Rebecca diagnosed diabetes yesterday

Discussion in 'Feline Health - (Welcome & Main Forum)' started by MLopes, Mar 23, 2016.

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  1. MLopes

    MLopes New Member

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    Mar 23, 2016
    good morning all!

    my name is Miguel, i'm from Portugal. i'm sorry about my english but it's not my first language. please feel free to correct my errors.

    our female 5 year old (march/27) cat Rebecca as been diagnosed diabetes yesterday. glicose levels around 500.

    Rebecca is, and always have been, a thin cat. she was 3,9kg till two weeks ago. she's now 3,2kg. she's very, very, very, very esquisite about food. she had a mixed dry/wet food diet. since day before yesterday she decided to stop eating her dry food (Bozita Feline Diet and Stomach, low fat because of her previous pancreatites). she's now eating Apllaws cans only (it's not a complete type of cat food so i need to do something fast).

    i've got no problem testing her (already tried today) and give her insulin (tried today with serum). i have a very precise 0,3uL glucometer and 33b lancetes. she's easy to test because she bleads easely and the glucometer needs very little blood.

    my main problems are:

    - considering she´s not obese (on the contrary), how to manage food? what kind of food, wet vs dry? with or without carbohydrates? high quality supplements (taurine, etc) if we decide to keep her exlusively on wet food?

    - which insulin to give her? our vet uses caninsuline. i talked to her about glargine like Lantus but she's not very into to it because of the dosage. after our test today (before the morning feeding) considering she´s eating very little aour vet recommended a 0,02 caninsulin dose twice a day and testing every 2 hours the next 4 days. she says that Lantus Solostar pen probably as not such a small dose.

    thank you for your time and any help you can give us. when giving any suggestions don't worry about the costs since, fortunatly for us, money is not a problem.

    thank you.
     
  2. Lisa and Witn (GA)

    Lisa and Witn (GA) Well-Known Member

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    Dec 28, 2009
    Good morning Miguel and Rebecca. Welcome to FDMB.

    So far you are on to a great start. Hometesting is something we highly recommend and you have already switched her to a canned food.

    Canned or raw food is what we recommend. I am not familiar with Apllaws since I am in the US. Pate flavors that do not have "gravy" or "sauce" in the name are usually lower in carbs. You want to avoid any canned food that has a lot of gravy such as shredded or bits types of cat food. Dry food is also high in carb and should be avoided. If either Friskies or Fancy Feast canned foods are sold in Portugal, these are also foods that many of us feed our cats. Initially Rebecca may be very hungry. That is because her body is not processing food efficiently. If you can, feed her several small meals during the day. Or if you only feed twice a day, you may need to give her extra food. Eventually as her glucose levels become under control, you should also see her appetite level off also.

    Lantus is a good insulin. Caninsulin works better in dogs than cats. It is a shorter acting insulin and can have steep drops in glucose levels. Other good long acting insulins that work well in cats are Levemir, ProZinc and PZI. If you are able to get your vet to prescribe Lantus, we recommend that you use the pens like a mini vial. Use a syringe to withdraw the dose you need instead of using the needles that work with the pen. With any insulin, you want to start at a low dose, such as one unit. If an increase is needed, increase by only 1/2 unit and we recommend waiting at least a week before dose changes. It can take that long for your cat's body to adjust to the dose and you to accurately determine how well it is working. You want to make sure you test before every shot.
     
  3. MLopes

    MLopes New Member

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    Mar 23, 2016
    hello Lisa,

    thank you very much for your reply.

    Rebecca is used to eat 3 or 4 times a day since she's 9 or 10 months old. at 7:30, 13:00, 19:00 and 23:30. since october the schedule changed to 8:30, 19:00 and 23:30.

    i can give her any kind or brand of food since i can order it online.

    our problem is she's not eating. she's loosing weight and eating less and less. today at 9:00 i took her to the vet to learn out to properly test and shoot her (nothing new to me but i wanted to be sure) and till 13:00 she has eaten just a very small amount of wet food.

    Friskies are sold in Porugal but it has a texture like Purina DM (mousse?) and she hates that. Apllaws can food is different. if she's eating a tuna variety it's tuna fillet you see inside the can, or prawns, or chicken, or...but it's not a complete type of food so she can't eat it alone. some supplements are needed and i don´t know which ones are the best.

    as with food, getting any type of insulin is also not a problem since all types are sold in Portugal and a pharmacist friend of mine can get it for me. today she even told me not to worry as i don't even have to pay for it. the same about glocumeters, strips, seringes, etc. :)
     
    Last edited: Mar 23, 2016
  4. Anne & Hyde (GA)

    Anne & Hyde (GA) Well-Known Member

    Joined:
    May 18, 2015
    Welcome Miguel and Rebecca

    Of course, all of us want to feed the best food for our babies but the most important thing is that she eats. My cat eats 2 meals of low carb wet food and always has low carb dry food available (because of her brother). We just work the amount of insulin around the extra carbs.

    When all else fails, I have resorted to meat baby food (make sure it is all meat - no onions or garlic). I have also had to syringe feed one of her brothers when he refused to eat for a few days. Our vets here in the US have some high calorie wet food (Royal Canin - Recovery is what we used). We also got some appetite stimulant medication called Mirtazapine here in the US to boost his eating.
     
  5. MLopes

    MLopes New Member

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    Mar 23, 2016
    thank you :) and thank you for your suggestions.

    isn't Mirtazapine an antidepressant sold under Demeron brand or something like that?
     
  6. Larry and Kitties

    Larry and Kitties Well-Known Member

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    Dec 28, 2009
    Correct. One brand name is Remeron (not Demeron)
     
  7. MLopes

    MLopes New Member

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    Mar 23, 2016
    thats it :) thanks.

    if i understood correctly what i've read, 1ml of insulin is 100 units, right?

    the vet recommended to shoot Rebecca with 0,02 so it's equivalent to 2 units every 12h. she weights, say 3kg so we are talking about 0,67 units per kg. isn't this too much to start with considering she's not eating well?
     
  8. Bobbie And Bubba

    Bobbie And Bubba Well-Known Member

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    Jun 15, 2015
    Hello and Welcome Miguel and Rebecca,
    I am going to tag @Gill & George as she lives in Spain and perhaps be a good information resource for you. Ask all the questions you have as that is how we all have learned here.
     
  9. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    Hello Miguel
    and welcome to FDMB, nice to have another member on the Iberian Peninsula, I live in Granada, but I am originally from Gibraltar:)

    The 2u does sound a bit high, but I have no experience of caninsulin, we started on lantus, my vet wanted to start with caninsulin but after reading a bit I wanted to give lantus a go and she agreed to prescribe that, she has been pleasantly surprised by how well George has done on it:):).

    I see that Rebecca has decided to stop eating her dry food, dry food is a lot higher in carbs and most of the applaws varieties are going to be a lot lower carb than the dry, this will make a big difference to her insulin needs. Being on a wet food diet is better for her in the long run, she will be better hydrated and that is good for her kidneys which are going to be under stress with having to deal with the diabetes, have you come across Dr Lisa's website on feline nutrition, it explains what to look for in a good quality cat food and why this is important.

    Most of us feed small regular meals throughout the day, after trial and error, George now has his main meal with his insulin and then 3 snacks spread out in the am and the pm cycle. When we started out he was getting the same amount of food but in four meals. I have bought an auto feeder so that I don't have to be playing at being waitress all day and night for him:rolleyes:

    You mention that you are home testing, which is a great start, but how often? are you getting some spot checks in mid cycle to see how low the insulin is taking Rebecca?

    Most of us aim to feed lower than 10% dry matter to our kitties, how low depends on the cat, every cat is different (ECID). I have used this food calculator to calculate the carb content of food and here is a list of low carb foods available in the uk/europe, (you'll see that Bozita do some wet food that is low in carb) I order my food online too, the choice is very poor locally. You can see the calorie and fat content of the food on the list and on the food calculator, which might be useful if you are trying to get Rebecca to gain weight, I have the opposite problem in that George is too 'fluffy' so I tried to pick foods that were lower in calories:rolleyes:
    At the moment George's menu consists of Thrive Chicken, Thrive Tuna,(I think the texture of these is similar to applaws, the chicken is shredded chicken and the tuna has tuna flakes, these are quite low in fat) and Granata Pet symphonie (salmon and chicken/ chicken / chicken and venison), they are all from good quality protein, I get all these from zooplus. If she likes the applaws you could always keep feeding that and introduce different complete wet foods until you find some she likes.
    You should also be sure to have some High carb wet food in your store cupboard, that should be easy for you to find locally, Gourmet Gold chunks in sauce is about 28% carb,(not the pate it has to be the one with sauce) you may need to use this if Rebecca's blood sugar levels go too low. See this link on how to deal with low blood sugar, it's important to be prepared for that eventuality especially when you are starting out on insulin and you don't know how your kitty is going to react to it.


    Keep asking questions,

    That's what we are here for:)





     
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  10. MLopes

    MLopes New Member

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    Mar 23, 2016
    good morning all,

    thank you @Bobbie And Bubba for tagging @Gill & George :) thank you very much @Gill & George for your words and advices.

    let me try to sumarize:

    Rebecca glicose values were in between 503 yesterday, 375 the day before taken in the morning before she eat. today she was 364 one hour after eating.

    no ketone body formation, ever.

    yesterday evening we gave her Mirtazapine. she was sleepy and walking funny for about 15 minutes. after that she was ok, more alert than before, willing to play and...hungry :) for the first time in 3 days.

    today she was hospitalized for the day. she will be taking serum all day and start insulin. unfortunately our vet has no experience with Lantus so, for now, she will be taking Caninculin/Vetsulin. we talked about Lantus and she will conference with a spanish vet with a vast diabetes experience. i hope we will change to Lantus soon.

    she will return from the hospital today at 19:00. tomorrow, saturday and sunday i'll be home. i'll be giving her the insulin and test her every two hours, 24h a day for 3 days. monday i'll give her the insulin 12h/12h and test her every time i can.

    i ordered (for free :) ) an Abbot Freestyle series glucometer that also tests ketone and some glicose an ketonemia strips.

    i also buy from Zooplus.es (the .pt version has higher prices, go figure!). she's eating (not so much) Apllaws wet food and a little Bozita. i'm trying to put her on wet food only. my problem is that she's not eating very well, wet or dry. if she starts eating better i'll be giving her only wet canned food mixed with home made recipies and probably some complete wet food. it's very difficult because she dislikes everything....

    problem: i need home made food recipies, asap

    problem: i need to know which high quality supplements to give her, asap

    i ordered Insta-Glucose from Amazon as an hipo-glicemic emergency response
     
    Last edited: Mar 24, 2016
  11. Anne & Hyde (GA)

    Anne & Hyde (GA) Well-Known Member

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    May 18, 2015
    Here is a website with instructions for home made food. http://www.catinfo.org/?link=makingcatfood
     
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  12. MLopes

    MLopes New Member

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    Mar 23, 2016
    :bookworm: :) thanks

    i'm embarrassed because you're all so helpfull i don't know how can i thank you properly
     
    Last edited: Mar 24, 2016
  13. Gill & George

    Gill & George Well-Known Member

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    Oct 27, 2015
    zooplus has this suplement to add to homemade/raw food http://www.zooplus.es/shop/tienda_gatos/complementos_alimenticios/vitaminas/161076
    and this one which is low in phosphorus for cats with kidney problems
    http://www.zooplus.es/shop/tienda_gatos/complementos_alimenticios/vitaminas/550480?rrec=true

    I don't know how good they are as I have been feeding complete cat food and have not researched making my own. Hope you find the useful.
    I sometimes order from zooplus uk as that has been cheaper, especially when exchange rates are favourable:rolleyes: I don't understand why the pricing is different.

    I would suggest that you create a new thread in the feline health forum here tomorrow or today.
    It's the main forum and get's much more traffic, and there will be other caninsulin users about. When I first started using Lantus (only last november) the members were great at keeping me company and giving advice, George took about a month of insulin and dose adjustments before I saw any movement, but that is not true for all cats, some cats have can have a strong response to the insulin, so if you have a thread going, and keep your thread title updated with the blood sugars as you get them we can keep you company and it might help relieve some of the stress of shooting your girl with insulin.:)

    I don't know if you have noticed but you will see that most of us have spread sheets linked to the bottom of the signature where we record our kitties BGL (Blood glucose Levels) this is a useful tool to monitor and look for trends, also members here are used to seeing the info presented in this way and it makes offering advice/suggestions when you need them a lot simpler. Here are the instructions on how to set one up, I see that in Portugal like Spain you use the same units as in the US not like the rest of Europe (go figure) so click on the link for the US spread sheet;) Setting Up Spreadsheet



    It's a very steep learning curve at the beginning, we've all been there, keep asking questions:)
     
  14. Anne & Hyde (GA)

    Anne & Hyde (GA) Well-Known Member

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    May 18, 2015
    @Bron and Sheba - Bron, from Australia, makes her own cat food. She could probably send you more internet resources for information about recipes and supplements.
     
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  15. Bron and Sheba (GA)

    Bron and Sheba (GA) Well-Known Member

    Joined:
    Feb 21, 2015
    Hi Miguel,

    I feed my cat Sheba a raw / home prepared diet and find it has improved Sheba's health a lot.

    Not sure what meats you have available in Portugal but I would always use human grade meat, not pet food meat as they often have preservatives in them. I use kangaroo as the main meat but it is unlikely you could get that there. So beef is a good alternative. I don't use a grinder, I just cut it up into fairly small pieces. I also give cooked chicken legs (not the bone) but you could try raw if you like. Raw chicken makes Sheba sick so I cook it and it is fine. I also give a couple of chicken hearts a day and some chicken liver.....just a small piece about the size of 2 of your thumb nails.
    I can't get a premix of the supplements out here in Australia, but you may be able to in Portugal online. If you can, you need to check if it has liver added to it, because if it has liver added you do not add more into the diet yourself as too much is toxic. Small amounts of liver are essential for health but not too much.

    So here is a link to a premix that you should be able to get online
    http://tcfeline.com/store-2/
    If you can't order it, tag me and I will get back to you with the individual supplements to buy to add to the food to make it a complete meal.

    I would start off by giving Rebecca small amounts of the individual types of meat to see if she will eat it and to see if it upsets her tummy. If you mix it all up together and it makes her sick, you will not know what it is that has upset her.
    Sheba also suffers from pancreatitis so I only give her meats that are not high in fat and cut off any visible fat from the meat and the chicken hearts. I also found egg yoke was too fatty for Sheba unfortunately.
    If Rebecca is thin and hungry you can feed her anytime except the two hours before you test before giving the insulin. Once her blood sugars come down more towards normal, she will probably be less hungry and hopefully will put on a bit of weight. When Sheba was diagnosed with diabetes the first time she had got very thin and did not want to eat. She get her appetite back slowly once the insulin started.

    Sheba eats 120 grams of food twice a day and she weighs 6 kgms. That is just to give you an idea of how much Rebecca might eat. There are very few carbohydrates in a raw diet so you need to watch her blood sugar levels do not drop too low.

    I always have a few cans of the Weruva cat food in the cupboard. They are a good brand and if you go online you can see how many carbs are in each of the foods. You will also need to have some high carb food available on case Rebecca drops low anytime.
    http://www.weruva.com/cat-cuisine.php

    The photo of the food below is how much I give Sheba for one meal....divided into two smaller meals....twice a day (in the morning and at night). The orange stuff is mashed pumpkin which Sheba has for her bowels.
    I hope this has helped. If not tag me.
    Good luck with it all.
    Bron
     

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    Last edited: Mar 24, 2016
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  16. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    @MLopes -

    I'd add a slight caveat to Bron's recommendation above. Some cats are very sensitive to beef; it can spike their blood glucose levels.

    To determine whether Rebecca is sensitive to beef you could run a food trial as follows:

    1. Trial a food that does not contain beef. Test after a minimum 2 hour fast, give a meal, then test at +1 and +2 hours after feed to see impact of food on BG levels.

    2. Trial a commercial food that contains beef as an ingredient and do a similar series of tests.

    No need to do food trials on same day - just do when practical.

    If the BG readings after the food containing beef are markedly higher than those for food not containing beef it would give you an idea of whether Rebecca is sensitive to beef protein. When making choices for which foods to use for the food trials it helps if they have a limited number of ingredients (i.e. composed of meat ingredients, vitamin and mineral supplements, and a little fibre).


    Mogs
    .
     
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