pmps, her BG readings are through the roof (the meter won't even read it - just says 'HI' which indicates a reading above 600) although I have noticed she is drinking a bit less water and is not as hungry all the time and she isn't having as many "misses" when she goes to the litter. So after 2 weeks of being at 2 units BID, I increased her dose to 3units BID. This seems to have had the opposite effect - her BG levels are higher than when I was giving her 2units BID. So yesterday I decided to go buy Lantus. This is where I need some advice...
1. how many units should I start Zoe at?
2. I also didn't know what kind of syringes to buy for Lantus (pharmacist needed to know how many units I was going to administer to advise on which syringes to suggest) so is it possible to still use my U40 syringes?
3. As for her food, should I stop feeding the diabetic dry kibble? I do have some fancy feast and friskies pate at home but I used to save those for treats. Zoe will gladly eat a wet food diet but I need to know how much to feed her and how often.

Thank you!!! So glad I found this forum!

 

Good morning and welcome to FDMB. My first suggestion for you is that you switch Zoe over to all wet food. The Fancy Feast classics are a good choice because they are less than 10% carbs which is good for a diabetic cat. The dry kibble is not good for a diabetic for two reasons, the high carb content and the fact that it is dry. Cats are obligated carnivores and are designed to get their moisture from their food. When you change the food be sure to only change about 25 % at a time to avoid tummy upsets.

Am I correct in understanding that you are not giving any insulin right now? This is important because a diet change can have an enormous impact on the need for insulin. My cat was on caninsulin and when I changed his diet he raced down the dosing scale from 6 units 2x a day to no insulin required in just one week! If you are still giving caninsulin you will most likely need assistance from experienced users here with adjusting the dose to keep the cat safe from hypoglycemia which can kill. You are already have a critical tool to help you adjust the dose safely - your BG meter! You will use it constantly to make sure you aren't giving too much or too little insulin. Good job on already having that part in place.

As for your question about how much to feed her, my cat eats about 2 1/2 to 3 cans of the classic Fancy Feast a day so that will give you a general idea. Of course the amount you need to feed depends on many factors - how much does she weigh now? How much is normal for her? My personal rule of thumb when I was starting out was if the cat is hungry feed him. But in the beginning my normally 16 pound cat was down to a very scrawny 10 pounds. Every cat is different so you have to make the appropriate adjustments that work for your cat.

I know this is a lot of information to absorb so I'll stop here. We are glad you found us and will be happy to help you help your Zoe. Please let us know what we can do to help.

 

Hi Jan,
thank you for your prompt reply. Ok I will switch Zoe to an all wet diet today. I have a mixture of fancy feast and friskies. Should I stick to one brand?

I'm still giving caninsulin until I can be advised on how to proceed with the Lantus. Luckily, I'm on mat leave for a year so I can closely monitor Zoe all the time for signs of hypoglycemia.

Unfortunately Zoe is also very thin at the moment - only weighs just over 9lbs. I hope that she will gain weight once I have her diabetes under control.

 

Hello Nat,

My Sasha was very thin and the vet said it was fine to free-feed him. He did put on a little bit of weight when his diabetes was under control. There is a thread on the forum that discusses food. I will look for it and come back and paste a link.

Here we go:
http://www.felinediabetes.com/FDMB/threads/nutrition-diet-links.115/

Also helpful:
http://www.felinediabetes.com/FDMB/threads/feed-kitty-as-much-as-they-want.130901/

 

Be very careful with your switch to Fancy Feast!! Read this information about what to do about hypos!!
http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/
Get your hypo kit ready before you switch the food!!

I can't get to your spreadsheet. I think it's because you have not given permission for others to view it. We will need to see your spreadsheet to help you more effectively. If you look at the directions again I'm pretty sure there is a place that must be clicked so others can see the spreadsheet.

 

Hi Jan,
I just changed my permissions. Can you see my spreadsheet now? Thank you for they hypo link. I've got my hypo kit ready but I don't think she's anywhere close to being hypo at the moment with the BG levels I've been getting but I will still make the transition to wet food slowly as to not throw her into a hypo episode.

 

Yeah!! I can see it now.

I'm no expert by any stretch of the imagination, but when I look at Zoe's spreadsheet and see all those high numbers my first honest thought is that you may be giving too much insulin. I'm not sure what the best course of action is so I will try to find others who can help you figure out what to do next as far as the next dose is concerned.

It will also be useful if you can do some additional BG tests today just to see what's happening during Zoe's cycle. How many hours has it been since you gave her the morning dose?

 

Hi Nat. I saw that you said Zoe weighs 9 pounds. Do you know how much she should weigh?

Just to clarify. The dry food isn't going to put Zoe into a hypo episode. The concern is changing to all wet low carb can greatly reduce the amount of insulin needed. That is why if you are switching to low carb wet that you need to have your hypo kit ready, and test frequently during the change.

Did the vet say why he started with 2 units?

 

Do you have the Lantus already in your possession? And who are you waiting for direction from? Someone here or the vet?

And does Zoe have any other health problems?

 

Stopping the dry food may reduce the glucose from 100-200 mg/dL and reduce the insulin dose from 1-2 units. Your mileage may vary.
Insulin dose adjustments are based on how low the glucose drops between shots, NOT the pre-shot test. Thus, it is important to test at the expected low point (nadir) which is around +5 to +7 hours post-shot for Lantus (+3 to +4 hours post-shot for Caninsulin).

Please work with your vet in switching to Lantus.

The starting dose is calculated as follows:
Take the lower of her current weight or her ideal weight.
Convert to kilos if weight is in pounds
- (pounds/2.2)
Multiply by 0.25.
Round down to nearest 0.25.
You will need U-100 syringes with half unit markings. We use the Lantus pens as mini-vials and draw out the insulin with a syringe; no need to get the pen needles.

 

No the vet basically just told me the dosage and left me with the vet tech which didn't say much more

 

Yes I just got the Lantus yesterday but I only have U40 syringes at the moment. If someone can tell which syringes to buy I can pick some up today. The vet didn't mention any other health concerns. And I would like guidance from the experts in this group. I was not impressed with my vet and it appears most vets are not experts in FD.

 

Ok I got a 10ml vial because the pharmacist told me the rubber seals on the mini-vials are not meant for multiple usage with a syringe next time I will buy the mini-vials. I really don't trust my vet's expertise in managing FD.

 

I won't be able to do BG monitoring for this AM post caninsulin shot as I'm away from home till later this afternoon but I can take her BG after tonight's shot.

 

Do you know how much she should weigh? Based on BJ's formula, I believe that her starting dose should be 1 unit. @BJM can you confirm?

 

Does not make sense. The inward end of a pen needle is a little needle the pierces the rubber stopper every time the pen needle is replaced. That is not different that sticking a syringe needle in the stopper.

You want human U1oo syringes. Those have an orange needle cap unlike the needle cap on U40 syringes which is red. You want syringes with 3/10 CC capacity and with 1/2 unit markings. Needle length can be 1/2 inch or 5/16 inch. Many prefer the 5/16. You want either 31 gauge (thinnest) or 31 gauge. You can get larger diameter (lower gauge numbers) ones too. The 1/2 inch length is not available in 31 gauge I think

 

Yes, 1 unit is the calculated starting dose for Lantus.

By the way, I think the reason your numbers were going higher on the Caninsulin may have been that the dose was too high.

 

That is odd...next time I will buy the mini vials.

I picked up the u100 syringes today so I'm ready to start Zoe on Lantus tomorrow. I will start her on 1 unit and do a BG curve and report back tomorrow.