Oreo and Justgin

Discussion in 'Welcome to the Group - Post an Introduction Here' started by Justgin, May 8, 2017.

  1. Justgin

    Justgin Member

    Joined:
    May 8, 2017
    Hi I am new here. Oreo got diagnosed a few weeks ago after vomiting the night before. He's 13. He was a feral cat from birth. I started feeding him and his two siblings and another kitty family on my back porch many years ago.

    On Monday night, April 17, Oreo vomited, he must have thrown up about 7 times. But he still wanted to eat. I'd noticed he'd been losing a little weight over the course of several months but thought it was due to lower carb diet. I took him into the vet the next morning, Tuesday April 18. They drew blood and urine but did not do a quick stick. I wish they had.

    The next morning, April 19, the vet phoned me at work and said his bg was 420's and he had some trace ketones in his urine. He wanted to see me the very next afternoon, but I wanted to get Oreo on insulin NOW.

    That night when I got home, Oreo didn't even want to eat and was lethargic. I was afraid he was going into ketoacidosis and took him the the vet ER. They tested his bg and it was 460's but they did not want to give him any insulin. I was due to see the vet the next day anyway.

    The next morning, April 20, I called the vet and asked to be seen sooner than 5:30 that afternoon, but that vet had surgery all day and could not see me. I had to be worked in. Oreo is a feral cat, and that first vet visit was very hard on him, I didn't want to sit there for God only knows how long until I could be worked in. So I called another vet office recommended to me by one of the techs at the ER the night before (she even told me she would not recommend taking Oreo back to that vet who diagnosed him, nor anyone else at that practice.)

    So I got an appt with the recommended vet office that morning, still April 20, and canceled at the other office just due to that vet's unavailability and the urgency of the situation. The 2nd vet put Oreo on ProZinc insulin starting at 3 units every 12 hours. She told me to dose blindly. She discouraged home testing and told me that you can't use a regular glucometer on a cat because their blood is different. SMH!

    Being a nurse, I didn't like blind dosing at all. I'd done some internet searches and found Dr. Hodgekins who recommended ProZinc and TR, so I thought this was the best thing for Oreo. In retrospect, I've wasted a lot of time. I even told this vet I work 12 hour shifts and she still put him on ProZinc. I used to work in a hospital many years ago back when the insulins used were Regular, NPH, and Lente. I'm not familiar with these newer ones.

    Anyway, vet #1 had already written me a script for Lantus the day he notified me Oreo was diabetic. When I had asked him about ProZinc, he said he didn't like to use it because Lantus was more stable. I wish I'd listened to him. None of these vets are taking the time to listen to me, which is discouraging.

    I started trying to test Oreo at home after I got a One Touch glucometer about a week ago. Oreo resisted, to say the least. I kept trying to take baby steps, getting him used to me petting his head, which he does not like, and rubbing his ears, which he hates!

    When I stopped giving any dry food last Thursday, May 4, I also stopped the insulin for almost 24 hours, per the TR detox rules. Then Friday May 5 I tested Oreo for the first time at 1930. His bg was 338, so I dosed him using the PZ scales used on the YDC website. I had been talking with one lady there, who told me about another smaller group website, but I find it difficult to get information from her because of the language barrier. Some of her info has been confusing/conflicting and at times even alarmist, which I don't like.

    I've had increasng difficulty sticking Oreo and getting a sample. Last night was the absolute worst. So today I'm taking the day off and not testing him. It's become a damned nightmare anyway. I almost threw that little machine and broke it because I was so frustrated. And after working 2 12 hour shifts, I was exhausted.

    So now I'm here looking for guidance as I switch Oreo over to Lantus. Will call his original vet today, the one who first diagnosed him and gave me a script for Lantus.

    I'm sorry this is so long. If you've read this far, thank you!
     
  2. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    Welcome! My goodness, you've been through the wringer. Yes, a feral cat will take more training time to be somewhat agreeable to having his BG tested but there are others here who have done it with a feral.

    What you need now is a plan and support from people here who have a ton of experience. I suggest you begin by asking some specific questions on the main health forum where your post will be seen by more people. We can help you get Oreo on track. Don't destroy your glucose meter yet! :);)
     
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  3. Justgin

    Justgin Member

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    May 8, 2017
    Thank you, Kris and Teasel!
     
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  4. Yong

    Yong Well-Known Member

    Joined:
    Jan 11, 2017
    Welcome Justgin and Oreo!
    Your Vet run around sounds a little like mine so I decided to take charge and a hands on approach. I will give an update to one Vet if they should ask me, the other I use to get his insulin because they're price is better for the Prozinc. Sounds like you are making some progress with Oreo and like Kris said, he will take more patience (We offer complimentary patience pants here! ;)). We do have a couple members with semi-ferrals, one in our Prozinc group @Djamila who might be able to help with some tips on how she got her boy to where he is :). Vet's don't approve the use of human glucometer because they don't seem to want to take the time to understand the numbers. Glad to hear your nurse instincts wouldn't let you shoot blindly :bighug:. Unfortunately, I injured myself about 2 weeks after my boys diagnosis so I had to shoot blindly, I knew he couldn't miss getting insulin. Think my hair got even thinner :rolleyes:. Let us know which insulin you plan to use. TR protocol is for Lantus, Prozinc doesn't have those sort of protocols since it is not a depot insulin. Going to leave you with some links to instructions now :cat:
    Signature information: http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/
    Spreadsheet template: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
    Hypo information, better to be prepared: http://www.felinediabetes.com/FDMB/threads/how-to-treat-hypos-they-can-kill-print-this-out.15887/

    Ask any questions, we would be glad to help any way we can! This is a support group for Oreo and YOU :bighug:
     
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  5. Justgin

    Justgin Member

    Joined:
    May 8, 2017
    Thank you Yong for all the info and links! It's been a tough couple of weeks :( Hopefully I'm zeroing in on getting Oreo on the right drug. He's off all dry food now and on low carb - as far as I know! I hate not knowing for sure just what the percentages are in each can. Some people who make their own kitty food swear it's actually cheaper to make it than buy it. I'd like to know more about that if you know anything about it.
     
  6. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    Many here just feed Friskies and Fancy Feast pates. They're low enough in carbs, easy to find and economical.
     
  7. Justgin

    Justgin Member

    Joined:
    May 8, 2017
    That's pretty much what I've been feeding. Except I did add in some NVI canned: LID Turkey and regular canned which has 95% protein on the label. (It contains peas and carrots, which I pick out. I called the company and they maintain that the carb content is about 1.something % in these cans even with peas and carrots. Do you know anything about that?)

    I found out that two of the Friskies cans I'd been feeding had RICE in it, so I stopped that. In fact, the pro and prebiotic I've been adding to their food has rice listed as the first ingredient. Since Oreo's been having sugars as high as 478 (last night), I want to make sure his carb content is as low as can be. It's already been 4 days on no dry/low carb. I don't understand why his sugars aren't coming down further.

    To complicate matters further, Oreo's "cousin" Nat has stage 1 CKD, as well as seizures (unknown origin). So that narrows the pickings further. I have a list of low phos/low carb but those cans are not easy to find. Any advice overall?
     
  8. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    I personally don't worry about the rice in Friskies because it's fairly far down the list. Go to the main health forum and look at the very top listing there. It's a searchable food chart put together by a vet who's very knowledgeable about feline nutrition.
     
  9. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    Welcome Justgin and extra sweet Oreo!

    Low carb treats after pokies - lots of treats! That helps a lot! Good low carb treats are freeze-dried chicken or shrimp, boiled chicken bits...

    Altho' I know someone over in health will post this for you also, here's a link to the latest food list by DVM Lisa Pierson. It's currently also being distributed thru the American Veterinary Assn.

    Food Chart 2017 - CatFoodProteinFatCarbPhosphorusChart.pdf

    Look forward to seeing you over in the health forum!
     
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  10. Justgin

    Justgin Member

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    May 8, 2017
    @Kris & Teasel, thanks I'll visit all the forums here eventually. I work long hours 4 days a week but I do have some down time at work thankfully.

    He's still running high even after removing Friskies with rice and even the dry food too. I don't know how long his sugar has been high and I just want it to come down now. He loves food and will eat just about anything, so it's not like I've removed what little he will eat.

    Is it normal to take this long after going low carb/no dry for bg's to stabilize on insulin?
     
  11. Justgin

    Justgin Member

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    May 8, 2017
    @Squeaky and KT, hi! What does the (GA) mean? Thank you for that link. I like Dr. Lisa and sure wish she was my vet! Her site is huge and a little bit daunting when looking for certain info. I actually didn't know she had a list of low phos foods. I'm guessing it's also low carb too? I thought the two were incompatible.

    Does this conversation need to be moved?
     
  12. Kris & Teasel

    Kris & Teasel Well-Known Member

    Joined:
    Aug 17, 2016
    We really do need to see spreadsheet data to have any idea of what's going on. Until you get there, try to test as much as you can. If you're still using ProZinc, give the standard starting dose of 1 u BID. Don't try any sort of sliding scale dosing right now. It's too early in his treatment for that. Your goal is to get him settled on insulin first. It can take a while for them to adjust to endogenous insulin.
     
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  13. Kris & Teasel

    Kris & Teasel Well-Known Member

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    Aug 17, 2016
    GA means "gone ahead" or "guardian angel" for kitties who have passed.
     
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  14. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    KT was our first diabetic cat, the one that got us here nearing 6 full years ago. KT crossed in 2014 from many health issues....it was almost 2 years before I could put that 'GA' behind his name. Still miss that guy something awful at times...this is KT (clickable thumbnail):

    KTonIceChest1.JPG

    <-----that silly 16 year old fuzzy thing as my avatar is Dakota aka Doc. Because KT taught us the sugar dance well, we adopted Dakota 4 years ago already diabetic. We're still dancing together...

    HUGS!
     
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  15. Yong

    Yong Well-Known Member

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    Jan 11, 2017
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  16. Jeff Davis

    Jeff Davis Member

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    Mar 21, 2017
    Welcome Kris and Oreo. Lots of knowledgeable and helpful people here. I'm fairly new to this whole thing as well with my cat. He like Oreo is somewhat difficult and hard to test. Do keep in mind that if Oreo is really stressed when you are trying to test him that his BG can be driven up substantially by the stress and not as high as you might think. I only mention it because there might be an inclination to increase his dosage which may not be the best thing. My vet who knows from experience how stressed and difficult my cat can be suggested (after I changed his diet) to shoot blind but to start off very low dose (1 unit twice a day now) and continue to test at home feeling that he gets so worked up going to the vet that BG might not be accurate. His numbers are coming down slowly but as she says even though its not good to be high its much worse to be too low. Her feeling is that we may not get him in the great range but we can at least lower it and continue to manage it over time. She said it may take several months to get him stabilized.
    By the way I use Lantus pen but fill syringe from the pen and inject that way.
    Hope Oreo starts to feel better and settles down for you! I know how stressful that feeling of wanting to help him but no cooperation on his part is!
     
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  17. Justgin

    Justgin Member

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    May 8, 2017
    Thank you to Kris, Squeaky, Yong, and Jeff for your information and encouragement. It really does help.

    After Sunday night being such a disaster (I was hell bent on getting that drop of blood because I wanted him to get better) I decided to blindly inject with the Prozinc twice a day as ordered. I needed the break to reset and so did he.

    Monday morning, I called the 1st vet back (the one who gave me the lantus rx) and he asked for oreo's weight, which had actually gone UP a few ounces :( The orignal order was for 4 units Lantus twice a day, so the vet said to start that same dose and make an appt to do a curve in one week. I'm kind of afraid to give so much when he was only getting 3 units Prozinc twice a day, although that did not seem to help him. Plus I work 12 hour shifts, and so on working days, he'll have to go 14 hours before his next shot and if I work the next morning, it'll only be 10 hours later. That's as close as I can get it done.

    Anyway, I have some honey and maple syrup on hand AND some of his beloved dry food still in the fridge in it's original container if the unthinkable happens. So I gave him his first dose Lantus last night at 10:30 pm after he ate. This morning I was to give a 2nd dose and see how he did but that didn't happen. He was at his water bowl and I should have injected him then, but I put it off a few minutes in order to do a few chores. Then the doorbell rang and they all began hiding. I could have drug Oreo out from under the sofa but decided instead to wait until tonight. I'm also off tomorrow to see how he does. I've noticed he seems less hungry already. Tonight I will give 4 u Lantus at 9pm since he did well last night on it. I did get up about 2:30 am and fed them all another 2 cans of food (they've been used to more calories in their dry food.

    He's due for his curve next Thursday which will be one week on Lantus, and I'm already wondering if it's a bad idea. Oreo is a feral cat who has become fairly tame, but the two times he's been at the vet were very stressful for him. Do you recommend me taking him or just testing him at home? Also when you say "nadir" you mean the point at which Lantus peaks and blood sugar is at it's lowest? Also, I'm really not very good at testing him just yet. He wants to avoid me and squirms and won't stay still for me. And even THAT is stressful for him and makes his sugar rise, though not as bad as being at the vet.
     
  18. Jeff Davis

    Jeff Davis Member

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    Mar 21, 2017
    Take a few deep breaths and know that you are doing the best you can for Oreo! I know its stressful because I sometimes still feel stressed about my cat Sketch who isn't fully regulated and also a difficult cat to deal with.
    Again I am a rookie so hopefully some more experienced folk (Kris, Yong, Squeaky) that have offered advice will chime in here.
    First 4 units twice a day (although I don't know Oreo's weight) at maybe only 10 hrs apart seems like a pretty strong dose. Especially if you wont be there to monitor Oreo post shot. I think my vet is pretty knowledgeable about feline diabetes and her advice with me using Lantus is start slowly with low dose and work up no more than a half unit at a time which seems consistent with what I've seen on this site....better for the numbers to be high than to crash. If you have a short interval in between shots maybe you might consider dropping the dosage for that event. My vet actually had me start Sketch on 1 unit once a day after switching him to an all wet diet. Then after 2 weeks we moved him up to his current level of 1 unit twice a day with a minimum of 11 hrs apart. Like Oreo, Sketch is panicked about visiting the vet so I am testing at home which is like your experience of hit and miss sometimes.
    As for food, since Sketch can't free feed any longer on dry at night (like Oreo)I leave some wet food on a plate for him. I usually add a little water to it to help keep it moist if it sits for a few hours. This slowed down his waking me up at 3;30 am because he was hungry. He has always been a night feeder probably because he was an exclusively outdoor cat previously.
    My feelings are that Sketch and I are making some progress towards regulation as you will with Oreo. Sketch has really mellowed out regarding the injections and now jumps on my lap almost seeming to look forward to getting his shot and treats. I started the injection protocol by getting a small plate with couple treats on it and setting on my lap allowing him to jump up and eat them. Then progressed to the injection portion of the event. The testing is still a challenge but I am getting better. His symptoms and demeanor have improved and I can tell he is feeling better. And although I'm sure it is not as optimal as a lot of the folks on this site with more manageable, indoor cats are achieving progress is being made. I believe Yong has pointed out that achieving regulation is somewhat of a marathon and you have to approach it as such.
    Additionally if you haven't checked there is some great info on this site for those of us using Lantus with some helpful tips. I know my vet advised me to not to use the pen but to fill a syringe from the pen and use that to administer the insulin. (FYI: I use BD 1/2 unit Ultra Fine needle Insulin syringes w/8mm length needle)
    Hang in there and know you are making progress!
     
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  19. Justgin

    Justgin Member

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    May 8, 2017
    Thanks Jeff. Oreo weighs 17.5 pounds. He probably should weigh only 10 or less pounds but the vet never said. I honestly dread restarting the testing. The shots aren't bad. Sometimes I give those as he eats and he never seems to even notice it. But when I pick him up (he hates that) and put him on the counter (he's not a climber anyway) that kind of messes him up. And he doesnt' like his head messed with anyway. So it's hard. I've tried sitting beside him on the floor at first before I ever stuck him and he moved away from me. So I knew I'd have to be more aggressive. So I wonder how much of his bg is due to stress of being tested by me? This vet never did run a fructosamine to officially diagnose him. But he has the other symptoms so I think it's moot at this point. Hope both of these kitties settle down and come off insulin soon!
     
  20. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

    Joined:
    Jul 19, 2011
    Oh my gosh! 4 units of Lantus? That's a VERY high dose of that insulin - my 15lb cat only needed about 2 units at the most. It works very different than Prozinc. Your vet translating a dose of Prozinc to a dose of Lantus says the vet doesn't understand the actions of Lantus and cats very well. NOT bashing the vet - they can't know everything.

    I get how tough testing is but if you're going to be giving anywhere near that amount, PLEASE do whatever it takes to test at least before you give a shot and about 6-7 hours after that. I promise, if you'll fight thru the first 2-3 weeks and always follow up with a treat he only gets at test time, things WILL get a lot easier. I get that he's a tamed feral, their minds are wired a bit different but even he will grow to understand and accept this as part of feeling better in his whole being.

    HUGS and hugs,
     
  21. Justgin

    Justgin Member

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    May 8, 2017
    This was the first vet. He originally wrote the rx for Lantus 4 units twice a day. But I couldn't get in to see him that morning so I took him to another vet in a different practice. She ordered the Prozinc to be given blindly, discouraged me from testing him and wanted to do a curve in a week. When Prozinc didn't work so well I decided to go back to the other vet. So vet #1 is not translating the dose from Prozinc, it was the original order. Plus this vet is all for low carb and thinks it's great that I want to home test him.

    Oreo in this pic is slim compared to what he is now. I think he was still a kitten in that pic too. He may only need to weigh 8 pounds because he has small paws and looks kind of delicate despite his weight. I suppose what I could do since I've already given him his dose for tonight is knock it back to 2 units tomorrow morning. He was hungrier tonight than this morning.
     
  22. Jeff Davis

    Jeff Davis Member

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    Mar 21, 2017
    They can be a challenge!
    As far as dosage I really think you should check that with the vet or get a second opinion to confirm...especially if you end up having to give a short interval shot.
    The weight based starting formula for Lantus is 0.25 unit per KG of the cats ideal weight. So if Oreo's optimum weight were say 12.5 lbs that converts to 5.67 kg. So based on that 0.25 x 5.67 = 1.4 units. So that 4.0 units seems very high.
     
  23. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    Do they know you're a nurse? Maybe they just want your wallet. We've heard this many times before, so stupid. Ask your vet if his/her child was diabetic would they follow the same protocol. Unbelievable!
     
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  24. Jeff Davis

    Jeff Davis Member

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    Mar 21, 2017
    The good news that if you can somewhat regulate him and get him down close to his correct weight he may go into remission. The vet should have a good idea what his ideal weight should be. Might be worth checking with the vet about the Lantus dosing and his optimum weight.
     
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  25. Phoebes

    Phoebes Well-Known Member

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    Jan 16, 2017
    You can test his pad on his paw as well if ear is too hard?
     
  26. Phoebes

    Phoebes Well-Known Member

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    Jan 16, 2017
    My Phoebe is so preoccupied with eating it's hard to get her ear, but I get the bead of blood and use my nail to get it then let her go and use the meter to the bead of blood. Welcome to you and your babies!! Head bumps. :)
     
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  27. Squeaky and KT (GA)

    Squeaky and KT (GA) Well-Known Member

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    Jul 19, 2011
    First - I just realized this conversation is still taking place in 'Introductions'. How about starting a new post over in the Health Forum - we'll link back to this discussion. There's a lot more people that will help get this all straightened out and have lots of suggestions for you.

    At least until you can test at least at preshot and about +5 to +7 after shot, I would definitely cut it back to 2. I'd likely cut it back further just from having done this sugar dance for years and knowing they'll throw you a curve ball at times.

    What was his preshot number tonight?

    AND I just saw your avatar pic now....Oh be still my heart! Is Oreo another smudgie black nose baby???

    HUGS again,
     
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  28. Justgin

    Justgin Member

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    May 8, 2017

    I don't understand. You are basing his dose on his ideal weight, not his current weight? That's why the vet asked me to weigh him again. Even at his current weight, the dose would only be 1.9 units. So I do wonder what forumula he's using.
     
  29. Justgin

    Justgin Member

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    May 8, 2017
    Yeah I was not impressed with her when she started saying that. And I did tell her I'm a nurse. I also told her I work 12 hour shifts, so Prozinc would not be the most ideal insulin in that case anyway. If I were retired and had a very laid back kitty, it would be different. Many vets are quick to talk, slow to listen. I have yet to find one really good vet in this area, and that includes the internal med vet I took one of my other kitties who passed away 2 yrs ago.
     
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  30. Justgin

    Justgin Member

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    May 8, 2017
    His last weight at the vet was 16.9. On my scale he's 17.5 or was the other day. He may have gained or not depending on the differences in the scales used. I'll ask him what our target weight is. Right now I've compensated for the loss of kibble calories with more wet food. I used to feed them 3 3ounc cans twice a day. Now I feed 6 3ounce cans twice a day and 1 extra can after midnight. Is this too much or not enough. I have 5 kitties and they are all overweight.
     
  31. Noah & me (GA)

    Noah & me (GA) Well-Known Member

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    Dec 3, 2016
    My vet, family doctor, chiropractor and neurologist are all women. That was a choice I made, men don't listen.
     
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  32. Justgin

    Justgin Member

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    May 8, 2017
    Thank you! I think it'll be easier getting blood from his ear than his paw pad. He doesnt' like to be picked up at all.
     
  33. Justgin

    Justgin Member

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    May 8, 2017

    I had asked if this conversation needed to be moved. I guess I should have flagged it for the moderators, but I can start a new thread in the other forum with a link to this one.

    Yes, and thank you, Oreo has a cute little smudgie black nose! Isn't he cute!
     
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