Recently diagnosed New Member

Hi There! I was advised to join here from the Facebook Feline Diabetes group. My cat Heffernan was diagnosed in September. He's about 12ish (we've had him 8 years) and has been 30+ lbs for most of that time (adopted at 33 lbs). He lost 11 lbs over the last 9 months and was diagnosed through BG and fructosamine test. We are using Lantus, he started on 2 units twice daily, then was upped to 3 units twice daily. We haven't been home testing until this past week, and we are testing once a day, more if we are able. I'm completely overwhelmed and trying to absorb a lot of information. I have had cats for 20+ years but this is our first diabetic cat. I also volunteer with cats at our local SPCA, foster for them frequently and have 5 other resident cats.

 

Welcome! You are right - this whole process is overwhelming, but the more you learn, the more confident you feel. Glad you are hometesting. It is very important that you test before each shot, to be sure it is safe to give the dose you are planning to give. With Lantus, dosing is based on the midcycle of the cycle(nadir) so a test then is important too. Is testing difficult for you? Could we help with some hints of things that helped us?

Lantus is a good insulin, but not mine so others will need to tell you about dosing.

The final part of the puzzle is wet, low carb food. A vet explains why it is best here: www.catinfo.org What is Heffernan eating? (btw, great name. Where did it come from?)

 

He had a urinary blockage twice last year so he was on Royal Canin S/O when he was diagnosed. We immediately switched him to 95% canned food diet of the low carb Fancy Feast pate style food or the holistic brand low carb foods. We printed out Dr Lisa's food chart and take it shopping with us. I have the "approved" FF flavors in my wallet now on a stickie!
I live with my sister & we both work full time so testing during the day is not an option. We are getting over our fear of testing--that bothers me way more than the insulin shot.
When we adopted him, his name was Jupiter because he was big as a planet. I wanted to name him Mr Big after Sex & The City, but we just kept saying what a heifer he is! Somehow that morphed to Heffernan. He is truly a Heff, he knows his name!

 

Good job on the food!

Testing may take a bit of time to get used to. If you can't get mid-cycle tests during the day, how about aiming for a before bed test, so you can be alerted if he is going unexpectedly low. Some folks will even set an alarm in the middle of the night to tests, when they thing the cat may be going too low. And days off or weekends are a good time to get mid-cycle tests. You do what you can.

Just an FYI - we like to do increases in 0.25 (eyeballed) to 0.5 unit amounts, as cats are small and you can miss the best dose by increasing too much at a time.

 

Hello and welcome to the board!

What kind of numbers are you getting now that you are testing?

I usually recommend 4 tests a day

- always before the shot - this is mandatory as you don't want to shoot when too low. As a newbie this too low number is 200 but is reduced over time once you have the data to know if its safe.
- mid cycle - 5-7 hours after morning shot depending on your schedule. This is to see how low he is going. The low point "nadir" is what you base dose changes on since you don't want him dropping too low (under 50).
- before bed (2-3hours after Pm shot) to get an idea of what his overnight plans are. If this number is less than the pre shot test number you may want to set the alarm for a test a few hours later as this implies an active cycle.

Wendy

 

During the week we have only been able to get 1 test in before his PM shot. It takes 2 of us to test right now. Yesterday he was at 404 PMPS on 1.5 units BID. There's no way for us to do a mid cycle test since my sister & I both work full time and are gone from 8-5. I'm going to start a spreadsheet tonight and continue to work on testing.

We were advised to feed first, then give his shot. Should we be giving his shot first or while he's eating? My vet wanted us to wait 1/2 hour or so after he ate to give his shot. He is an avid eater, so him NOT eating isn't really an issue.

 

I also work 8am to 5pm which means I leave the house at 7am and return at 6am. This makes my testing times 6:30am and 6:30pm. It was difficult at first to change my whole routine, get up a little earlier, make sure I was home on time and the weekends... oh gosh, I was exhausted for weeks but when I saw the improvement in his numbers - it all seemed so worth it and now it's just a part of my day.

You'll figure it out.

I only see two Holistic Foods on the list that are lower than 8% - the Selects, chicken & lamb and salmon & shrimp. Are these what you are feeding. I am happy that you are using Dr. Lisa's list. It is so helpful.

Sue is right though - because your sugarcat has already experienced urinary problems, dry food is not a good food. In fact, I believe it is not good for any cat and causes Urinary Tract issues and renal problems - my opinion but I feel strongly about it. Low carb is great for the diabetes but all dry is bad for cats urinary tract. It's a hard transition and it is totally up to you but I would recommend that you read catinfo.org about it.

 

I like to give it while eating since they are distracted.

Here are some testing tips but the key thing here is treat. Always give a treat to make it a pleasant experience. https://docs.google.com/document/d/13c_CPZVKz27fD_6aVbsguadJKvjSrSAkD7flgPPhEag/pub

Does he like his ears scritched? If he does you dont need to restrain him, just wait till he is snoozing, go over and rub the ears then poky poky test treat.

wendy

 

Hmm...by Holistic foods I mean Wellness, Tiki Cat, Soulistic, EVO, etc--food with no by-products or preservatives. Nothing with the 3D's--diseased, deceased & decaying used to make their food. Generally food that only uses USA sources. Holistic Select was too high carb for him, we feed it to our other cats.

We are learning a new routine that's for sure. We are very involved with extracurricular activities, so it's shuffling things & making sure someone is home for feeding & shot that is taking some adjustment. Testing isn't coming easy to us. But we will get there.

I hear you on dry food, believe me I do. I have 6 cats with many different issues. Two are raw fed. Ideally, I'd love them all to be all raw fed, but they refuse to eat it so they are fed a mostly wet food diet with some kibble. IMO it's more important for the cat to eat and be happy than refuse food because it's what I want them to eat. I have fostered cats that refuse to eat, have given up and would have died if I didn't force feed them. I just lost a cat in July to renal failure. I get the importance of wet food and water. Heff is getting 1-2 tablespoons of the Young Again kibble daily mixed in to his wet food. His treats, other than Nature's Instinct chicken have been completely removed from his diet.

 

Hi and welcome! :YMHUG:

With Lantus, as long as the cat isn't having any appetite issues, you don't really have to worry about them eating at shot time. It's more important to consistently give each shot 12 hours apart than it is to make sure they eat their breakfast. So, if they're just not hungry, it's okay to still give them a shot as long as their pre-shot number is high enough. For new members, we generally recommend a "no shoot" number of 200 once you start testing.

For treats, you can feed them pretty much any freeze-dried meat. Just check the ingredients on the package and make sure it's 100% meat and no other ingredient. I actually buy the dog version of freeze-dried chicken to save on cost, so you might have some luck with finding more treats that way. I also will boil some chicken breast every now and again and use that for treats, or even raw chicken if I'm in the process of making it for myself. :lol:

 

You are doing a great job. Heff is lucky to have such a committed momma bean. Renal failure is such a difficult thing to watch your cat go through. I am sure it is still a raw part of your heart.

You are right, it is important to make sure that they are eating and you are certainly well versed about good foods. You'll get the testing thing down, I'm sure.

 

Greetings!

Just wanted to welcome both of you and your kitty, and let you know that we are all here to help you. Gobbles, is my (still-sugary sweet) diabetic cat in remission. He was diagnosed in November 2012 and went "OTJ" (off the juice) this past May. Without the help, support, compassion and guidance of FDMB members, I am scared to think where we'd be at now with his diagnosis. This all gets easier, believe me. Please ask ANY questions you have. Good luck!

 

Thanks for the welcome!! We are getting in a groove with AMPS & PMPS testing. Today's AMPS was 299 so we are heading down which is good! I adjusted his dose from 1.5 units bid to 2 units bid this morning. He was having some trouble pooping this morning, so I gave him some more fancy feast with Miralax hoping that gets things moving.

 

You cant tell how the insulin is working from preshot tests - the key is how low the insulin is taking him during the cycle. Which is why mid cycle tests are important. Because its bad to increase the dose without knowing if he is dropping under 50 (hypo!) during the day.


ie this is how lantus works:

Example of an active Lantus cycle:

+0 - PreShot number.
+1 - Usually higher than PreShot number because of the last shot wearing off. May see a food spike in this number.
+2 - Often similar to the PreShot number.
+3 - Lower than the PreShot number, onset has started.
+4 - Lower.
+5 - Lower.
+6 - Nadir/Peak (the lowest number of cycle). This is the number you base dose changes on!!
+7 - Surf (hang around the nadir number).
+8 - Slight rise.
+9 - Slight rise.
+10 - Rising.
+11 - Rising (one of the quirks of Lantus/Levemir: some cat's blood glucose numbers dip around +10 or +11... not to be confused with nadir).
+12 - PreShot number.

Also be careful when you change dose - Lantus needs to build up the depot. This means the insulin builds up in the cats system over time before you see the complete impact of a dose. Any dose change takes 2-3 days for it to build up in the cats system and before you see an impact.

More info: http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=18139

Do you want to set up a spreadsheet? It will help us a lot and you to track trends: http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

Wendy

 

I'm at a loss for what to do now with Heff...his numbers aren't improving even though we've changed his diet and have been trying to adjust his dose. There doesn't seem to be any rhyme or reason to his numbers other than he's high. We aren't able to test during the day. I am hoping to get more numbers this weekend.

 

This morning, you skipped his shot because he was too low, so that's probably contributing to his high pre-shot tonight. One low pre-shot might be part of Heff getting used to the new dose. Mikey sometimes throws out a low number in the first cycle or two of an increase and then he levels out a little better. Try holding the 2.25 dose for at least 3 more days, unless you have to keep skipping shots due to low pre-shot numbers or you get some numbers under 50 (automatic dose reduction).

 

His AMPS shot today was 121 so I skipped again since we are gone all day. I wonder if 2.25 unit bid is too much? Do I start over at 1 again to distribute the insulin more evenly? I can't edit the spreadsheet at work--I have yesterday's tests under 10/31...ugh I need more coffee!

 

With no mid-cycle numbers, there is no way to know how low he is going.
I would NOT increase unless and until you have data in the +5 to +7 hours after the shot.

With the low pre-shot, I'd be inclined to reduce because you don't know what is happening in between. Pre-shot tests are generally higher than mid-cycle tests and do not determine dose increases.

If that means waiting until the weekend or a day off, so be it.

You could set an alarm to get up at night and get those tests, too.

 

You could try dropping the dose to see if you can give the shot twice a day ....since you don't have enough data to know if you can shoot at numbers under 200 yet.

Perhaps try 2 units - but hold that dose consistently for 3-5 days (read this protocol:http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581) unless he drops under 50. Lantus works best on consistency as its a depot insulin - it takes a few days to settle in the cats system before you know how its working so you don't want to move the dose around a lot until it settles.

Also can you try and get a before bed test (2-3hours after nighttime shot) consistently? It would help provide more data on what he does at night.

Wendy

 

I am starting over at 1 unit today. His AMPS was 190, +3 317. Thankfully we have a very relaxed weekend since my sister & I are both under the weather so we can get more tests in.

 

Sorry to hear you aren't feeling well.

So far so good on 1 unit - lets see if he stays pink or not. Give it 3-5 days and see how it goes..

Wendy

 

Thanks Wendy! Unfortunately we weren't home very much yesterday to do a curve or much testing.

So today is day 3 of 1 unit bid. Do I go up to 1.5 or a 1.25?

His eye seems to be red & irritated the past few days, clear discharge. I've got ointment that I've been using. Could that also contribute to higher BG's?

 

Tomorrow morning increase 1.25 unless you see a blue or green nadir before then. Dose increases are made in 0.25 increments usually - see protocol http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

Wendy

 

Looks like we are heading in the right direction. Thanks to new washer & Dryer deliveries we were able to get some daytime numbers! I think he's due for a dose increase of .25 but the syringes I got at Target don't even have a .5 unit marking. I have to see if I can get different syringes. I don't trust eye balling.

 

Bad news: half unit marks are as good as it gets on syringes. Gonna have to eye ball it.

Mel, Maxwell, Autumn and The Fur Gang

 

Well the eyeballing of 1.75 seems to be working. Way better numbers on this dose. Relieved to be out of the pinks mostly!

 

1.75 looks like a better dose. When you see a blue (or low yellow or green!) pre shot though I would definitely try and get a +2 or mid cycle. If the +2 is lower then also get a mid cycle test. You want to see how low this dose is taking him

Wendy

PS not sure I understand how washers and dryers influence the testing but whatever works

 

LOL we aren't home normally to get a +2 during the day, so when the washer & dryer broke, we also had to have plumbing and electrical work, so someone was home!!

 

Here's hoping you can get some other +2 tests without anything else breaking in the house. :lol: :shock: :lol: Maybe try that one last test before you head off to bed test on a regular basis.

 

Great job, that tells me a lot. Essentially that his numbers are pretty much the same.

Probably this is glucose toxicity from being at a too low dose for too long. It may mean the dose needs increased a bit.

So... Give this new dose another day or two and if you don't see any green, the protocol says increase again by another 0.25.

Also keep getting those spot checks mid cycle. That's when you are most likely to see the lows. And try and get a before bed test...l especially when your preshot is yellow.

Wendy

Ps what kind of fancy feast is it?

 

It's mostly the FF classic pate--i rotate flavors off Dr Lisa's list--I try not to do too much fish because of his urinary blockage history. He gets the occassional flaked FF which I think are 7 or 8% at most.

My sister is home cooking today so I asked her to test as often as possible. Between today & tomorrow hopefully we can better numbers.

 

Cool - lets see how it goes!

 

So how can his AMPS be 181 and +6 be 354?? He hasn't moved off the couch all morning!!! All he's eaten was Turkey FF for breakfast. UGH!!!

 

Looks to me like he has one heck of a bounce going there. Sometimes, we don't understand why, but the numbers go up again really high after those lower numbers.

Some people call it "liver training school". The lessons are still being learned, the liver hasn't quite gotten the hang of the lesson yet that the lower numbers are ok. It can take a while for the lessons to sink in. Patience little grasshopper.

 

Its a bounce. Nothing to worry about. It would have been interesting though to get another test in after that 114 as he might have even sneaked into green later!!!

Lets see what happens when this bounce clears. Because if you don't see green then I see another dose increase in his future.

Wendy

 

Why is he constantly bouncing? He was high again this AM.

Patience is not my strength. LOL This disease is either going to teach me patience or kill ME! @-)

 

because he is a cat. Most cats bounce until they don't. Many bounce into remission as the liver learns to stop panicking every time it sees a number it doesn't like and as it relearns what is normal. However we do need him to get into more normal numbers to allow his body to heal. he is still a bit high.

Wendy

 

Just updated his spreadsheet with today's numbers. So tomorrow should I go up to 2.5 bid?

 

Yep I think so. Although your data has a lot of holes, I could be wrong, but I don't think he is dropping low. But next time you get a yellow or blue pre shot, I would strongly suggest a +2 or +3 and IF that is lower than pre shot, is set the alarm for a test in a few hours. We have to be so careful to make sure he isn't dropping low at night. My cats do it a lot!

We really need to know how low he is going. Because if that low is green then we re-evaluate everything!!! Hunting for the low number is so critical in lantus dosing so we want to test more when he looks like he is dropping..

Wendy

 

Welcome to the forum - you are doing great so far!
Some cats are more carb-sensitive than other cats. I see that you are feeding around 7% - 8% carbs. My cat's BG would jump around a lot until I put him on less than 3% carb foods (he actually does best on 1% or less). If you decide to give very low-carb foods a try, make sure to test regularly and also have some of your higher carb food available in case the BG gets too low (less than 60 in your case since you are just starting out). When you reduce carb intake, you may also need to reduce insulin, but keep a very close eye on Heff's BG throughout the process. Safety is most important.
When you try the low-carb foods, feed small meals at +3 and +6 to help prevent low numbers, but if you have a number that's too low (especially under 50), then give higher-carb food and re-check the BG in 20-30 min to make sure the BG comes back up to a safe number.
You may discover that a regular diet of very low carbs will help regulate Heff's BG. It's not a guarantee, but it may help! Good luck!

 

Thanks Jess! My only problem with the super low carb foods is that they are mostly seafood. He had 2 crystal urinary blockages in the last year so I was told to feed fish based food sparingly.

His numbers have not adjusted this week with the dose change. I think I may need to change insulin to Levemir maybe.

 

Nutro: Natural Choice soft loaf canned food comes in Turkey, Chicken, and Duck (my cat loves the duck the best) and has almost no carbs. It's the only non-fish option that I've found with so few carbs. Natural Choice isn't on any of the food lists, but I know that the carbs are extremely low (possibly zero). Mr.Cat is on a mostly raw, homemade diet of turkey/chicken meat and liver, but I do feed a little canned every now and then. Whenever I feed any other brand of canned cat food, I notice Mr.Cat's BG goes up at least 20 points (I've tried Wellness, Merrick, and many other 3-4% carb foods and they all spike his BG). With the Natural Choice soft loafs, his BG is as low as feeding raw (and his BG never bounced). You can buy NC at petco or petsmart.
Of course, if you decide to put Heff on very low carbs, make sure to keep a few high-carb cans around the house in case of emergencies (BG under 50). But try to feed mostly low carb as much as possible and see how it goes for a few days before you switch to Levemir.

 

Do you have any recent numbers for us? Did you increase the dose to 2.5?

Wendy

 

Sorry, I'm at work-meter is at home to update spread sheet. We did up the dose to 2.5 and was planning another increase to 2.75 since his numbers aren't changing much. His +6 the other night was 218, but pre shots continue to be high 300's. Could it be that he needs more snacks, more often?

 

Did you get any late pm cycle tests in with this dose? It could be he drops low then and you are missing it

Feeding many small meals through the day is a good idea anyway.

 

I forgot his PM Shot. OMG. It's 2 hours past when I normally give it. Do I give a small dose? Do I give it now? I'm a horrible mom.

 

You can shoot now normal dose no worries. However it means tomorrow morning you will shoot at the same time making you two hours off schedule . You will have to gradually move back by 15minutes each time. Or 30minutes a day.

Wendy

 

You are not a horrible mom. I asked some one from lantus land to help you.

My sugar-cat is on ProZinc....I am not sure of how lantus protocol works.

 

I gave his dose (and some of his YA treats). UGH. I am such a failure at this disease!

 

You are not a failure. We all have had our "moments" during this sugar-dance.

There were many times when Rumpelteazer was just beginning her sugar journey that I was ready to bang my head off a wall. I would post my feelings (ahhhh...let's say vent) in her daily condo here and other (totally awesome) members would calm me down/cheer me up/help me out/etc. I always felt better afterwards.

Everyone here is "here" to help in any way they can. You are doing fine...I send positive vines to you. :smile:

 

Laura,

Heffernan is leading this sugardance, and you are following his lead, doing the best that you can. Some days, it's a slow waltz, others a romping polka or the salsa or a tango. Every day is different. Some days will be easier than others, some days will be tougher. cat(2)_steam

We all know that you are trying your very, very best to help Heffernan.

Forgetting a shot is perfectly normal. Giving a fur shot where you miss shooting all or some of the insulin into your cat is perfectly normal and something even the most experienced of us have done. Sometimes life's other responsibilities don't allow us to give the shots on the recommended 12/12 schedule every day. You make adjustments and shuffle your many life responsibilities around the need to take care of Heff. That may mean that on some days, Heff gets a shot later or earlier than normal. Life happens.

You need to remember to take care of yourself first Laura. Heffernan needs you to be healthy not only physically but mentally. Yes, I know that can be difficult to do every day, but remember to treat yourself too. Heffernan gets treats. So should Laura. A piece of chocolate, glass of wine, reading a good book, taking a short walk, deep breathing exercises. Whatever you need to do, to refresh your own spirit. Please, take at least 10 minutes of "ME time" for yourself every day.

Enveloping you in {{{{{HUGS}}}}}

 

Thanks Deb, I really appreciate your support. It's been a tough year losing 2 cats and It's been a stressful week--another one of our cats is sick and my vets office is closed. I upped Heff's dose to 2.75 units and his pre shot numbers have been below 300. We are trying to stick to a strict 12 hour schedule. I think the variance of even a 1/2 hour for him might be throwing him off.

 

those numbers sound good - can you update his sheet so we can see?

 

Numbers have been updated. Every time I plan on getting more tests in life happens. One of our cats we rushed to the vet tonight with some pretty bad GI issues. Heff is happy cleaning out his bowl from his shot treat!

 

Sending healing vines and get better soon vines to your sick civie. Hope he/she gets better soon. I see from your signature that you have 6 cats including Heff, so we know you have your hands full.

 

Hope your pets are doing ok!

Any chance of some mid cycle tests this weekend to really see how this dose is doing? we need to know how low this dose is taking him mid cycle to see if he needs another increase or if he is hitting blues and greens when the lantus hits maximum action at +4 to +7.

Wendy

 

Hi there, sorry I haven't been on line. My cat Randolph was hospitalized all weekend, and we just brought him home yesterday. it's been chaotic to say the least. I havent had a chance to get extra tests in, in fact testing has become difficult for us and I don't know what I'm doing wrong. Could be stress, worry & fatigue on my part. I have to update his SS too.

 

Sorry to hear about Randolph, how is he doing?

Wendy

 

Hi Wendy, he made it! He was basically dying when I brought him in, but he survived & is home recovering with us. Some sort of nasty virus hit him--not quite sure what, but it was awful.

Heff's numbers are terrible. I don't know what to do! I have no idea why he is still in the 300's so often.

 

Two things.

I urge you to try to get those shot times on a more even keel if your schedule permits. As close to 12 hours as possible. An early shot as like a small dose increase and a late shot acts like a small dose decrease. So bouncing around a lot on the shot times could be a factor on some of the wild swings.

I'd try to get a "one last test before you go to bed test" every night if you can. Many cats drop lower at night and this test can help to fill in some of the SS and help us to see a pattern.

Glad to hear that Randolph is back home and recovering nicely. That virus sounds scary.

 

Yeah if you can get a couple more tests during the day (or at least a before bed one and a curve at weekends), we would know more to be able to see if he needs a dose change.

Glad randolph is ok

Wendy