Tentative Diagnosis of Diabetes Mellitus & Kidney Disease

Discussion in 'Feline Health - (The Main Forum)' started by sirswithin, Jul 14, 2013.

  1. sirswithin

    sirswithin Member

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    Jul 14, 2013
    About a year and a half ago our cat Grady was diagnosed with hyperthyroidism. After 6 months of topical treatment we decided we would opt for the iodine radiation to get it over and done with. He seemed to come out of it fairly well, but over the past few months we've noticed him slowing down, sleeping a lot (even for a cat), and drinking a lot of water. Last weekend we decided to take him in to the vet to see what was going on. They took his blood and urine and sent them off to the lab for analysis. The results, which were read off to me over the phone by the doctor's assistant (I was trying in vain to write everything down), seemed to indicate that Grady had Diabetes Mellitus. His blood glucose level was at 18, and I was told normal was around 10. In addition to that, we were told that his BUN (not sure what that is) and creatinine levels were elevated (creatinine 278 vs 189 which would be in normal range). They recommended starting him on the Hills Prescription Diet k/d in order to help his kidneys. They're telling me he needs a low protein diet so his kidneys don't have to work so hard processing the food, but after doing my own research on the internet I'm not sure I agree with that. They also wanted to start insulin injections as soon as possible. No mention of a low carb diet was made or how that might change his glucose levels. They're also telling us we need to bring him in several times so they can do a blood glucose curve, which (based on a single visit and lab work at $250), could get very pricey very quickly. The lab work also stated that his sodium and chloride levels were low. So now we're supposed to take Grady in again to get another urine culture and be taught how to inject him. I'm wondering if I should hold off and start him on a low carb diet of only wet food (he usually supplements with a small amount of dry), or am I endangering him by not getting him insulin? I was also given a bottle of PetRemedy's Glucose Support Formula by a friend. I've read that it both performs miracles and does nothing for diabetic cats, so I'd like to get people's opinion on whether or not I should continue to use this. In the past six years I've lost three cats to one disease or another. I'd rather not experience that gut wrenching sense of loss a fourth time in such quick succession. I'd be grateful for any advice I could get to keep my cat alive and healthy for a while longer. Thanks.
     
  2. dsmithkma

    dsmithkma Member

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    Jun 8, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Hi=

    Welcome to the forum. I'm a newbie here but wanted to say hi. I'm sure someone will be along shortly to help answer your questions.

    Dan
     
  3. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Hello and welcome to the board,

    There are three things that are key to getting diabetes under control and we can help with all of them.

    First is food, you don't need a prescription food to manage it , any low carb wet canned will work. What were you feeding before? Many of us here feed fancy feast classic pâtés, friskies pâtés or wellness grain free. There is a big list of foods that will work on this site and it also talks about food and the relation to kidney issues. http://www.catinfo.orgA low carb canned can bring his blood sugar down enough he may not need insulin, or not need it for long if he does. But if there was any mention of ketones then you should start insulin immediately.

    Second is home testing the blood. How else will you know if the food change is working? And it saves on unnecessary, unreliable and expensive vet curves. They are unreliable because the cat is stressed at the vet which causes raised blood sugar and a too high dose of insulin to be recommended. When the cat gets home, the stress is gone, teh blood sugar drops but you shoot the too high insulin and the cat has a hypo. It's a recipe for disaster. Home testing is much more reliable and gives a lot more data. You should also test the urine for ketones as diabetic ketoacidosis is a very serious condition and expensive to treat and you should be on the lookout for it.

    Third is insulin like lantus, levemir or prozinc which are the best.

    but let's do the food and home testing first. Where do you live and we can advise on what testing kits to get etc.
    Wendy
     
  4. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    These foods are both low carb and low in phosphorus. It's a shortcut list developed from the catinfo.org food list. Lots of choices here for you.

     
  5. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Have you found Tanya's CRF website? Here: http://www.felinecrf.org/

    Chock full of info on CRF. Overwhelming, so read it in small chunks is my suggestion.
     
  6. sirswithin

    sirswithin Member

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    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Thanks for the quick replies! We're in western Canada. Up to now we've been feeding him a combo of pates ranging from Meow Mix to Natural Choice by Nutro to a generic Western Family brand at the supermarket. No mention was made of Ketones, so I'm hoping that's a good sign.
     
  7. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Great. All debs foods are available in Canada.

    You can get the keto stix behind the counter in any pharmacy including places like shoppers, Walmart, wherever.

    For meters our choices are narrower unless you want to drive over the border to get the us Walmart relion brand which is good and cheap. Otherwise I use the bayer contour which comes free with strips and I order strips online from eBay. You can also get them more expensive at shoppers but then you get points.

    Free meter offer for Canadians
    You can get a free bayer contour USB meter and 25 strips if you go to http://www.bayerdiabetes.ca/BDoffer and use code "BDS 11-14" And then if you register the meter when it arrives, you get a free USB wall charger. Its a reliable meter.
    This offer was in the flyer comes inside the BD ultra fine 3/10cc syringes you get in Walmart Canada. I used a similar one six months ago and it worked great so bayer seem to run it a lot.

    Shopping list

    1. Meter ie bayer contour
    2. Matching strips
    3. Lancets - little sticks to poke the ear to get blood . new members usually start with a larger gauge lancet such as 28g or 29g until the ear learns to bleed. Optional - lancing tool.
    4. Cotton balls to stem the blood
    5. Polysporin ointment with pain relief to heal the wound
    6. Mini flashlight (optional) - useful to help see the ear veins in dark cats, and to press against
    7. Ketone urine test strips ie ketodiastix - Important to check ketones when blood is high
    8. Sharps container - to dispose of waste syringes and lancets.
    9. Treats for the cat - like freeze dried chicken pure bites.
    10. Karo syrup/corn syrup or honey if you dont have it at home - for hypo emergencies to bring blood sugar up fast
    11. A couple of cans of fancy feast gravy lovers or other high carb gravy food- for hypo emergencies to bring blood sugar up fast

    Wendy
     
  8. sirswithin

    sirswithin Member

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    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Went to the Bayer site and put in the code but all I got was * Invalid or Expired Offer Code. I guess we'll see what kind of meters are available around here. And what were the keto stix for? Does anyone have an opinion on PetRemedy's Glucose Support Formula? Should I continue to put it in his food twice a day or just ditch it? Thanks again for all your support.
     
  9. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    oops sorry use this code instead BDS 06-12. The other one is expired! I checked this new one (came in a flyer in my latest box of syringes) and it works.

    keto-stix is to check the urine for ketones.


    Wendy
     
  10. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Sorry, forgot you were probably in Canada or international location with those BG numbers you had given us. Only us backwards folks in the US still use the mg/dL measurements.

    Would you please put some information in your user control panel so I can avoid embarrassing myself with a gaffe like this again? Sure would appreciate it. It's optional but it really does help us and only takes a couple of minutes. Some people hate me asking new members to do this, but it's one of my "crutches for an aging brain".

     
  11. sirswithin

    sirswithin Member

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    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    The code for the meter worked this time, so thanks! The question is, what do I do between now and 4-6 weeks from now when it's delivered? Just do the low carb wet food and get the ketone strips?
     
  12. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Mine arrived in a few days... I have an idea though, I have one here . If you don't see yours by Monday I will ship you the one here (still in the box) then when yours comes in, you can keep it as a back up..How does that sound? Or if you are feeling generous you can ship yours to the next Canadian newbie, pass it on as it were..
     
  13. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Have you started changing the food yet? Sooner the better assuming you havent started insulin yet?
    let me know
    Wendy
     
  14. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    The first thing we did was ditch the Hills k/d wet food the vet gave us ($8 for 3 tins!). We're just working through his regular supply of wet food until we get to PetSmart this weekend, then we'll stock up on the low carb, low phosphorous foods.
    Our vet sent me an email inquiring after Grady. I then let them know that we were changing his diet and would do the BG monitoring at home. They replied with the following regarding cat food: "Low carb is great, especially to work with Diabetes, just check to ensure we are also going with a low protein diet to help support the kidney disease. The insulin will support the Diabetes, but if we don't support kidney disease with anything then that disease process will continue to get worse, and in turn affect the Diabetic management, eventually making it difficult for the body to deal with either one, insulin or not." I'm assuming I should just ignore this and go with the list you guys provided, right?
     
  15. Deb & Wink

    Deb & Wink Well-Known Member

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    Jan 31, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    High phosphorus makes the kidney disease progress faster. The value of a low protein diet is hotly debated for CRF kitties.

    Since you have 2 medical issues, the diabetes and the CRF, you need to try to feed for both. I would try for the foods on our short list first.

    What stage is the kidney disease?

    Have you read Tanya's CRF website? Here's the link to the food section. Tanya's CRF - food
     
  16. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    By "short list" I assume you mean the one you posted earlier with the carb % and phosphorus levels under 250. I have that on my phone so it's always handy when we're out shopping. I don't know what stage the kidney disease is at. All they gave me over the phone was that the BUN levels were elevated and the creatinine number was 278. They said 189 would be normal. They wanted to do another urine culture for more testing. That's going to be another $140 if we get it done. Plus we have to go in for the insulin consultation, so they can teach us how to administer it to Grady. Thankfully, there's no charge for that. Should I be watering down Grady's food?
     
  17. Deb & Wink

    Deb & Wink Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I recommend more water in any cats diet. I always add more water to the canned food I feed my three cats. None of them have kidney disease, but one does have diabetes. The additional water in their diet helps to keep them hydrated, helps to flush out the kidneys and urinary tract system and seems to make them feel better.

    When your diabetic cat is over renal threshold (230-280), the excess glucose passes in the urine. These high glucose levels provide a perfect breeding ground for urinary tract issues. Wink had several bouts of diarrhea and UTI's until I got him regulated and switched from dry to wet food.

    Diabetic cats pee excessively, so can be prone to dehydration. Another reason for more water in their diet.

    I add about 1 to 2 tablespoons to each meal I give them. It ranges from applesauce consistency, to soupy. It also can help to keep the food moist throughout the day, if your cat is a grazer. Mine eat pretty fast, even the slowest one is done in 10 minutes now. I rarely see one of my cats take a drink from a water dish any more, since they are getting the water through their canned food diet. It shocks me when I do see one of them drinking water from the dish.
     
  18. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Grady does not seem to be taking well to watered down wet food. He gives me a look like "WTF?" and walks away. Stocked up on some of the food on the list we could find. Authority, Eukanuba, Merrick, Wellness, and Weruva (can't seem to locate the Friskies Special Diet). We'll make up a spreadsheet to keep track of what he will and won't eat. Got the Ketone Diastix from the pharmacy and have an appointment today with the vet to go over Insulin procedures. Will keep you posted.
     
  19. BJM

    BJM Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Sometimes tap water may have an odor or flavor the cat dislikes. You might try distilled water.

    Also, make any food changes gradually - ex 1 teaspoon of water per meal, next day 2, next day 1 tablespoon, etc. Generally, there is less refusal, or GI upsets when making gradual food changes.
     
  20. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Okay, I'll try that. He just ate an entire 3 oz can of the Weruva Paw Lickin' Chicken, so he seems to like that one. Since it's actual shreds of chicken, though, can't really water it down.
     
  21. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Just got back from the vet where we were shown how to inject the insulin and how to get the blood drop from his ear for the BG testing. Tried to get a urine sample so they could do a culture but he peed it all out before they could get a sterile sample. So, now off to the pharmacy to get the insulin and needles and then wait for the meter to arrive.
     
  22. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    What insulin did they recommend? If its lantus you can get it cheaper (pack of 5 pens) in Costco for $99. Syringes are reasonable there too.

    Wendy
     
  23. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Don't know yet. They had to phone in the Rx to the pharmacy because they ran out of pads and it's too late in the day now to get it. We'll have to pick it up tomorrow. So far he's been good with the new food. The Weruva Paw Lickin' Chicken and Mideast Feast did not last long, while he wasn't a big fan of the Nature's Variety Duck, but he still ate some of it. Forgot to mention his weight at the vet was 5.53 Kg.
     
  24. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Prescription? In Canada you dont need a prescription for insulin. I wonder which one they are giving you??? If its not Lantus, Levemir or Prozinc you dont want it. Those are the best for cats and best for remission. If the pharmacy gives you humalin, novlin or vetsulin, dont take it and ask for Lantus instead.

    We can help with dose etc .

    Urine catching tips: https://docs.google.com/document/d/1quta5WLEjdO0Y_t2dAYSwN84h-LNZWxOdtVsJDKZ16A/pub

    No sign of the meter yet?
    Wendy
     
  25. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    No, the meter has yet to arrive. We'll head over to the pharmacy after breakfast and see what's waiting for us.
     
  26. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I will ship out the box on Tuesday if you dont have your meter by then

    Wendy
     
  27. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Okay, so we got the insulin (Lantus) and we received an official prescription receipt, so I don't know if you still actually need one or not but we have unlimited refills, so there's that. The insulin (5 15 mL cartridges) was $108.99 and the syringes (50) were $36.00. The cartridges are supposed to have a longer shelf life than the vials as you're not cracking open one vial and then having it expire before you've used it all, so we'll just use them like tiny vials.
     
  28. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    That's exactly what I do, except I get my lantus (no prescription) from Costco for $99 for the five pens. Now keep them in the fridge .. Not the door.

    What syringes did you get? Do they have half unit markings? You will need those

    Wendy
     
  29. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Yes, they have half unit markings. We don't have a Costco membership so that's not likely to happen.
     
  30. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Ok good. Well it's only $9 and the stuff you have now should last you a long time.

    Wendy
     
  31. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Any sign of the meter? Usually it comes by courier so it might be at the post office?
     
  32. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Well, if it comes by courier there won't be anyone at home to receive it. I thought it would come by regular post, otherwise I would've given my office address. When I go home at lunch I'll see if there's any sort of ticket left behind.
     
  33. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Now that I have the insulin, should I be administering it? I thought I'd be able to measure his blood first to get some sort of benchmark for his glucose levels, but I don't want him to go without while I wait for a meter to arrive. I just don't like the idea of shooting blind and hoping for the best.
     
  34. BJM

    BJM Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    There are some Secondary Monitoring Tools in my signature link which may be helpful.

    If you decided to give insulin, I would give no more than 0.25 (eyeballed as the syringes don't mark that small) to 0.5 units, max, if and only if you are seeing excessive thirst, excessive hunger, and voluminous urine output - the classic signs of diabetes.
     
  35. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I am seeing a lot of water drinking. After insulin is given are there signs to look for that he's feeling slightly better? Less lethargy, less thirst, brighter demeanor? What are you supposed to do with the syringes once they're used?
     
  36. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Dont shoot without testing. I will ship you the meter tomorrow.
    Wendy
     
  37. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Okay, I'll hold off. And thanks again.
     
  38. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Put $ that the meter you ordered gets there tomorrow after I ship mine ;) . I will use expresspost. Once your ordered one arrives are you ok to ship it to another newbie ? Or you can keep it as a backup I guess.

    Wendy
     
  39. BJM

    BJM Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Ask your local pharmacy if there are local laws regarding sharps dispoal. If not, use a sturdy container - laundery detergent ones work well - to collect all sharps for disposal.
     
  40. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Shoppers will give you a free sharps box if you tell them you get your supplies from there. Then they will take the old full one and replace with an empty one for free.

    Wendy
     
  41. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Just did my first urine test with the Keto-Diastix. Looks like his glucose levels were somewhere between 1/2 & 1 g/dL or 28 & 56 mmol/L, and the test for ketones came out negative. He didn't seem to mind too much, me standing behind him with a ladle. Now that I have that information, what does it tell me?
     
  42. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    The urine sugar tells you he is spending time over the renal blood sugar threshold of 270 and sugar is spilling into his urine. U have just confirmed he is diabetic and needs insulin. The concentraion of sugar does vary with how much time the urine sat in his bladder and how much liquid he drank in that period which is why blood testing is more useful.

    The ketone test tells u that he doesn't currently have diabetic keto acidosis dka which is a good thing. U want to test for ketones twice a week or whenever he is over 340. Dka is very serious complication of diabetes and is costly to treat.
     
  43. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Looks like you lost the bet. Your package arrived today, ahead of the one ordered online :D . Looks like I'll be pokin' the kitty when I get home. I haven't even looked inside the box to see what else is in there. I just took the meter out and stuck it in a usb port to charge. Should I attempt the first reading before the next feeding?
     
  44. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    :( .. glad I didnt put any $ on it.. lol.

    I included a print out of tips in there. Register it and you get a free USB wall charger.

    Sure give it a go! Remember the treat, and some cats are easier than others so dont get discouraged if you dont succeed first time. Give it three tries (and three treats) and if unsuccessful try again later.

    Wendy
     
  45. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I can't remember the last time Grady got a treat. He doesn't really do treats. I guess pets will have to suffice. Now I just have to figure out where to do it and try not to stab myself.
     
  46. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Take a look at the tip sheet I provided - there is a photo of the sweet spot. Something hard behind the ear will help you get some pressure and not poke yourself if you happen to go right through.

    No treats? Time to invest in a bag of freeze dried chicken treats ( puresnacks at walmart)

    Wendy
     
  47. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Got my first reading! 21.0 mmol/L. Now, what does that mean?
     
  48. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Great job!

    Means he needs insulin as he is fairy high. Normal cats are 50-130. Anything above 270 is stressing his system as he is above the renal threshold where sugar starts spilling into his urine.

    Did the vet recommend a starting dose of insulin?

    Wendy
     
  49. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    1.5 units every 12 hours. He has just eaten.
     
  50. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    What weight is he?

    Did he eat before the test? Standard procedure is to remove food two hours before shot so that the preshot number isn't influenced by food. Then test, and feed/shoot. Always test before every shot and as a newbie don't shoot under 200 until we have enough data to know how he will behave.

    Wendy
     
  51. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    He did not eat before the test
     
  52. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    What weight is he?
     
  53. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Approximately 12 lbs
     
  54. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    My calc says 1.4units so do your syringes have 1/2 unit markings? I am thinking you start on 1.25 to play it safe.

    Are you going to shoot tonite or when?

    Wendy
     
  55. sirswithin

    sirswithin Member

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    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Yes, 1/2 markings. I was going to shoot right now.
     
  56. sirswithin

    sirswithin Member

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    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I've given him his shot. As close to 1.25 units as I could come. When should I next test his blood glucose?
     
  57. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Perfect. Generally we suggest four tests a day

    - always always before every shot
    - mid cycle 5-7 hours after morning shot if your schedule allows
    - before bed (2-3hours after PM shot)

    If you need to move shot time to accommodate schedules you can do it roughly 30mins a day.

    First week on lantus you want to hold the same dose to let the depot build up... Lantus takes time for the dose to settle in his system. Unless he drops under 50 and you reduce the dose by 1/4 unit.

    Maybe read the protocol here http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=1581

    Also you should set up a spreadsheet to track your readings, we use this one which allows us, you and your vet to see what's going on.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

    Wendy
     
  58. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    That spreadsheet is great but I have no idea what I'm looking at. I used the World version. I put the date in and 1.25 under the first U, which I assumed was Units but I don't know where I should put the 21 (his first reading).
     
  59. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    When I mentioned to the vet's assistant that I had tested Grady's urine for ketones this is how she answered: "As for the ketones, I will pass that by the doctor tomorrow. It's not something we typically use, if ever, and they seem to play a minor role in the management of disease. But we'll see what she comes back with." Not sure how to take that.
     
  60. Barb & Mr. Frog

    Barb & Mr. Frog Member

    Joined:
    Apr 4, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Probably not helpful info at this point, but I just wanted to point out that (at least in my area) you do not need to be a member of Costco to use their pharmacy. I don't know however if the prices are the same for non-members as for members (I believe it is, but unsure)

    And that vet tech answer sounds like they were just trying to sound smart (and failing)
     
  61. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Second reading approximately 3 hrs after insulin shot was 16.5.
     
  62. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Excellent.

    Heres how the spreadsheet works

    AMPS and PMPS column is where you put the preshot readings ie last night PMPS column should read 21
    You are correct - U is the dose given at that time ie 1.25
    + 1, +2 , +3... etc is the amount of hours (1, 2, 3...)after the shot. So your PMPS +3 column would read 16.5

    Can you share the sheet and give us the link so we can see it?

    Wendy
     
  63. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
  64. BJM

    BJM Well-Known Member

    Joined:
    Oct 6, 2010
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I can't see your spreadsheet. You may need to click SHARE in the upper right corner of the page and/or select Publish, under the file menu.
     
  65. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
  66. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Yes, skip the shot, its too low for you to shoot yet since you don't have enough data to know what he is doing. Get a test in a few hours though.

    Your colour coding is wacky though. Last night shouldn't be green, should be pink.? not sure what went wrong there.

    Tonite try 1 unit. Shows me 1.25 is too much, we need to find a dose you can give twice a day

    Wendy
     
  67. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I see the problem, you put the data in the us sheet and its giving coding assuming you are using us numbers,

    Also can you put the link into your signature so we can find it easily?
     
  68. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    But it says World on the spreadsheet. I guess I can convert the numbers. I'm off to work now. I'll take another reading at lunch. I didn't give him insulin.
     
  69. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    It says world on the other tab... The tab you are using says us/dl
     
  70. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Also the reading you got this morning should be in the AMPS column (next to todays date) as it was in theory your a.m. Pre Shot (amps) test number. Then put "skip" in the U column beside it.

    Wendy
     
  71. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Okay, changed it. I'll just stick with the US. I didn't even see the tabs at the bottom.
     
  72. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Yeah that's what I do too since most people here are from the US.. Makes it easier for them at quick glance.

    SS looks good, have a nice day at work! You can expect Grady's blood to shoot up now because you missed the shot but that's ok. First week there is always tweaking to find a good starting dose. 1 unit might be too much too but we will see.


    Wendy
     
  73. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Grady's looking even more unsteady on his paws than usual this morning. He ate most of his breakfast but not all. He's swaying a little from side to side as he walks like he's just slightly inebriated. This has been happening before now, but it's more pronounced this morning. My wife is at home with Grady today so if he needs anything she'll be there.
     
  74. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    So, when I go home at lunch and test Grady's blood and the glucose level is high again should I shoot? The time intervals were going to be 8 am & 8 pm for his shots 12 hours apart, but since he didn't get a shot this morning is that idea out the window? If I shoot now (1 unit) would I have to do it again at 1 am?
     
  75. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Yeah 1pm would mean 1am. Might as well wait till 8pm and then it puts you right on schedule.
     
  76. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Meter reading was 268.2. So, yeah, it was back up. I'll do another test before 8 tonight and then give his 1 unit shot. Unless I should be doing something different?
     
  77. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    That's perfect but no food two hours prior to shot to ensure that the preshot test isn't influence by food. Then test, and shoot/feed. 1 unit if (?when) over 200.

    If not over 200 then stall 30mins.. Don't shoot, don't feed and wait 30 to see if it rises on its own and let us know.

    You are doing great!

    Wendy
     
  78. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Meter reading 352.8. One unit of insulin given, then food. Also did a ketone test. Still negative.
     
  79. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
  80. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    That video was very helpful but also made me realize I'm a bad person. I inadvertently contaminated my first vial. I drew too much insulin out and so squeezed what I didn't need right back into the vial. So, yay for me! Start from scratch again tomorrow with fresh vial. I'll keep the bad one in the fridge as a sort of emergency backup.
     
  81. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Reading before bed 309.6.
     
  82. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    No reason to stop using the that vial. Just use it until it no longer works.
     
  83. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    One off wont do any harm. You are fine to keep using.
     
  84. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    291.6 this morning. Gave 1 unit shot and fed. Everything seems to be going along fairly smoothly. I notice Grady flinches every time I depress the plunger of the syringe (not when the needle goes in). Does the insulin sting as it enters the body?
     
  85. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    252 Meter reading mid day. Off to the vet to try and get a sterile urine sample for a culture.
     
  86. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
  87. Larry and Kitties

    Larry and Kitties Well-Known Member

    Joined:
    Dec 28, 2009
  88. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    It figures that the ones I have (Soft/Chunky Loaf) aren't listed. I'm going to assume they're not terrible for him and give them to him when he won't eat anything else.
     
  89. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    What you are looking for (in terms of diabetes control/remission) is the column C on the link Larry provided, to be less than 10%. So less than 10% calories from carbs. Some of the natural choices meet this requirement.

    Wendy
     
  90. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Yep - shove them in a cupboard for emergencies. And yes the insulin does sting some cats but usually its at higher doses - so it could also be cos its cold. Try leaving the syringe out for 5 minutes before shooting to warm up a little.

    Do you have your hypo kit set up yet? (below)

    Wendy

    Put together NOW the following items and put in an easily accessible place!
    Phone number of your vet
    Phone number, address and map/directions to your nearest emergency vet (or phone number of the cab company and some cash/credit card)
    Karo syrup, honey or corn syrup
    High carb canned food with gravy – 2-3 cans
    Some favourite treats
    Spare pack of 25 blood glucose strips
    Coffee for you ;)
     
  91. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    The insulin that's currently in use remains out, so it's room temperature, while the rest is in the fridge. We have most everything on that list. Just need some glucose strips and some new honey (the stuff in the cupboard has crystallized) or corn syrup.
     
  92. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    I always keep mine in the fridge to extend its lifespan.. Months..
     
  93. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Would you please add Lantus to your signature block? Right after the meter info would be a good place.

    Yes, the manufacturer only tested for a 28 day life span. But we have found, that with refrigeration, the Lantus Insulin will last 4-6 months. It's expensive so we like to "waste not, want not" keep it cool and extend the insulin life whenever we can.

    Handling info for Lantus. Sticky: Lantus & Levimir - Info, Proper Handliing and Storage from the ISG Lantus TR forum.
     
  94. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Okay, I'll keep it all in the fridge.
     
  95. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Mistakenly gave insulin before doing conversion of numbers. I guess I didn't think 9.8 was that low but after the conversion it's actually 176.4, quite a bit below the 200 threshold. Hopefully, this doesn't impact him negatively. Of course the vet wanted me to shoot him with 1.5 units twice a day, regardless of any measurement. Will check his glucose in another few hours.
     
  96. Wendy&Tiggy(GA)

    Wendy&Tiggy(GA) Well-Known Member

    Joined:
    Nov 15, 2011
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Ok test him at +2 and let us know. U may have a fairly active cycle tonite so I hope you are ready with extra strips, syrup and coffee (for you). We need to be prepared.

    Here is a primer on shooting low.. http://www.felinediabetes.com/FDMB/viewtopic.php?f=9&t=147
     
  97. Deb & Wink

    Deb & Wink Well-Known Member

    Joined:
    Jan 31, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    A +2 would be good.
     
  98. Wendy&Neko

    Wendy&Neko Well-Known Member

    Joined:
    Feb 28, 2012
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Hello and welcome from someone just across the water from you. Grady seems to be having a good reaction to the Lantus so far. Since I'm in the same time zone as you, I'll be up a little later than Wendy and Deb if you have questions tonight. Post when you get your +2 test and we'll see where you go from there.

    BTW, I get my insulin at Save-on-Foods pharmacy and they give free sharps containers. London Drugs has better prices than Shoppers on diabetic supplies in the west.
     
  99. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    Damn. I just picked up a sharps container from Pharmasave and paid $5 for it. And we shop at Save-On!
     
  100. sirswithin

    sirswithin Member

    Joined:
    Jul 14, 2013
    Re: Tentative Diagnosis of Diabetes Mellitus & Kidney Diseas

    +2 reading 192.6. He did eat after his shot, although not a lot, which is his norm. He seems fine so far. What's up next?
     

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