Please help me help my boy!!

PLEASE HELP. My cat, Milo, was daignosed with Diabetes back in September, he was almost ketoacidocic. He was very ill. Since his diagnosis, we have undergone numerous vet visits, thousands of dollars, to no avail. He is suffering from sever neuropathy in both front and back legs and his blood sugar has not dropped ...below 400. He has been urinating outside his box off anf on for weeks now. He has been tested for every underlying disease under the sun and nothing has shown up. He is 8 and he is now on his 3rd type of insulin, 5 u 2 times per day, and still not getting better.

Can someone tell me when its time to let go. MY husband is out to sea and i am having to endure this by myself. Of course my friends are around and support me, but they believe its time to let him go. Someone send me something that helps me make this decision.

Also, i dropped his insulin this morning and now its useless...


Edited to remove 911 icon~~Venita and the Boyz

 

I understand your stress.

A couple of questions to help us help you...

1) What type of insulin? 5u twice daily is extremely high if there are no other medical conditions. (The dropped vial may still be o.k.)

2) Are you hometesting his blood glucose levels?

3) What type of food are you feeding?

Hang in there. Help is on the way!

 

I'm sorry you're having such a hard time.

Are you hometesting your kitty's blood sugar? That's the first and most important thing you need to do right now. Without knowing how your kitty is reacting to insulin, changing insulin and changing doses is not really effective.

What type of food do you feed?

Others will be around with more advice, please just relax for a moment, read what they have to say, check the FAQ section and feel free to ask lots of questions.

 

5u twice a day is way too much

Was what the BG at diagnosis? Do you hometest him before each shot?


Welcome to our FDMB family and be patient with yourself. You sound like you really love your cats, so you have come to the perfect place. Get some chocolate, sit back and get ready to read. Also, remember Every Cat Is Different. (ECID) Also, remember opinions may vary sometimes on this board, so you may get different views. Unfortunately, that is human nature.
Sorry this is very long, but there is a lot to say! Also, remember we were ALL newbies once and are feeling just like you are right now! OK……..breathe………. :RAHCAT

This disease is very manageable and by no means a death sentence. There is just some learning we all had to do. You do not need any type of prescription food or “special” diabetic food. Janet & Binky’s chart is on the top of this page! Low carb is best for diabetics. I try to stay around 10% or under. I feed Whiskas, 9-Lives and mostly Friskies. If you are giving a high dose of insulin and feeding dry, be careful with switching to canned food. You MUST reduce the insulin at the same time you switch to canned food.

Please create a profile if you have not already done so. It will help us to help you. We need to know what kind of insulin you are on, what needles you are using (U-40 or U-100), what are you feeding, how much insulin you are giving and when, BG test results, etc. There are many people on this board from all over the world, so it will be helpful to know what area and time zone you are in.

Remember that your cat is YOUR cat, and YOU are paying your VET to help you take care of him; diabetes was probably a day or two worth of notes when the vet was in college; it is probably NOT a day-to-day existence with his own cat trying to maintain a quality of life. Sorry to say, but I would have overdosed my guys on insulin if I followed my vet's advice. Vets, unfortunately are not as knowledgeable as they should be on diabetes.

Sometimes, as I did, you have to take a leap of faith and trust these people on this board who deal with diabetes day in and day out. Trust me. You will not be disappointed. OK………..breathe again……….get some chocolate…….. cat_pet_icon

Also, please realize that it takes insulin about a week to settle. START LOW AND GO SLOW!! The usual starting dose from our experiences is 1u twice a day for at least a week. Insulin in cats is NOT and I repeat NOT based on weight. This is a misconception that a lot of us have gotten from our vets here. pc_work

You have to be patient, as I also had to learn!! Do not adjust the dose upwards based on one test. Don’t freak out based on one test result. As long as the levels stay on the high side, keep the same dose twice a day for at least the initial week period and you should see improvements. When you have some time (hee hee), read my profile.

If you are not hometesting already, you really need to start!! Hometesting is VERY important. Think of it as a human diabetic does. *If it were you or a child of yours, you'd be testing blood glucose levels at home prior to each shot; you'd be working with your doctor to determine a proper dose based on those shot results, correct?* Some vets do not agree with hometesting and I cannot for the life of me understand why. Most vets, sadly are not knowledgeable enough in feline diabetes. Insulin is a VERY powerful drug and you NEED to hometest before giving a shot. This is very important. The vet would rather have you bring the cat to them, stress it out more, which may spike the levels anyway and then they can charge you $$. Hometesting saved me a lot of money and it is VERY important for you personally to know the cat’s levels and how it is reacting to the insulin before you shoot so you do not pass up your ideal dosage.
Thanks to everyone's help here I learned to home test 2 cats and they both got off insulin within 3 weeks with diet change…but of course, they reacting both DIFFERENTLY with the process. If I can do it with 2 cats twice a day (and more on curve days), ANYONE can do it. It does NOT hurt them as much as you think it does. It just stings for a moment and then it is gone, you can try it on yourself. Also, put pressure on the ear after poking and it should minimize the nub. They won't mind it once they start feeling better. I use the True Track meter (CVS or Walgreens brand) which I love. And, the strips are also reasonable. Also, remember to give them a treat after the test. Here is a link to a member videos on hometesting:

http://www.youtube.com/watch?v=_zE12-4fVn8
http://www.youtube.com/watch?v=cZ6iXetR398

I would not feed DRY food if at all possible. Of course, it is better than nothing – you MUST get them to eat if you are giving insulin, but if there is any chance, get them off the dry. I took my guys off dry and within a month they were off insulin. Again, remember that switching from dry to wet can cause a drop in blood sugars, so you MUST reduce insulin at the same time to make sure you are not giving too much insulin. I truly believe also that I saved some of my many others from developing diabetes. I also saved so, so much money changing them all to regular canned cat food.
When Blackie and Jackie got diagnosed, I was afraid to start shots. The people on this board made me realize it was no big deal. (They went on PZI insulin around 3-25-06 and went off on 4-18-06! Please also realize that diet plays a BIG, BIG part in insulin needs. I switched my cats off dry food to all wet and I was never so happy. It was a challenge to try to regulate 2 cats at once.


Welcome to the Sugar Dance. flip_cat
Welcome to the Vampire Club.

If I can do it, ANYONE can!!!
It does get easier. Trust us.

You need to test BEFORE you shoot. It usually goes: Test, Feed, Shoot



There's a saying something like "better the sugar level is too high for a day than too low for a minute".

 

We absolutely would like to help you. We need some more information:

How was he diagnosed (fruitosamine test?) At what dosage did you start? What insulin are you using?

We have a three pronged approach.

Diet. Wet lo carb food. See this website to understand why? http://www.catinfo.org

Insulin. We favor long onset, longer lasting insulins like Lantus, Levemir and PZI. We like to see new diabetes start at a low dose (0.5 to 1 unit 2 X day) and increase slowly. If you start at a higher dose, you may have missed the perfect dose and his body may be reacting by rebounding: http://petdiabetes.wikia.com/wiki/Somogyi_rebound

Hometesting. This is really important. We figure we would never give our children insulin without testing their blood glucose levels first to make sure it is safe. We do the same for our kitties: http://www.youtube.com/watch?v=_zE12-4fVn8

We all felt like you do this morning - overwhelmed, scared. And we all decided to be proactive and learn about this disease. You can start reading and rereading and asking lots of questions. You can do this. Everyone here had or has a regulated diabetic cat who is happy and healthy. We can help you.

 

Hi please tell us

What insulins you used and are using.

How you arrived at the dose you are at.

Are you home testing?

Do you know about home testing?

What kind of food are you feeding?

Where are you located?

Does the cat have any other medical conditions?

What tests did the vet run? just a blood test or was a fructosamine test run too?

We can definitely help you and your boy. But in order for us to do that we do need this information from you. The more information you can provide the better.

Also, there are ways to treat neuropathy - it's with vitamin Methyl B12, but it goes hand in hand with insulin regulation. There are several B12 on the market, but the one you need is methylcobalamin only. Here is what I used: http://www.vitacost.com/NSI-Vitamin-B-1 ... lcobalamin

I would empty one capsule into the wet food daily.

But before we jump ahead, please give us these answers and we will go step by step from there.

 

Hi all,
Thank you so much for your quick responses. I am at work, but this has been consuming me for over a week. He is doing terribly. When he was first diagnosed in Sept 09, we only noticed because he looked super skinny, and was peeing and drinking alot. We took him to the emergency vet and his BG was through the roof. They gave him fluids and sent him home for me to follow up with our regular vet the next day. We did and the jouney began. We started off using Vetsulin, at 2u twice a day and testing BG curves every week for improvements. We finally reached 10 units twice a day when they told me that the vetsulin was recalled by the manufacturer due to ineffectivness. What a waste. Then we had to start all over with PZI. Again, slowly geting up to 9 units twice a day, and constant vet BG curves and fructosamine test. No drop in BG below 400.

I have 4 cats, all rescues. I had been caring for one of my other cats who was diagnosed with GI lymphoma one month prior to Milo being diagnosed with diabetes. They are both 8yo. So, now as of 2 weeks ago we started using LAntus, agian starting with 2 u twice a day, he is now on 5 u twice a day.

As for diet, well Milo has allergies to certain foods and he is also deaf. Poor guy. WE had them all on Max cat. Then i tried a food with no sugar. As of 2 days ago, I got Natural Balance, low carb, grain free. I am in process of switching all of them, to the dry food, and giving Milo (Diabetic), canned food in the evening with his insulin.

ITs very haard to feed them all wet food as one of my other cats pukes it up every time she eats it. Gross..

Milo is also excreting waste behind my futon. His back legs are muscle wasting away, but he really tries hard to get around. PU/PD has not changed.

Hope this inof helps.. I have also been toying with the idea of home testing, but my vet doesnt support it. I told her yesterday i was doing it with or without her help. We are quickly running out of options for him.

 

Thanks for coming back with the info.

One of the things I notice is that every time you have used an insulin, the vet has started at 2 units. It is possible that this dose has been too high every time and Milo is continually rebounding. See the site with explanation in my post above.

You do not need your vet's permission to hometest. If Milo was your child, you wouldn't accept the doctor saying that you should just give the insulin and come back in a week or so to see how it was working.

We are just voices on the internet. But we do know diabetic cats. Most vets are like gps - they know a little about a lot of things. We know a lot about diabetes in felines. My vet started my cat on too much insulin and didn't know about hometesting. We came here that first day, started hometesting and changed the diet. It was clear immediately that he was getting too much insulin so we reduced the dose. My vet was amazed at our progress and now supports hometesting. She's a great vet; she just isn't an expert in feline diabetes.

We can help you learn to hometest - either with a member who lives near you, or over the internet. It is the only way to get Milo back on track.

 

oh. btw, im in Hampton Roads, VA. confused_cat

 

Hometesting is what you need to do. Testing at the vet doesn't help because cats are nervous and their BGs naturally rise. I also believe that raising the dose so much caused rebound, made the liver produce even more glucose causing even higher numbers.

Are you still using Lantus now?

I highly recommend that you pick up a glucometer at the pharmacy, any human one will do, One Touch Ultra, Relion (from Walmart), True Track (Rite Aid), Accu Check Aviva, any with sipping strips. We have videos that can show you how to get blood from the ear.

Also recommend you reduce the dose down to 1U (assuming Lantus) and post here daily with your BGs. Chart them too, we have a spreadsheet you can use. Look at my signature, you'll see Tucker's there. It's not up to date, but when I have questions, I do update it first.

Grain free food is great.

Regarding the legs, MethylB12 supplements can help that until the proper dose of insulin kicks. My Misty(GA) had neuropathy, but after a few months it went away, once she was regulated.

 

You do have your hands full.

I can't comment on all of the issues as I have no experience with all. Bottom line, home testing is your only option for knowing precisly what Milo's BG is and what the appropriate dose of insulin is.

We used Vetsulin for 2 1/2 years, switching to Lantus this past November. Not because of the FDA warning, but because I was tired of stagnant BG levels. We have been extremely pleased with the Lantus. More than likely Milo has been in constant rebound due to the very high insulin dosages.

There are FDMB members who feed dry food. It can be done, but is not optimal.

Finally, your vet DOES NOT have to support home testing. Would you shoot insulin into yourself or your human child without first testing your blood sugar? Didn't think so...

 

Just to let you know as well......my vet started Webber on 4 units once a day on Lantus. THe vet obviously did not know that Lantus is a twice a day medication. We all agreed that 4 units was too much to start with. The next day I could not even give him a shot because the insulin carried over and his glucose was still so low.

It does sound like Milo could be rebounding from the high dose. I did not follow my vets advice and started Webber on 0.25units twice a day. Three weeks later we are at 1.25units and he is doing much better.

 

Please, drop the dose since you stated you are switching to canned only. Removing dry food removes a lot of carbs and with that dose you are currently on it may very well be too much. Do not listen to your vet about hometesting.....majority of us just went ahead and did it on our own. It is probably the most important thing you can do when treating a diabetic cat. Always, always test before every shot. Methylcobalamin is also a major factor in helping cats with neuropathy and will improve along with better regulation of the diabetes.

 

You guys are a god send.. I will get a glucometer after work today. Also, we are using U-100 syringes.. I do have the U-40 as well becuase i has extra from the other two insulins we had tried. Im not against wet foood at all, but everyone wants it when i feed them and its game on.. lol So, i will give the dry a try and see what we get. Unfortunately im going away for 10 days, next week. During christmas i trust my pet nanny to care for milo, which she did, and kept my house clean, but she re-used the syringes 3 times before throwing it away. omg!! Anyway, im a bit nervous about trusting all of that, so the crappy part is i have to board him somewhere. Which will not make him happy. He hates the vet with all his being.

 

Oh my, what a time you are having!

I am not going to address the testing or the starting dose because I see that many have already addressed those issues. What I will address is the dry food because I feed my diabetic Moochie dry food because of quite a few problems with her.

As has been stated, canned(wet) food is much better for all cats BUT sometimes we work with what we have. Have you tried Wellness CORE or Innova EVO grain free dry foods? They are both high in fat and in calories which can be a concern under certain conditions but they are both high protein/low carbohydrate foods.

It truly is not optimal to feed dry food but yes, it can work. By the way, both of those dry foods that I mentioned are quite pricey compared to most dry but they are still lower cost than canned foods.

 

Putting all your cats on wet food is a good thing. It may save the others from having issues later on.

When you go away, are you going to have your pet nanny test as well as shoot?

 

Sorry, one last question.. After much research, i assume his BG levels should be between 80-120?? Please advise. I will take all the advice given here. And I will begin home testing tonight. :smile:

 

Please make sure your pet nanny knows not to reuse the syringes again. I believe with lantus you have to be extremely careful, but I wouldn't do it in any event as the metal on the needle does start to deteriorate and will be painful and your introducing bacteria into the fresh vial of any insulin/med when reusing a needle.

 

They are getting NAtural Balance Limited Ingrediants Diet. Low Carb, GRain free. And NO- I am not trusting the pet nanny to do anythign with him. I am boarding him at our vets. Its the cheapest and best option for him. IT sucks to do this, i know, but if he is not using the litterbox i cannot put any of my friends out to take him in. If i leave him at home, again it will be a huge responsibility on my friends. Boarding at least he will be around people who know him and can take care of him.

 

Good start. Pick a glucometer that sips and requires a tiny bit of blood - 0.3 ot 0.5 is nice. If money is an issue, the Relion from Walmart is the least expensive, as are its strips. Other brands of glucometers may even be free at pharmacies. It's the strips that are expensive. But if you get some to start with, then you can order them over the internet and on ebay for much less. You also need lancets - ultra fine may be too fine in the beginning. Also pick up some ketone strips so you can test Milo's urine if necessary (inexpensive and nice to have on hand)

 

Thank you i will.. I already got the urine strips to check for keytones. None as of last week. Thank god.

 

Oh good - I wasn't familiar with the Natural Balance.

And yes, 80-120 would be considered non-diabetic numbers. That doesn't mean that all of our cats get or stay below 120 but many do and those are definitely nice numbers to get them into.

 

Hi!

You've had lots of excellent advice so far, so I'll just add my own two cents: please, please reconsider starting over at .5 or 1 units of Lantus twice a day, so that you can find your cat's ideal dose. It's highly possible that you have passed up the ideal dose - but the good news is that you can start over!

My Porky was started at 2 units twice a day at the vet, then quickly moved to three! After much advice from the board (and a low blood sugar when I was afraid to give him the whole 3 units), I decided to follow the Tilly protocol, and I started him over at one unit. Within a couple of weeks, we were down to only .25 units, then .1, and now Porky is in remission - no more insulin!

So, just to reiterate, lots of home testing - and start over at .5 or 1 unit twice a day - your baby is worth it!

 

Welcome!

You've already gotten lots of good advice. So I won't repeat, other than to say that I agree with the other posters -- the dose was started too high, and raised WAY too fast, and you really need to start hometesting ASAP...

We have a very experienced member who's nearby (Virginia Beach). I don't think she's on the Health board very often, so I'll send her a PM to come check in on this thread. Be on the lookout for Carolyn and Spot.

Hang in there! You can do this. :YMHUG:

 

Thank you!! Can someone explain how to use the spreadsheet??? This way I can monitor his activity. Thanks again..

 

Spreadsheet template and instructions are here: viewtopic.php?f=6&t=16

You fill out the spreadsheet with your cat's daily blood glucose numbers. The first column is the date. The next one is AMPS, which is the morning pre-insulin blood glucose level. The column after that is U which is the amout of insulin you gave your cat. The next bunch of columns with the + numbers (+1, +2, etc) is where you enter any bloog glucose number you get from a spot check. Then there's the PMPS column, or evening pre-insulin blood glucose number, and another U column, and more columns for any evening/night blood glucose number. At the very end is a comments column.

You can take a look at anyone's spreadsheet to get an idea of how to use it. Most people have the spreadsheet link in their signature.

 

So how often should i check his blood sugar?? at least two times a day, before insulin and meal. When else? Just some random time either during the day or at night? This is all great info..

 

No problem! I sent a PM to Carolyn.

Many people here use Google Docs for their spreadsheets and/or profiles so anyone can access them quickly to help. If you want to see some examples of spreadsheets, look for the links in people's signatures like 'spreadsheet' or 'BG Values'.

To give you a head start on figuring them out, since we are an international group the time of day doesn't mean anything to us. It may be 9:00 pm where you are, but 3:00 pm or 3:00 am for someone else. So we count everything in hours:

• AMPS = Morning Pre-Shot
  PMPS = Evening Pre-Shot
  
  Then +# for the number of hours since the last dose of insulin. ie, +1 = 1 hour since the last shot, +6 = 6 hours since the last shot, etc. The count starts over again when you give the next shot.

Here some stickies (from the TECH forum) with instructions for creating spreadsheets and profile docs to get you started:

• Spreadsheets: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=16
  Profile Docs: http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=531

 

Sending you a PM, I am in Virginia Beach in the Great Neck area and I can come over anytime. It's not too late, and I'll be glad to help you -- I even have the best vet in Virginia Beach to recommend!

Thanks Wendy for the heads-up!

 

I just joined this board last week, as my Chloe was diagnosed on 1/18 and let me tell you how much I've learned from these wonderful people in the short time I've been here. I never, NEVER thought I'd be able to give my cats shots, much less prick her ear and gather blood for a test. I can't even watch when *I* get my blood drawn.

Since listening to advice, I went out and got a glucometer and tested my girl and guess what? Her BG upon diagnosis was 593 and her BG this morning? Hanging out at 60. And that's without insulin for over a day. It is so, so important to test, like everyone else says. I definitely would have overshot Chloe had I not listened to everyone. And by the way, my vet said NOTHING about hometesting. He said NOTHING about curves, just to come back in a week. And put her on canned Science Diet m/d, which is 14% carbs. Ugh!! Trust yourself and your instincts, but also definitely pay heed to the folks over here. They really know what they're talking about.

As for feeding time, maybe get Milo into the habit of eating in the bathroom? Or another place where you can close the door to keep the other kittyfaces out? Try to make it into a routine. Maybe you can test him in the bathroom too, then give a treat/food as a reward. We have Chloe in my bf's bedroom, as his/our civvie isn't neutered yet and likes to stalk my poor girl. Chloe ate dry food all her life, so that maybe accounted for her really high BG number at the vets (+stress, I guess), but switching to wet for a WEEK and a half and small doses of insulin twice a day has brought her down.

I highly suggest testing her ASAP. Maybe it's like everyone says, the insulin is too much and causing her to rebound, and if you can, try just canned for awhile, with a carb % lower than 10.

I tested Chloe 4 times yesterday (my first day of testing). I tested before her supposed shot (saw that she was under 100, so I didn't shoot), then I fed her. I tested again an hour after I fed her to see how she was doing, still low. Then AGAIN +6/+7 hours after the initial food/testing. When giving insulin, the nadir is when the insulin is at its strongest point and the BG should be at its lowest. With the 12 hour insulins (like the ProZinc that my Chloe is on), it is important to see how your baby is doing at that point as well. So if you can't do a curve, which is testing every 2 hours, at least do one before shooting, maybe one after eating, one at the nadir point, and then again in the evening before shooting. Once you get the hang of it, it isn't difficult at all.

I hope I'm not repeating too much what everyone said up there ^, I just wanted to give some advice from my newbie standpoint.

 

I'm sure this was covered in another's reply, but since I didn't see it, I'm going to tell you of my own experiences of going from dry to a low carb wet with a diabetic.

Em was diagnosed when she was 9. The vet at the time suggested W/D a high fiber diet because it works for dogs. Em had a horrible time with it (diarrhea) and so we returned it and the vet suggested we continue to feed her what she was eating - which was friskies dry. Her insulin needs were 7 units BID (twice a day) another vet suggested she might have better control with PZI (she was on Humulin L which has since been discontinued) but she was up to seven units of that and that was three times more expensive so we kept her on L.

When I finally heard about low carb I switched her over, and her insulin need went from 7 units to 1 or 2 BID. I even had her eating raw for a few weeks and I am sure she was in remission during that time.

So as you can see, the need for insulin dramatically drops with the lower the carbs - at least it did for Em and for a lot of cats on this board. Do not switch food with out home testing and with out being able to do at least one curve (testing every two hours) before switching the food. The curve will tell you how the insulin is working in your kitty. How far it takes the blood sugar down before starting to rise again. Home testing gives you a lot more control and peace of mind that you know what is going on.

Connie

 

Thanks for sticking with us and providing the additional information. It's so helpful to us to be able to give you the appropriate recommendations.

It's great that you are using lantus - wonderful isulin, with many kitties have great results. In order to truly understand how it works, be sure to visit the Lantus board (click on board index, then look for Insulin Support Group, Lantus). Read all the starred information as it tells you everything you need to do when dealing with lantus.

Also, you can say on that board, as once you start home testing, we will want you to post there daily. Look at other posts to get an idea.

Regarding neuropathy, you can start to treat it with B12-Methylcobalamin. Here is a link to where I bought mine. http://www.vitacost.com/NSI-Vitamin-B-1 ... lcobalamin

I emptied one capsule daily into the canned food and served. It took time to reverse the effects, but with insulin regulation and the B12, it can happen and then hopefully he will be able to use the box again and not the floor.

So, here is another piece to your puzzle.

The way I look at diabetes is threefold - insulin, home testing, diet - each component on its own is important and they all interact together.

 

Absolutely DO NOT use anything except U-100 syringes with lantus, which is a U-100 insulin.

You cannot use U-40 syringes with lantus.

Although you can, with the proper conversion chart, use U-100 syringes with U-40 insulin,
you cannot go the other way.

 

Always test before giving the insulin injection. So, twice a day every single day.

If you think your cat might be hypoing, then test the blood glucose level right away. Here is the hypo reference sheet: http://www.felinediabetes.com/hypogly.htm A blood glucose under 60 mg/dl (3 mmol), and it has been at least a few hours since the last insulin i njection, is considered a hypo. Some cats may show symptoms, others will only show symptoms when the blood glucose level gets very low, and other cats will never show any symptom. You just have to know your cat.

Do spot checks whenever you can. Two or three is usually good. Mix up the spot check times to get an idea of what your cat's blood glucose levels are like. Many people who work full time can only do spot checks at night. You don't need to spot check every day but some people do.