? Senior cat just diagnosed - Concerns!

Discussion in 'Feline Health - (The Main Forum)' started by Bobbi & Angel, Jun 29, 2016.

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  1. Bobbi & Angel

    Bobbi & Angel Member

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    Hello, my name is Bobbi and my cat, Angel, is 16 years old. We went to the vet on Tuesday afternoon because Angel had not been eating well (completely stopped eating dry food, so switched to wet food to get her to eat), lost some weight, and was drinking excessively. There is a lot of info here, I'm sorry if it is too much or too confusing, I am just very concerned.

    The results at the vet were not entirely clear and indicated high blood sugar as well as some issue with her kidneys. The vet wanted to do a urine sample, I think for a specific gravity test?, but we couldn't get a urine sample at the time. He decided that we should treat for diabetes to get her blood sugar down. She was given an insulin shot in the office (around 1:30pm), I am not sure how much, as well as sub-q fluids. She really perked up for a couple hours when we got home, but I'm not sure what the cause was.

    We were prescribed Humulin 2 units every 12 hours to be started the next day. The vet also said we should switch to a low carb food, so we bought Wellness wet food and have been feeding her that. She is not eating as much as she should be, but seems to be eating slightly more than before the trip to the vet (she seems to like this food a lot). Her drinking was much less yesterday (probably due to the sub-q fluids?) and seems to be a little bit excessive today. I can try to measure how much, but we have another cat, so it would only be an estimate.

    I did Angel's first shot this morning at 7am after she had eaten something. She seemed pretty lethargic most of the day and would pick at her food every so often, then around 1pm she followed me in the living room, laid down, and when I started petting her, she kind of grumbled at me a little bit. She went to use the litter box, then vomited right afterwards. :( This is the first time through any of this that she has vomited, I'm wondering if it was due to switching her food so abruptly.

    I was very concerned about giving her more insulin after this without knowing her blood sugar levels and I read some info on this site about meters. I took a reading at 6pm (+11 hours from her last shot) and it was only 80. I have been reading some of the forums on here and saw that I should wait and test again, which I did, at 9pm (+14) and it was 78. So I decided to skip her dose for tonight, I hope this was the right decision!

    I am worried that the diagnosis might not be correct, since the vet only had the one blood test to go off of and seemed to think it could be a problem with her kidneys instead. I am supposed to try to get a urine sample tomorrow (will be hard because we have 2 cats, so I'm not sure the best way to do this) and have it at the vet by Friday. My plan is to test her blood sugar again in the morning around 6am to see if they are elevated, and then proceed from there, but I am hoping to get some advice here........thank you.
     
  2. Sharon14

    Sharon14 Well-Known Member

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    Yes you were right to skip tonight! 78 is a normal number. Do you have a copy of the bloodwork? If you do, you can post it we have several members that can read labs and give you some info.
     
  3. Jan Radar

    Jan Radar Well-Known Member

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    Hello and welcome to FDMB. We are very glad you found us. :)Good job on the home testing. I find that the testing I do helps me so much as I'm trying to tell how the insulin is working in my cat. Interpreting the results of those tests takes a little time, but don't worry we will be right there to help you as much as you'd like. I'm not familiar with the insulin you are using and since it's almost a big holiday weekend there may not be as many people on here as usual... but I see that there are much more experienced eyes than mine online right now so I'll tag one of them and ask for assistance. @Tricia Cinco(GA) & Harvey

    For what it's worth I do think you were wise to skip tonights dose... I think I would have done the same in your shoes. In the early days when one doesn't have much data from testing, it seems wise to err on the side of caution. ...
     
  4. Bobbi & Angel

    Bobbi & Angel Member

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    No, I don't have a copy of the bloodwork. At the time, I was so overwhelmed with everything they were giving to me for treatment, I didn't even think to ask. I should be able to drop by the vet in the morning and ask for a copy, right?
     
  5. Sharon14

    Sharon14 Well-Known Member

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  6. Bobbi & Angel

    Bobbi & Angel Member

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    I just did a reading at 6:15am and got 316. I'm hoping that her eating a few bites of food while I was trying to get a reading didn't mess this up? It was probably no more 5 minutes between her eating and me finally getting some blood to test.

    I am not sure how to proceed. Should I give her only 1 unit instead of 2 units?
     
  7. Sharon14

    Sharon14 Well-Known Member

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    I'm not sure what members know about Humulin @Rachel do you? Did you shoot?
     
  8. Bobbi & Angel

    Bobbi & Angel Member

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    I just did 1 unit, to be safe. I won't be home for a couple hours today and I really didn't want to give her too much.
     
  9. Sharon14

    Sharon14 Well-Known Member

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    Good, better to be safe! Will you be able to get a few tests in during the cycle? And do try to get those labs from your vet.
     
  10. Bobbi & Angel

    Bobbi & Angel Member

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    Yes, how often should I test? I will try to get the labs before I go to work.
     
  11. Sharon14

    Sharon14 Well-Known Member

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    Try to get a test @+2(2 hours after shot) then a few more if possible before the usual nadir of +6. Then depending on what that number is, a few more after that. You won't have to test so much everyday, we're just trying to establish a base for how well the insulin is working, so the more tests the better. Always get that preshot(PS) test. I'll try to find someone that knows about Humulin. After we check your labs, you may want to consider changing to a different insulin. ProZinc or Lantus are the best for cats and have longer duration and gentler curves.
     
  12. Helen & Snickers

    Helen & Snickers Member

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    Snickers started on Humulin and it dropped her fast and low. Thanks to the advice here, I switched her to BCP PZI, although nowadays you can go with Lantus or Levemir as well. Great job testing--that's key!
     
  13. Bobbi & Angel

    Bobbi & Angel Member

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    Here is a copy of the lab results from Tuesday.
     

    Attached Files:

  14. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, I will keep this in mind going forward. Thank you!
     
  15. Sharon14

    Sharon14 Well-Known Member

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    I'll tag @Marje and Gracie to help you interpret the labs. She lives out west, so it may be awhile before you hear from her.
     
  16. Bobbi & Angel

    Bobbi & Angel Member

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    Thanks a lot!

    I just did a test at +2 and got 285. Does that seem right? I have to go to training for my new job in about 45 minutes and I could be there for 2-4 hours. I will get another reading as soon as I get home.
     
  17. Sharon14

    Sharon14 Well-Known Member

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    Yes, from what understand Humulin drops them early, so if you could get an out the door test right before you leave, that would be great. Also, do you leave food out?
    Good luck with the new job training!
     
  18. Larry and Kitties

    Larry and Kitties Well-Known Member

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    The blood test results creatinine, phosphorous and bun indicate quite advanced kidney insufficiency. A high phosphorous can make a cat feel bad and such a high level mean that a low phosphorus food or phosphorous binder is necessary. Administering of subQ fluids is also likely called for.
    For info on kidney insufficiency see:
    http://www.felinecrf.org/index.htm
     
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  19. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, thanks. I'm not sure how I should proceed from here. The plan was to get a urine sample in by tomorrow, but it's been difficult because we have 2 cats. I'm just worried about all this time that we aren't treating her for the right issues...
     
  20. Bobbi & Angel

    Bobbi & Angel Member

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    I just called to make a quick appointment for Angel to have a urine sample done at the vet an hour from now, since I'm having no luck getting one myself. While I'm there, would it be inappropriate for me to ask for sub-q fluids to be done, or to be sent home with stuff to do the fluids myself? I am assuming this appointment will only be with a technician since they slotted me in so easily.... It really seemed to make her perk up the first day and I feel awful not treating her for the kidney problems.
     
  21. Sharon14

    Sharon14 Well-Known Member

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  22. Bobbi & Angel

    Bobbi & Angel Member

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    Just got back from the vet. They couldn't find her bladder again, just like the first time, but did sub-q fluids. A different vet looked over her bloodwork and we are going in tomorrow morning to do IV fluids (keeping her there for the day, I think?) and to talk about what to do from here on out. Needless to say, I am super worried now because they didn't really tell me anything today and going in for the IV seems serious. I just wish we had some answers!

    But on the plus side, she seems to respond pretty well to the fluids. She's much more energetic and alert, just like last time.
     
  23. Sharon14

    Sharon14 Well-Known Member

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    Check out the link Larry gave you for feline CRF. Learn as much as you can so you'll know what questions to ask.
     
  24. Bobbi & Angel

    Bobbi & Angel Member

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    Thanks, I looked over a lot of the information on that page and will do so again before our appointment tomorrow.

    I just did a test at +11 (it's about 1 hour and 20 minutes before her next dose is due) and I got 89.... Do I skip the dose? I don't understand why this keeps happening...
     
  25. Sharon14

    Sharon14 Well-Known Member

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    Have you fed her? If not, don't and test again at shot time. I'll try to find someone familiar with your insulin. Often if the AM preshot number is high and the next Preshot number too low to shoot, the dose is too high and you need to reduce.
    @Sue and Oliver (GA) do you know about Humulin?
    @BJM
     
    Last edited: Jun 30, 2016
  26. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, thanks a lot. I really appreciate all your help, it has been keeping me sane throughout this process...

    She has been grazing on and off, I haven't taken up her food since she isn't really eating much at once and I'm afraid to stop her from eating when she wants to. She just ate a few bites right before I did the test and had a couple of freeze dried chicken treats afterwards. I will try the test again in an hour, when I'm supposed to do her PM shot.
     
  27. Sharon14

    Sharon14 Well-Known Member

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    Great. I'm glad she's eating some!
     
  28. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    I would not shoot under 200. If she is 200+ test, feed and then shoot. I would give one unit, not two until you can get some more data and see how the insulin is working. Humulin tends to have a fast onset so you want some food on board. This link is rather old but has good info:

    http://www.felinediabetes.com/FDMB/threads/humulin-n-primer.303/

    I wonder if she is lower because the initial dose is too high.
     
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  29. Bobbi & Angel

    Bobbi & Angel Member

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    Thank you. I have looked through that post but will do so again.

    For her AM shot today, I did 1 unit instead of 2 units because this same thing happened yesterday, where her PM preshot test was too low for a shot (80). Tomorrow morning, she has a vet appointment 1.5 hours after her AM shot and I'm under the impression that they plan to keep her for most of the day, so I'm assuming they will be doing bloodwork again at some point and will be able to see how her blood sugar is.
     
  30. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    It doesn't look like she will be high enough for a pm shot so one unit from this am may be too much also. If she is above 200 in the tomorrow morning, you might try 0.5 units. She may be high because it will have been 24 hours without insulin, but I'd suggest reducing anyway. You want to get away from this pattern of preshots too low to shoot.

    One caution: cats' levels are very likely to be higher at the vet than at home (noise, other animals, people who are not the mommy :D) Some people report levels 100+ or more. If the kitty is higher at the vet because of the stress of being there, doses based on those inflated levels can be too much insulin once the cat gets home.
     
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  31. Rachel

    Rachel Well-Known Member

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    Hey Sharon! for some reason I didn't get the notification on this post until now. I don't really know much about Humulin though. I think Sue has some knowledge of it, so I'm glad she is here!
     
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  32. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, good to know, thanks so much!! I will bring all of this up to the vet once we figure out what is going on with her kidney issues. If we can get that sorted out, maybe with at home sub-q fluids or something, we can focus on how to deal with her insulin shots. I am just hoping we are able to deal with the kidney issues, like I read about on the link Larry provided. I'm not sure if my hopes are too high and unrealistic when it comes to the kidney issues.

    My vet, who I just switched to, does not seem to care much about this at-home testing and monitoring. He only told me to do the 2 units twice a day and watch for signs of hypoglycemia....if I hadn't done my reading on this forum, I am sure we would have had serious issues with too high doses!!! I am hoping the vet I see tomorrow (same office, different vet) will be of a different opinion and will be willing to discuss a plan for safe at-home treatment. I did not discuss the dosing changes with a vet yet since I haven't seen the same vet again. I will make sure tomorrow to tell them was dose I did when I drop her off. I hope they won't be upset that I didn't follow their instructions, but I'm glad I didn't...
     
  33. Sharon14

    Sharon14 Well-Known Member

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    Hope you get some answers tomorrow. She's a beautiful girl!
     
  34. Bobbi & Angel

    Bobbi & Angel Member

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    I just did another test: 106 at +12
    It took a couple tries, I'm not very good at this yet and she doesn't like me touching her ears. Poor thing!! She does like her dried chicken treats though lol

    Tomorrow I will try 0.5 units. I wish I had gotten some more measurements today to see how low she dropped.
     
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  35. Sharon14

    Sharon14 Well-Known Member

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    If you'll be around one day over the weekend, you can run a curve-testing her PS, +2,4,6,8,10 then PS. That will give you info on when the insulin kicks in and how long it lasts. Can you set up the spreadsheet? It's a great way to see how well things are going.
     
  36. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, I can try that, assuming she is only kept at the vet for the day tomorrow. I have been using the spreadsheet and put in all the numbers I have gotten so far.

    I was just looking at my syringes and they are not in increments of 0.5. Is it ok for me to estimate tomorrow or do I need to go buy new syringes somewhere?
     
  37. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    For now you can eyeball half of one unit

    The vet can't tell you that you can't test at home. She is your cat and it's your job to keep her safe. Seems like it would be hard to argue with your recent testing - if you had given 2 units last night or tonight, you'd likely have been dealing with deadly hypos
     
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  38. Bobbi & Angel

    Bobbi & Angel Member

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    Angel's preshot test was 331. I am going to do 0.5 units.

    I have a question. Will blood sugar levels that are too low or high cause a cat to be lethargic/less alert? I mean like any of the numbers I have been getting for Angel, so 80s or 300s. I am jsut trying to understand why her behavior keeps changing throughout the day.
     
  39. Sharon14

    Sharon14 Well-Known Member

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    Good morning Bobbi. Yes blood sugar levels can cause lethargy. Even though 80 is a normal number if Angel isn't used to being in those numbers it may be causing her to feel tired. Good luck at the vet today, keep us posted.
     
  40. Bobbi & Angel

    Bobbi & Angel Member

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    At the vet. They are planning to do a glucose curve today along with the IV.

    I am glad I did my research with the links you all provided because this new vet is not explaining anything to me like it has been explained in the sources provided on here.
     
  41. Bobbi & Angel

    Bobbi & Angel Member

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    They finally got a urine sample and confirmed that her urine is dilute, indicating kidney failure as expected. Her urine specific gravity test result was 1.015 (I think that's how it works? He said "ten fifteen")

    They decided to keep her for today and tomorrow to do IV fluids and are giving her something that's supposed to settle the acid in her stomach and hopefully bring her appetite back. I think the word he used was gastritis or something similar.

    They will also be checking her glucose every so often. I told the technician that I only gave 0.5 units, so I dont know what they will do later. When they call to update me I will ask for her glucose numbers and make sure they know the dose I did this morning.

    I hope this helps her enough that we can do an at home treatment plan to manage the diabetes and the kidney failure. I'm not sure how optimistic to be. :/
     
  42. Sharon14

    Sharon14 Well-Known Member

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    Always ask questions, like Why they are doing anything they're doing, what numbers mean, etc. lots of folks here have kitties with kidney failure and will be able to give you some tips. Get copies of any tests they do today.
     
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  43. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Did they talk about pancreatitis?
     
  44. Bobbi & Angel

    Bobbi & Angel Member

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    No, he didn't mention it at all.
     
  45. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Pancreatitis is a condition that can affect appetite. But let's let them do their thing today and see what answers they have for you later. Just be aware they may get much higher levels than you get at home as Angel may be stressed, and they may prescribe a higher dose that you'd want to give based on her levels at home.

    Many diabetic have elevated kidney values - it goes along with diabetes. It could be that she has kidney disease and you'll need to treat that. The site Larry gave you is material you can read and reread.
    http://www.felinecrf.org/index.htm

    Meanwhile, remember to breathe. Sounds silly but deep breaths relax and restore you. Regardless of what they do and find, clearly Angel has a life filled with love with you and is a lucky kitty.
     
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  46. Bobbi & Angel

    Bobbi & Angel Member

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    I'm picking Angel up this afternoon. She has been on IV fluids at the vet since yesterday morning.

    They're sending her home with Science Diet k/d canned food. If anyone has other recommendations for food, please let me know. I think there was a link posted above, but I'm not sure if it was recommended specifically for kidney disease? My other problem is that we have 2 cats and the other one will not keep his nose out of Angel's food, so I need to make sure it's ok to feed him the same food she eats.

    The plan is to have Angel home for a week, then to bring her in to test her kidney values again. It seems wrong not to have her receive fluids for a whole week, form what I read about kidney disease. They're giving a medicine as well, but in my rush to decide between tablets or liquid, I can't even remember if she said it was for lol, so I will have to ask. We will be doing 0.5 units of insulin twice a day. Thank you to everyone here who helped me find the right dose. They recommended that, once she begins to eat full meals, I give her 1 unit, so I'll keep that in mind.

    I'm getting copies of all the tests they did. If there's anything else I should ask or do before I take her home today, please let me know.
     
  47. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Yes, try the food chart on that CRF site.

    http://www.felinecrf.org/diet_and_nutrition.htm

    Science Diet wet certainly has nothing over the pet store brands except that it costs more. Also here is a thread for kidney cats and diet.

    http://www.felinediabetes.com/FDMB/threads/kidney-disease-in-cats.158451/#post-1687509

    You can read a lot more threads by searching (upper right hand corner of this page search box). Try CRF diet or kidney disease +diet

    If you want, you can give fluids at home. Lots of people here have done it and think, once you get used to it, it is very doable. Then she wouldn't need to wait a week and wouldn't need the stress of another lengthy vet visit. Here is a site with pictures and info:

    http://www.felinecrf.com/managb.htm
     
  48. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, thank you so much! I will look through these threads and search for others.

    I have done fluids at home before, when she was sick a couple years ago and stopped eating/drinking completely, so I would be comfortable doing it again. The worst part is that no matter what, she seems to know I'm trying to stick her with a needle and gets scared.
     
  49. Sharon14

    Sharon14 Well-Known Member

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  50. Bobbi & Angel

    Bobbi & Angel Member

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    Ok, I have Angel home now and we weren't given anything to do fluids. When I asked about it, the technician said that was something the vet wanted to discuss after we bring her back next Saturday for another blood test. Should I have been more insistent?

    Also, I'm supposed to give her Famotidine 10mg every morning to help with stomach acidity, not sure if this is standard or not?

    Angel is not really very interested in eating right now, at least not any more than she was before her stay at the vet. She will not touch the k/d wet food they gave me (for what it counts, my healthy cat won't touch it either lol), but grazed on the k/d dry food when we got home. I haven't been able to get to the store yet to buy her any of the food on the low carb, low phosphorus list. I just did her preshot test and got 350 (+11). She's just drinking a lot of water right now and didn't eat more than a few bites of her food. Is this because of her sugar level or should I be more concerned about her kidneys? I really am not sure what to do because she doesn't seem any better after her stay at the vet and I don't want to make her worse by reacting too slowly.

    I'm going to give her 0.5 units of insulin again tonight since that seemed to be the correct dose, especially given that she's not eating much.
     
  51. Sharon14

    Sharon14 Well-Known Member

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    Try giving her some tuna or unseasoned chicken breast. She needs to eat some. I'm not sure of the dosage of Pepcid but I know it's ok to give
     
  52. Bobbi & Angel

    Bobbi & Angel Member

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    I did not realize that was generic for Pepcid, thanks for letting me know. It will be easier to find at the store now that I know that it will be with the Pepcid.

    As for food, she likes the original Wellness food (grain free chicken, turkey) I bought when we first got the diabetes diagnosis, so I'm giving her some of that. It's not on the low phosphorus list though so I guess I have to find something else? I'm not sure how to check the phosphorus levels in food.

    She also eats the freeze dried chicken treats that I bought and usually one of those treats will prompt her to eat the wet food afterwards. I will go to the store tonight to find some different types of food and see which ones she will eat.
     
  53. Sharon14

    Sharon14 Well-Known Member

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    I think grain free turkey is on the list. It has a green label?
     
  54. Bobbi & Angel

    Bobbi & Angel Member

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    Yes, it's green. I wish the chicken was on there, it seems to be her favorite flavor.
     
  55. Bobbi & Angel

    Bobbi & Angel Member

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    From a quick google search, I found this link: http://www.catinfo.org/docs/FoodChartPhosphorus9-22-12.pdf
    If someone could let me know if this is a safe source, that would be good. I am not sure what to trust. The Wellness chicken is on there, I attached a screenshot of the entry for it, but I'm not sure what levels of carbs and phosphorus are appropriate. Any advice would be appreciated.
     

    Attached Files:

  56. Sharon14

    Sharon14 Well-Known Member

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    Catinfo is an excellent site!
     
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  57. Bobbi & Angel

    Bobbi & Angel Member

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    I am going to look for the Max Cat flavors as well as the Wellness flavors on the low phosphorus list. I have another cat, do you think all of these foods are ok for him as well? He will definitely at least sample her food and if I put something better tasting out, she is likely to eat that instead.
     
  58. Bobbi & Angel

    Bobbi & Angel Member

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  59. Sharon14

    Sharon14 Well-Known Member

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    The wellness low carb, low Phos food is fine for your other cat. The only one I might be wary of for the other is the hi tor neo because it is low protein. It won't hurt the others to get some though, just wouldn't want to feed it exclusively. I'll check out the Purely FF. I'm trying to get Colin on a low Phos diet too!
     
  60. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    If you want to give her fluids at home (especially as you have experience) you should be able to do that. Do you still have the apparatus? You can get the fluids and go ahead and start?

    She is your cat and you are her best advocate. You can decide what you want to do for her
     
  61. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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  62. Bobbi & Angel

    Bobbi & Angel Member

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    I would have to look around for it, I've moved houses since she was last sick. Plus, my normal vet's closed tomorrow and I'm not sure about Monday, since it's the 4th. I guess I should have been more assertive today, but I trusted that they wouldn't steer me wrong.

    Having her home, she really doesn't seem too much different than before her trip, though I did get her to eat a bit more by giving her the tuna I mentioned above. She's drinking water like CRAZY so the fluids would probably have been a smart idea. I'll try to get them asap because I don't want her to become dehydrated and stress her kidneys any more than they already are.
     
  63. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    It's great she is drinking - good for her kidneys!
     
  64. Bobbi & Angel

    Bobbi & Angel Member

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    Well, at least that's helping her then! I feel so bad for her

    I'm just not sure what's causing her not to have much of an appetite... I bought Pepcid to give to her every morning like the vet suggested.
    She's eating, but not nearly enough, and right now she's hiding... More often than not, whenever she goes over to eat, she just ends up drinking tons of water instead. I'm assuming she still isn't feeling well, but I don't know how else to help her. :/
     
  65. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    If she likes tuna, you might put some of the juice from it on the food. It is good she is drinking so she won't get dehydrated.
     
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  66. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Ok, thanks!!
    What seems to do the trick is getting her to eat one of these dried chicken treats, then immediately putting food in front of her. It's like, she eats the treat, then BAM she's so hungry, she can't help but eat lol. She started purring so hard just now while she ate, she was making these little chirping sounds lol.

    Also, what she's eating is the k/d dry food we got samples of from the vet. I have put so many types of food in front of her lately, I'm surprised this one actually interested her.
     
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  67. Sharon14

    Sharon14 Well-Known Member

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    So glad she's eating and purring!
     
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  68. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Just got a preshot value of 453! yikes

    The vet warned me that her dose might need to be adjusted once she started eating more. Right now, she's eating some k/d dry food. Of the many foods I've laid in front of her, that seems to be her go to. I'm not sure if I should give the 0.5 dose or go up to 1 unit. Is it safe to jump up by that much between doses?
     
  69. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    It's good she's eating. The K/d is high carb so she may need more insulin until you can get her eating the low carb wet food. I think the 1 unit is ok as long as she is eating and you be able to test some today so we can see how the dose is working.
     
  70. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Ok. Another thing, how do I get her to take a Pepcid pill? I've cut it up into smaller pieces but she always seems to know it's there anyway I try to give it!
     
  71. Sharon14

    Sharon14 Well-Known Member

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    If she'll eat some wet food, you can crush it and mix it in with a little water. If she says no to that, does she like cheese?
     
  72. Bobbi & Angel

    Bobbi & Angel Member

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    I tried mixing it in the food, she can tell right away!
    But yes, she loves cheese.
     
  73. Sharon14

    Sharon14 Well-Known Member

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    Hope the cheese wrap works!
     
  74. Bobbi & Angel

    Bobbi & Angel Member

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    I will let you know! I'm letting her have a break from all this doctoring for a few minutes

    Whenever I give her insulin shot, she yelps at me when the needle goes in. Am I doing something wrong or is it because she's not expecting it, like she would be at the vet? Like this morning, she was purring and very calm when I gave the shot, but she yelped at me when I pierced her skin. Then she just goes right back to purring like nothing ever happened... I have been giving the injections more on her side than on her shoulders because she is always laying down on her favorite chair when I give the shot.
     
  75. Sharon14

    Sharon14 Well-Known Member

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    My cat has never yelped, but once and awhile he moves off right when I stick him. Be sure you're injecting at a 45 degree angle so it's under the skin and not into it. I've read something about the bevel going in at a certain way, but I can't see the bevel, so I haven't explored that. I'll look for the post though and link it.
     
  76. Sharon14

    Sharon14 Well-Known Member

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  77. Bobbi & Angel

    Bobbi & Angel Member

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    Oh that's interesting, I will try that when I give her shot tonight.

    Also I managed to force about 1/2 the Pepcid pill into her mouth to swallow (I cut it in half to try to hide in food). I will try to give the rest in an hour or so. Do you think it would be ok to do the whole pill at once this way? It seems kind of big. I will also have to get one of those pill shooter things so she doesn't bite me.
     
  78. Sharon14

    Sharon14 Well-Known Member

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    Have you tried crushing it into a powder and mixing it in wet food?
    It's fine to force it, but try to wash it down with a little food. Maybe a treat?
    I've read on this site and others that the Pepcid dose for cats is 1/4 of a 10 mg tablet. I'd not give her more just yet until we can check that dose.
     
  79. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Okay, I will leave her alone then. If it's only 1/4 of a 10mg pill, that's a lot more manageable.

    Yes, I tried crushing it, but she licks at the food and then tastes it! She's always been really hard to give pills to, so hopefully we can find a way.
     
  80. Sharon14

    Sharon14 Well-Known Member

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    From Tanya's site:
    The most effective treatments for excess stomach acid are slippery elm bark, from health food stores (seeHolistic Treatments) and/or a drug called famotidine, trade name Pepcid AC (not Pepcid Complete).



    With Pepcid AC, you usually start with a quarter of a 10mg tablet once every other day, but if necessary you can go up to a quarter of a 10mg tablet twice a day (all with your vet's approval, of course).
     
  81. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Okay! I won't give the dose they prescribed then.

    I found this thread for low carb foods with the phos level also given: http://www.felinediabetes.com/FDMB/threads/shortcut-shopping-list-all-less-than-8.94685/
    It advises a number under 250 for phos, not sure what the number signifies, but the Wellness turkey and chicken that Angel likes are on the list so unless there is a reason not to, I will continue to feed her those foods if she will still eat them.
     
  82. Sharon14

    Sharon14 Well-Known Member

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  83. Elle & Squeak (GA)

    Elle & Squeak (GA) Member

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    Jan 13, 2016
    Pepcid is fairly bitter, so if your kitty is in any way picky, tasting it in their food will likely put them off. I know that was the case for Squeak.

    When I was giving her Pepcid, there were two methods we'd use - the first, and easiest, was putting the pill piece in a "food ball." You need a pate food that's a bit drier and sticky - I'd flatten a bit of food out on a saucer, put the Pepcid in, then roll it into a tight ball. If I found it too sticky, sometimes I'd put it in the fridge for a bit to firm it up. If I was lucky, Squeak would just eat the whole ball at once and the Pepcid would be down the hatch.

    If she wouldn't take the food ball, my husband and I would pill her with a method recommended by my vet. One of us would pull her head back until we had a straight line from her chin down to her throat. Then we'd open her mouth and the person with the best aim would drop the pill in and it would go right to the back of her mouth. Then we'd let her head down and carefully syringe a bit of water into the side of her mouth until she'd swallow. The water helped not only with getting her to swallow, but also with making sure the pill didn't get stuck in her throat as I've read that I can burn if it gets caught.

    Hopefully one of those methods might work for you.

    Also, I wanted to confirm that my vet prescribed 1/4 of a 10mg Pepcid AC, just like what it says on Tanya's site.
     
  84. Bobbi & Angel

    Bobbi & Angel Member

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    The food ball is a great idea, I will give it a try!!
     
  85. Bobbi & Angel

    Bobbi & Angel Member

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    Angel's preshot test was 322. Does it seem safe to continue with 1 unit as her dose? She is definitely eating better today and seems to have a bit more energy even. I have been leaving out the k/d dry food I got from the vet and she's eating that along with Wellness turkey wet food. I will be leaving the house tonight after her shot for a few hours and I just want to be safe and check in with you guys!
     
  86. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Hi Bobbi, sorry no one was here when you posted. Have you shot? Can you test some tonight?
     
  87. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    It's okay!

    I did 1 unit. I will be out of the house from about 8 until maybe midnight at the latest (her shot was done just a few minutes ago at 7:10), but I will get a test as soon as I'm home. She's been eating better on her own, so I think she'll be ok while I'm gone, but I will make sure to get her to eat more before I leave just to be safe.
     
  88. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Yes give her some food and leave some out for her to munch. Right now eating is important. Have fun tonight!
     
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  89. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    I did a test about 30 minutes ago when I got home, 346 (+5). I'm wondering if this has anything to do with the k/d dry food not being low carb? She seems reluctant to eat enough of the wet food to fill her up, but tomorrow I will try to feed her only the wet food if possible since it's actually low carb and I will be home basically all day. Plus, she's definitely eating more now than she was last week. I will stick with the 1 unit dose in the morning unless anyone here thinks I should do something else?
     
  90. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Try the wet first, only give the dry if she won't eat enough to shoot. Sticking with the one unit is good. Try to get some tests in so we can see how well it's working.
     
  91. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Thanks, Sharon. I did 1 unit this morning. Her preshot test was 405. How often should I try to test today?
     
  92. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Just read the Humulin info. because Humulin tends to peak early, it suggests you run a curve, testing at +2,3,4,5,6. If you can, that's what I'd do. If she's still dropping at +6, run more tests after as well.
     
  93. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Thanks. She was 151 (+4), 126 (+5), and 137 (+6). I think I will do another at +8 or so just to see what happens. She seems pretty tired out right now and she wasn't like this yesterday. I wish I had gotten some numbers during the day yesterday to compare.
     
  94. Sharon14

    Sharon14 Well-Known Member

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    Good numbers! Yes get another at +8. Is she eating and drinking well?
     
  95. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    Yes, although she seems so sleepy. I brought the food to her a couple times just to be safe and she ate just fine.

    Is there any kind of dry food that would be acceptable to leave out as a supplementary thing? She isn't the kind of cat who will sit and eat a bunch of wet food at once and it gets dried out if I'm not home to fuss over it (then she doesn't want to eat it). My new job starts tomorrow and I don't want her to stop eating during the day while I'm out! I haven't seen any lists with low carb, low phos dry food on them, so I'm not sure if that's really possible to find?

    Edit: never mind, I found this list: http://www.felinecrf.org/dry_food_usa.htm
     
  96. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Check this one out
    https://www.youngagainpetfood.com/cat-food.html
    I think the mature zero formula is low Phos. Call them and they will send samples. It seems expensive, but is so dense they don't have to eat much to get the calories they need. Wet is still better for her though, to make sure she gets moisture. Some people use an auto feeder with frozen pucks of canned food that melt by the time the feeder opens. If you're interested in that, I'll tag someone that uses one to tell you about it.
     
    Last edited: Jul 4, 2016
  97. Bobbi & Angel

    Bobbi & Angel Member

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    Part of my issue is that I have 2 cats and while they sort of eat separately, the non-diabetic one is a bit of a hog and will eat whatever wet food he can find. Being able to leave a dry food out just in case he gobbles up all her wet food makes me feel a little better.

    I will call for samples of that food.
     
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  98. Sharon14

    Sharon14 Well-Known Member

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    Aug 16, 2015
    Make sure you tell them she's diabetic so they send the Zero formula. It is 5 carbs.
     
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  99. Sue and Oliver (GA)

    Sue and Oliver (GA) Well-Known Member

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    Dec 28, 2009
    It looks like her lowest point (nadir) was +5. Sometimes Humulin drops right away, so this later nadir is good. The next thing you want to figure out is how long the insulin lasts - when does the number rise to a higher level like your morning number? Having information on how the Humulin may work in her body will help you figure out dosing.

    Right now, one unit is looking pretty good. She dropped slowly and not too terribly much.

    Just for general reference, on a human meter, we consider a cat regulated (the first goal) when they are in the mid 200s at preshot and lower hundreds or double digits at nadir (but not below 50 which is nearing hypo range). So her numbers are pretty good.
     
  100. Bobbi & Angel

    Bobbi & Angel Member

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    Jun 29, 2016
    So, if her number goes too high too soon before the pm shot, that means her dose might not be quite high enough?
     
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