Very unregulated newbie -- Charlie's all over the place!

I apologize for how long this is about to be but we need some help! Charlie was diagnosed on May 27 but we're just now getting into the swing of giving him insulin because we went on vacation for a week at the beginning of June. Vet originally prescribed lantus 1 IU BID, but after giving him his first morning shot at the end of May he went hypo (around 30 mg/dl on a human meter) which earned him an emergency vet trip. Our vet seems relatively unknowledgeable and left us on our own to track down 0.5unit syringes, then said we should give 0.5 U once a day (obviously not what you should be doing with lantus). After vacation we switched to alphatrak after the vet talked us into it. So we forged ahead and decided to start giving him 0.25 unit twice a day starting June 14. Here are our struggles:

• Charlie is a VERY picky kibble addict and is resisting being switched off of HC dry food. He now eats fancy feast pates throughout the day but is still losing weight (around 2 pounds and climbing since diagnosis). We bought tikicat dry food and are trying to transition using a mix. Our three other cats also don't like the change. The only treats he will eat are temptations (terrible, we know). He won't even eat cooked chicken! We bought freeze-dried salmon ones but he also won't eat them. Trying freeze-dried chicken next. So he's not entirely low carb yet.
• Shots and BG are a major, stressful struggle. He has developed very negative associations due to us being unknowledgeable and holding him down to have these done. Tenting method doesn't work for him, he has so little fat now. We tried rolling this morning and it seemed to work, but he now hates to be grabbed at even if he doesn't feel the needle. We use 31gauge 8mm syringes. Also hates sitting still for BGs so that's why there are so few in our spreadsheet. My daughter is the one who does all the poking but she's leaving for medical school so I'll be down a person and will have to relearn all of these techniques. He is not majorly food or attention motivated so those damn temptations are the only way to reward/motivate him.

A few days ago we upped the dose to 0.5 U BID after seeing a 550 the morning after a shot. He was never higher than 380 upon diagnosis. We've had possibly a few fur shots because of how he flinches/panics, but is it normal to see his numbers actually worsening? We've read about the bounce possibility. We just have no idea if he's getting the right dose or what the next steps should be (other than working on BG technique so we can take more measurements to get a better picture). Your help is GREATLY appreciated.

 

We've all been there done that, in fact I think I gave a fur shot yesterday. I think part of your higher number can be attributed to the alpha trak strips. They run higher. I can relate to the food issue too. I can't tell you the number of cans I opened and threw away when they turned their nose up at it. (I have one diabetic and one non diabetic). It was terrible in the beginning. You have to keep at it and they will accept the change. My non diabetic I still give her kibble because she is small to begin with and her refusing the pate had me worried about her weight. The way I handled that was to buy microchip feeder (on amazon or chewey.com--its a "sure feed". Watch You tube videos on how cats adapt. Bella rejected it too at first because of the noise. It links up to their micro chip (they supply one for a collar if your cats aren't chipped) That way only the cat you want to eat the food can open it. You have to buy an attachment for the back to keep the sneaky diabetic out of it. Zoe still tries to get the lid to open for her, but it wont. There is a neat video where a cat owner has 3 cats with 3 different health issues and they all have their food protected using them. Its about $140 ish and the attachment was about $10. In the end it was well worth it because Zoe is a food stealer for sure. She is always hungry.

Shame on your vet. I sort of had it handed to me like that at first but I am a nurse and had some knowledge about insulin and shots, but believe me this place is your best friend and a lot of great people will get you through it.

My cats were kibble addicts too and Temptations are still a favorite. Bella (nondiabetic) demands them. Zoe the diabetic adores them but I have to be very careful. I do let her have a couple every so often. In fact they are what helped me train her to come to the sofa and sit on the arm to have her ear pricked and shot. She went from a skittish touch me not to an easily picked up and handled lovable sugar cat. She would do anything for a treat. I would give her one after a test and shot. Gradually I didnt have to give her anything. Now bless her heart, she sees me sit down and hears the flip of the test strip container and she comes and gets in her spot! Even if its during a frequent check glucose curve! It would be best to just cut out kibble for all if you can. The diabetic can't handle the carbs. Forever young has a carb free dry you can try in the transition.

I will let the more senior members guide you in your dosing. Welcome and take a deep breath. It gets better. I am still not there myself!

 

I wonder if he went low on the night of the 18th and bounced. He went lower than his body is used to then his liver dumped some stored glucose thing it was "saving" the body. It is a normal process and cats tend to do that until their bodies readjust back to normal levels. I am going to suggest that you get at least 1 PM cycle test in. Even if it is a before bed test. Cats tend to go lower at night.

Maybe you can reset the button on the testing routine. Pick a spot, give treats (even if you have to break up that temptations treat into little bits and give 1 at a time). Play with his ears. Roll or tent the shot site. Do it several times even when you are not testing. Just put him in the spot, treat, rub ears, treat, tent treat and put him back down with lots of loves and scritches. That may help with getting him in a better mood for testing and shots. Search youtube...there is a lot of videos. There is a member here that has a good one...just can't remember who. I will find it.

I would hold this .5u for now.

Have you looked at Young Again or Dr. Elsey's dry kibble? It is low carb dry food. Something to try while trying to convert your kibble addict to the FF pate. Check out Dr. Lisa's site...catinfo.org. She has some suggestions for food and how to convert an addict.

There is yellow sticky threads at the top of the forum that has some great information for your reading pleasure.

Other than that, I commend you for testing your kitty.

 

@JanetNJ has a video!

 

I don't know why I can never remember the name correctly. I called it Forever Young and I meant Young Again. LOL

 

Here is a link to your other post as well.

http://www.felinediabetes.com/FDMB/threads/help-with-my-newly-diagnosed-cat.215585/#post-2389314

 

Thank you so much for your suggestions! We got a sample of young again and picky man did not touch it. He at least will eat some of the tiki. We will look into Dr. Elsies. We have looked at that website for transitioning a kibble addict and tried a lot of the techniques but man he is resistant. We would love to switch him to entirely wet but are worried he wouldn’t eat enough, he’s still losing. Which is more important: eating enough or eating entirely low carb? We’re just scared he would not eat enough if he only had access to wet, since he seems to be sustaining himself mostly on kibble.

The behavioral suggestion is so helpful and what we’ve been trying today. We chose a neutral spot and have been taking him there to roll him, mess with his ears, and give him a treat. Hopefully that turns him around because he is obviously not feeling well.

 

I will second the Surefeed suggestion. I got one several years ago because we have one cat who is a grazer, one who will devour everything in sight, and a dog who will also do the latter if left to her own devices. I never had issues getting my cat used to the noise, and it has always worked like a charm.

I am new to the forum so I also cannot advise much on dosing. All I can say is that my kitty, Ty, has had lots and lots of trouble (two DKA hospitalizations, and last week had ketones again) and his numbers have been all over the place. We started with Humulin and are now using Lantus. The vets we've seen have been very kind and are trying their best, but we had also gotten lots of conflicting advice about dosing. We are still trying to figure it out. All of this to say - people on this forum have been very helpful and have had great suggestions. Best of luck to you and Charlie.

 

Welcome to the Lantus Forum! You are in the right place to get help. Like Sybil said, we've all been in the same situation as you. I've been here for over 16 months & do not feel qualified to give dosing advice. Insulin is a very powerful Hormone.
If you follow the advice of the people here, that have been donating their time to help others for many years, you will do just fine!

I can tell you that our animals feel our emotions. Take a few really deep breaths & try to be calm when giving the insulin. First pick a comfortable spot with good lighting that you can give the shot every day. I personally do not give "treats". My 3 cats were raised on a raw meat diet.
My Ravans' treat is to get extra LOVE, petting ,scratching whatever makes him happy! Get Charlie used to that spot even when your not giving him insulin.

Second, I've seen cats go into remission just by eliminating all dry food. If you read the Yellow Sticky notes by Dr Pierson ,she tells you why Dry food is so unhealthy for all cats. She also suggests ways to very gradually transition to wet food only.

The majority of people here use a Human meter. For me cost was an issue. I've been using a Relion Prime meter & strips from Walmart (strips 100 for $18)

here's a pic of the "sweet spot" to get blood

You don't need to only shoot the insulin in the scruff of his neck. In the beginning I tried it & did a fur shot. I decided to shoot into his flank. I've never done a fur shot since!

You just part the fur till you see skin & inject at an angle just under the skin. Works great for me!


Good luck to you! Read as much as you can about the insulin & everything else. ( the Yellow sticky notes) The more you know the easier it will be. When I started I knew nothing about Diabetes or giving insulin injections. The people here guided me thru it all. I'll be forever grateful to them for their advice, compassion & putting up with my constant questions?
My Boys are moved away & i'm 72 yrs old & alone. If I can do this so can you! ASk questions ,lots of Questions We all want to HELP you ( where are you located? they need to know the time zone?) Read about the 2 methods of shooting insulin SLGs or TR You will need to pick one that works for you.

One more thing. You will need to get a few tests in at night. Some kitties go low in the evening. The more information on Charlies' SS ( spread sheet) the better! I still set my alarm to get up a few times to test!

 

Start getting some good associations with testing. For every attempted test give a treat that he only gets at testing time. For my cat it was cold cuts (turkey, roast beef). After about two weeks she didn't fuss at all about tests. Now she sits patiently. Make sure you aren't hitting the vein as it hurts more and bleeds more than you need. I have a video in my signature showing how I test my cat CC at home.

 

Welcome to the group!!

I'm a big fan of reinforcing behaviors that get you and your kitty comfortable with testing. It's also important for you to be calm and comfortable with the process. Our kitties can pick up on our being nervous!!

Having your cat eat is ultimately more important than the carb count in the beginning of this process. Dr. Lisa's site notes that transitioning a cat to low carb can take a while, so don't rush Charlie. One thought may be to try Stella & Chewy's freeze dried raw food -- either as food or treats. The food looks like kibble and is crunchy.

Before you increase the dose, can you try to get a before bed test every evening? The PM tests are just as important as AM tests especially since many cats experience lower numbers at night. Lantus dosing is based on the lowest number in the cycle so catching those lows is important. Also, don't be surprised if you see high numbers this morning. Charlie dropped from 592 to 385 in just 3 hours. The drop could trigger a bounce. In addition, you don't know how much lower he may have gone.

All of this takes time to wrap your head around. Please ask questions. The people here are very generous with their time and knowledge. We're here to help.