Pudden introduction

Hi everyone,

My cat Pudden was just diagnosed today with diabetes. Her glucose levels were over 500. She has athma and is on 5mg of prednisilone a day as well as inhaled steroids. The vet believes the pred pushed her into being diabetic. She wants her weaned off immediately. We will see how that goes as far as asthma attacks go.

My vet wants me to purchase a glucometer, but I am at a loss on which one to get.

I am also wondering when I should test? Before her morning meal or after?

Right now I have been instructed to give the insulin in the morning after she has eaten. They are going to show me how to use the glucometer on Tuesday, but I know I can teach myself and want to get started now.

Also Pudden eats small meals of Fancy Feast classic all day long. She prefers dry food, but I have been weaning her off it for weeks. With her being on steroids I have been preparing for diabetes to rear it's ugly head and am not surprised it has.

Are two big meals really necessary or can she have food inbetween? She is at the present time begging for food while I write this and I feel so bad. I worry she won't eat enough at once and will become underweight.

I want to thank everyone for their help in advance and to Sara and Sushi for recommending this group!

Best Wishes,
Lindsay and Pudden

 

Hey Lindsey and Pudden and Welcome to the best place you never wanted to be. Unfortunately the predisone is the culprit for the diabetes and good luck with her asthma as you wean her off. You are off to a good start by weaning Pudden off dry as it is way to high in carbs and the Fancy Feast Classics is a great choice for low carbs.

I am so glad you want to home test as it is so important. : Here, we all home test. It is mandatory to understand how your kitty is reacting to the insulin and the dose. You will want to test before each shot and some additional test in between the 12 hour cycle. Another reason to home test is to keep your kitty safe. Find a place in your home where you will always perform the test and give lots of hugs before and after testing. There are many videos showing you how to test. Here is a picture of where you test on your kitty.

http://s106.photobucket.com/user/chupie_2006/media/testingear/sweetspot.jpg.html
And another good video:
http://www.felinediabetes.com/bg-home-test.htm

Before you start testing, choose a spot where you will do the testing and simply rub Pudden's ears to get her used to you touching her ears and then give her a treat (low carb, like freeze dried chicken or Bonito Flakes) and then let her go after you hug her up. She will then associate the treats with a pleasurable experience and when you actually start she will be more receptive.

There are many meters. There is a pet meter called the Alpha Trak2 and human meters. Some use the pet meter because it is what the vets use so the numbers will match up. The meter and strips are expensive though. Most use human meters that can be purchased at any pharmacy. It typically reads a little lower than the pet meter but we have ways of compensating it. Many use Walmart's brand, Relion Micro or Relion Prime, because it only needs a tiny drop of blood. The Prime testing strips are ½ the price of the Micro. You will want to always test before you shoot the insulin to make sure it is safe. The routine is test, feed and shoot. Do you know what insulin you will be using yet? Also, you will want to get a reading approximately 1/2 through the cycle to see how low the insulin takes Pudden.

As far as the frequency of feeding there are those who believe twice a day is best, that way you will be able to determine the nadir (lowest point of the cycle) Personally that is what I do. However , there are those kitties with other health issues beside the diabetes and they need to feed more frequently because of that. And there are those you feel it is better for the cat's pancreas to have several smaller meals a day rather than two larger You will have to research and decide what is best for you and your kitty.


We all use spreadsheets to store kitties test results. Our spreadsheet instructions are here. If you look at the signatures of the members here, you will see a link to their kitty’s spreadsheets. We keep track of all our tests. This is basically a place to collect data and help you to determine patterns, doses, etc. It also aids those that may be helping you to better understand your kitty.

Please asked what ever questions you need answered; someone is always online to help.

 

Hello Lindsay and Pudden!
I can see that you found your way here easily! Welcome!

You will feel supported and (I have to say) Loved here!

Don't feel so bad about the low dose of prednisolone on top of the inhaled steroid... We have to do what we have to do! Sushi had a massive asthma crisis because he had to stay at the vet with ketoacidosis (result of diabetes gone wild) and on top of that I started to give him shots at home. And then I started poking him on the ears and paws to test... I felt really gilty for having to give him the prednisolone, that I could have done something better... I had to understand that it is a lot for him too sink in as well! And my cat's asthma is highly triggered by stress... So I had a good scrubbing around the house, I have Feliway pumping 24/7 at some plugs and we are getting used to this the best we can... All this to say: Don't be rushed to wean him off the prednisolone too soon...as that can backfire and make things worse... You know your cat... Go with your gut!

You are amazing and doing great!! Your cat is very lucky to have you!!

 

Welcome to FDMB.
It may not be possible to discontinue the steroids and still manage the asthma successfully. If so, you'll adjust the insulin dose around the pred.
It will help to feed low carb food.
You'll want to use a depot insulin (slight overlap between doses) such as Levemir or Lantus, as with good home testing, you can shoot low to stay low. See my signature link Secondary Monitoring Tools for some assessments which may be helpful in evaluating your cat.

 

Thank you so much for all the help eveyone! I just got back from Walmart and bought the relion prime meter and strips.

I wasn't sure what lancets to buy. Because we prick the ear I bought the relion thin 26 guage alternate lancet as I thought maybe her ear is harder to pierce than fingers.

I am now thinking maybe that was wrong. Should I get ones with a smaller guage? I can run over to rite aid if I should buy smaller ones.

I think I will feed Pudden 4 small meals a day, then three, then two. I just think to all of a sudden change her eating habits may be to upsetting for her. She is a lover of food and I am not innocent of that myself, so I understand her pain

I will lower her pred to 2.5 tomorrow and see how she does. I agree that drastically lowering it is not a good idea. Especially for a cat with severe asthma.

I am keeping my fingers crossed I can get her off and into remission. But if not, at least I know that diabetes is controllable and not something that is a death sentence. I'm sure Pudden and I will get into the swing of things soon.

Thank you again everyone! I already feel so much more at ease. It's always such a comfort to have great support!

Best Wishes,
Lindsay and Pudden

 

I forgot to mention. She is on prozinc insulin 1 unit once per day in the morning.

Best Wishes,
Lindsay and Pudden

 

That should be perfect we recommend 26-28 gauge at first, Perfect!!

You will work it out to what is best for you and Pudden. Keep in mind that you do not want Pudden to have food within 2 hours of testing so the test is not influenced by food.

You are a good bean! Pudden and you will settle in and do fine. Until then, we are here and we are glad to help you.

 

We

We have found that once a day ProZinc is far from ideal. Once you are testing, you will be able to see why. It lasts about 12 hours in felines. So your shot in the morning takes her down to a low about 5-7 hours after and then she climbs up to about the same level as the morning. (We call the cycle a "smile"). Without a shot at night, she will continue to climb until the next morning. This must feel like a roller coaster. And she is above the healing renal threshold (we think in the 250 range where the pancreas can heal) at least 12 hours in each 24.

I'd strongly urge you to dose twice daily.

 

Ok I will talk to my vet about taking it twice daily when we go back on Tuesday.

I was having some trouble with the meter and got it working so I decided to test tonight instead of waiting til tomorrow.

She is now at 315 when she was at over 500 this morning. I will be interested to see what it is in the morning. Now I know to be prepared for it to be back in the 500s again. Hopefully me testing at home will take out the guess work for my vet on dosing.

I did think of a question. I know I have to feed her before giving insulin, but how long after eating should I wait to give the shot. Do I give it immediately or wait half an hour or so.

Thanks!

Best Wishes,
Lindsay and Pudden

 

Hi Lindsay, with ProZinc the routine is test, feed, and shoot immediately after eating. As Sue said, Prozinc needs to be administered twice a day 12 hours apart. That is why you are seeing Pudden back in the 500's in the morning.

 

Ok so I gave her the morning test. The meter said hi which means over 600!

I gave her some food and she only ate a little. Do I still give insulin?

She is suffering from bladder spasms and keeps trying to pee. This is initially why I took her in thinking she had a uti, they said no bacteria was found.

Can high sugar levels effect the bladder? I could see the bladder twitch and spasm.

 

As long as she got a least a TSP of food in her, go ahead and give the insulin. Once her number comes down she might feel like eating, so offer it again.

 

Ok so I just gave it to her. It went very easy for my first time alone! She is now going around looking for a place to pee. The poor thing seems so uncomfortable. I never heard of diabetes causing uti symptoms. Can it irritate the bladder wall?

 

I personally have not seen blood sugar have these symptoms in either of our two sugar cats.

Many years ago our Ben had Interstitial Cystitis, which had the bladder symptoms that you explain. He probably squatted in the litter box (and later, the couch, sinks, carpets, etc) at least 50-100 times a day until we got it under control. Not kidding. Sometimes he didn't pee anything at all, other times it was just a few drops. No bacteria was present, it was a problem of bladder inflammation. Often he would let out a little whimper. They said that, as the urine hit his bladder it would actually burn, which is why he would cry and feel like he needed to pee even though he didn't have much in there. So your vet will probably want to know if Pudden is actually producing any urine, how much, and if she is crying at all.

But I would have expected them to see blood in Pudden's urine sample. We could see it ourselves when Ben was kind enough to give a "sample" in the sink. Or maybe there wouldn't be blood yet if this is a brand-new thing for her? I can't say, I just wanted to share our experience so that you know that bacteria/infection isn't the only possible problem.

I hope you find something soon, poor Pudden. :-(

 

I was thinking it may be bladder inflammation. I read stress can induce it. Maybe the stress of not feeling well brought it on. I don't see how I can reduce stress right now with everything goin on. She is resting now, poor thing.

 

Feliway, a calming pheromone, sometimes helps.

 

Oh good, glad it went well for your first time alone, it is always nerve racking the first time. I really don't know if the diabetes is causing the UTI or if it is two separate things. Maybe some other will weigh in on that subject. Poor Pudden. If the UTI is stress related maybe all stress of diagnosis and testing could have caused a flair up ad Sharon had a good suggestion with the feliaway. If it is bacterial they will give antibiotics but I understand for inflammation only, antibiotics are not necessary.

 

Make sure you let your vet know exactly what she's doing with the straining, etc. there may be some other meds to help her.

 

Hope the bladder issue settles down. I would definitely call the vet about the symptoms and see what they think. I am guessing you are understandably pretty stressed with the different info you are getting here and from your vet. You do communicate stress to your pets so once you get a system going and feel confident (testing will help SO much with this - congrats on the test!) both of you can settle in. I am not saying that is part of her bladder issue - just saying things will improve - promise!

Sometimes food can raise the level by 100+ points. We do suggest testing and then making sure food is in their tummies and staying there before the insulin with the harsh insulins like Humulin and Vetsulin. But ProZinc does not have a harsh onset for the vast majority of cats so It is not so important. If the testing happens after the food is on board for more than 25-30 minutes, then it may influence the number upward and you can be shooting a higher dose than needed. So, as Bobbi says, test, feed and shot. Was this something the vet said? I wonder if they are familiar with the way ProZinc works - giving food before testing and especially giving the shot once daily are pretty basic and not part of the usual regime. Many vets see a diabetic cat once a month; we see several new ProZinc diabetics daily and have developed a process that is very successful.

 

Here is information from the Prozinc company that you can give to your vet and it states:

The initial recommended ProZinc dose is 0.1 – 0.3 IU insulin/pound of
body weight (0.2 – 0.7 IU/kg) every 12 hours. The dose should be given
concurrently with or right after a meal.

Here is the link to this document. If you go 2/3 down the page, there is a link to a downloadable PDF file. Once you download this document, this statement can be found under "Dosage and Administration." https://www.prozinc.us/prozinc.html

 

Hi everyone,

I am a little confused about Pudden's numbers today.

She was at 411 this morning so I fed and gave a shot of 1 unit.

I then checked her again 5 hours later and she was at 226. I made sure she didn't eat any food for two hours although she may have had one or two treats that were 1 kal a piece about an hour and a half before testing. I don't know if a half hour makes that much of a difference.

I checked her at 11:45 at night and she was at 187. I am confused that she is lower at night than midday.

I did end up calling the vet and asking for an antibiotic and pain meds for a uti. She wouldn't stop straining and was so uncomfortable that I had to do something. The vet admitted there was a very small amount of bacteria in there, but they didn't think it was enough to cause a uti which is why they didn't precribe antibiotics. Pudden's urine is very diluted from the diabetes so i bet the test was inaccurate. She seems so much better already.

She has been on the 2.5 dose of prednisilone for 2 days and so far so good.

 

That is an interesting cycle. The insulin seemed to last longer than expected. Remember, it's one cycle. Your job is to gather enough data to be able to figure out how the insulin works in Pudden and what you can do to work with it. Congrats on getting tests in today! Looking forward to more info.

Can we get a spreadsheet set up for you? It is so helpful for you, us and the vet to be able to see Pudden's history at a glance. Here are the directions:

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you need help, send me a PM. (touch my picture and start a private conversation). I'd be happy to set it up for you.

One caution. Anytime your pre shot number is going lower rather than rising, be sure to get another test in before dosing. You want to be sure the number is rising, not still falling, before adding more insulin.

 

I checked her this morning and she was 435. I checked again 20 min later and it was 427. So not too much lower. She is eating now. Should I go ahead shoot the 1 unit?

Thank you for the spreadsheet link! I will try and get to setting it up today.

 

Good morning. Any chance you can update your signature? That would help us out a lot as it will contain information at a glance. Here is how you do it.
* In the upper right corner of the screen, within the dark blue bar, you will see ID, Inbox, and Alerts, Click on your ID.
* On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback. You are limited to 2 hard returns, so separate pieces by | or -. This is where you paste the link for your spreadsheet, once it is set up. Add any other text, such as your name, cat's name, date of Dx (diagnosis), insulin, meter, general location (city and state/province)any other pertinent issues like if there are any food issues, history of DKA, hepatic lipidosis, pancreatitis, allergies, IBD, etc.
* Click the Save Changes button at the bottom.

What time are your shoot times? Has it been 12 hours since you last shot? If this is your normal shoot time, then yes especially since you already fed her. Even though it is going down, the number is high and it has been 12 hours since you shot. Prozinc is an in/out insulin and usually only last 12 hours. The difference in your number (or lowering) is the variance in your meter.

 

I agree. One unit sounds good.

I may have confused you, sorry. The only time to worry about the pre shot number still falling is when it has been falling all cycle and still is lower than your previous numbers. Today's pre shot is higher than your last nights' preshot so it is fine.

Let's see what this cycle does.

You are doing a great job getting data!

 

Thank you for your help guys! She got her shot and is taking a nap now. I will be sure to work on my signature and spreadsheet today.

 

Hi everyone,

I was able to update my signature, but can't download the spreadsheet on my android tablet. I currently don't have a computer. It keeps telling me download failed.

 

Hey Lindsey, since you can't get the SS on your android, if you need help dosing, post in Health and Prozinc at nights as ProZinc isn't as active at nights) that way more eyes will see your post. In the title preface it with Dosing Advice ASAP so peeps can get back to you quickly.

 

Rather than downloading, try this.
Log into your Google Account.
Navigate to the template link in another window and open it.
File, Save As should save a copy in your Google Drive account. This means you don't have to save it on your Android device.

 

I was able to get it working. Thanks everyone!