We are one month in...

Hi Everyone,

It has been a while since I've visited the board. Life got incredibly hectic and I am really glad I am on vacation.

However, that doesn't come without stress!!

Tomorrow we are going to see a vet that specializes in diabetic cats. I hope she can give me better information than the other three vets I went to. I am sure this will cost me a fortune. I know they will run labs for her because it has been a month since her last set. I've been home testing and will bring her all of that data too.

Today I am doing a BG test every hour so that the vet can see a solid set of data. Nugget is not loving this. Last night's BG test left a huge scab on her ear- I always hold a cotton pad on her ear until it stops bleeding, so maybe she ripped it back open. Not sure. The other ear without the scab is hard to test from, all of a sudden last week I stopped being able to get enough blood to test from that ear.

I've been adjusting her dose of Lantus depending on her BG, but I am nervous that I am not doing the right thing. There are days where she stays in the 100s-160s with just 1 unit, and then there are days where she stays in the high 100s low 200s with 1.5 units. Today was the first day I got a reading over 200 in 10 days.

I am really worried that there is something more going on with Nugget. She feels like she's lost weight, her shoulder blades are more pronounced and I see a difference in her waistline. Obviously some of this can be attributed to the change in her diet. For the last 5 days there has definitely been an increase in her appetite, so much so that I ended up feeding her 2.5 cans of food (total of 7.5 ounces) on Friday, Saturday and Sunday. I don't know if how much I feed really affects her BG so I am trying to keep her at 3oz in the morning and 3oz in the afternoon.

Now for the really stressful part. I am leaving on Friday morning to go away out of state for a few days. My SO and I desperately need a vacation. We leave Friday morning and come back Tuesday evening. Nugget will be staying with my mom. Mom has always had cats (still has one), and has given insulin to humans so I trust her 1000000% to take care of Nugget. But we haven't really been apart since her diagnosis and I am crazy worried. My mom will be home all day with her on Friday, Saturday and Sunday, but she goes back to work Monday and Tuesday. I'll have to bring Nugget to her on Thursday evening... that's 5 nights away from my sweet girl. This is stressing me out to the maximum and I am tearing up just thinking about it.

I hope everyone and their furbabies are doing well. As always, thanks for listening.

 

Why did you drop the dose from 1.5 to 1? 1.5 wasnt taking her too low. There are two dosing protocols described in the lantus forums.... Read through them and decide which is a better fit for you.

Don't hold back on food if she needs to gain weight. You can feed as much and add often as she wants, just no food 2 hours prior to the preshot test.

 

The third vet that we went to said that 2 units was way too much insulin, to drop her down to 1 unit... I tried that and thought maybe it wasn't enough. That's when I had the "$%^@##^" moment and got so frustrated that every vet was telling me something different. I am struggling to really understand the two protocols for dosing. I think it's because I don't have an all day curve to know exactly what is happening over the course of 18 hours.

I tried to weigh her this morning, but my scale is definitely broken. If she has lost weight (we will see tomorrow @ the vet), then I will start to feed her more. I got on the scale (yikes), then picked up Nugget and the scale didn't change. I don't think she is underweight. On 3/1/18 she was 9 pounds 13.5 ounces.

When I wake up I test her before I feed her, so definitely not getting food 2 hours prior to the pre shot (she usually finishes whatever food I give her a few hours before I wake up in the AM or get home from work in the PM).

 

The people over on the Lantus forum have a lot of expertise with the two dosing methods and can guide you through it. One of the first things they'll say is that a consistent dose AM and PM is best when using Lantus. I recommend posting there. It'll be interesting what the diabetes specialist says.

 

Hi, good luck with your vet visit.

Just some thoughts, Lantus requires that you keep the dose as consistent as posible that is that you give the same dose AM and PM and that you maintain the dose at least 6 cycles (if you are following the tight regulation protocol ) or a week ( if you are following the SLGS protocol) to allow the depot to form that's how Lantus works best.

Also the more data the better but since his ear is a little bit hurt I don't think you need a test every hour unless he's going too low or some other problem ( which doesn't seem to be the case ) so maybe you could get just his preshot test and a random test during the day for a few days to let his ear rest a little

 

I have been trying to stay as consistent as possible with the timing, I guess I have not been consistent with the dose, mostly due to miseducation and misunderstanding of how this Lantus works.

The first vet was so nonchalant about giving insulin, they told me to come back in a few days to learn how to give the insulin, and that I would have to give it to her once a day.
The second vet was definitely preying on my nervousness and fear and told me if I didn't start giving her insulin THATNIGHT she would die, and directed me to give 2 units BID and not home test.
The third vet didn't know anything about Lantus (she said "Oh, that's the expensive one I've never used it before"), and told me I was using the wrong syringes (she said I needed U-40...). At that point I freaked out because everyone was giving me different, conflicting, confusing information.
Fingers crossed the vet tomorrow is able to give me much more information that is correct and valid and helpful.

The reason I was testing every hour was to try to find out what her nadir is because I honestly don't know when she hits that low point.

 

I'm sorry to hear all the trouble you've been through unfortunately most vets do not have much experience with diabetes let alone feline diabetes, a little bit more with dogs so they tend to deal with it as they would if it was a dog which doesn't really work well.

I suggest you take a look at the information about Lantus in the Lantus fourm (http://www.felinediabetes.com/FDMB/...the-basics-new-to-the-group-start-here.18139/) and more specifically on Lantus (http://www.felinediabetes.com/FDMB/threads/lantus-levemir-what-is-the-insulin-depot.150/) that may help.

Also Lantus is a 100 u/ml so it's best if you use U-100 syringes, you can use the U-40 but then you have to make conversions and it gets very complicated

 

I will go take a look at that info now. That will probably help me better understand the two methods.

I have always used the U-100 syringes... that 3rd vet had NO clue what she was talking about! Thank goodness I had done enough research at that point to know you can't interchange the syringes without changing the dose. Phewph!

 

Don't hesitate to make any question you may have there's a lot of people here with tons of experience that can help you

 

Ugh I think I made the mistake of looking at reviews for the Animal Hospital we are going to tomorrow... none of the reviews mentioned the doctor we are going to see but almost all of the reviews talk about how they push for expensive diagnostic testing or euthanasia.

Besides a standard blood panel and urinalysis are there any other tests that should be done? That way if they start saying they need to do a battery of tests I can tell them no? I'm scared now

 

Is she eating, pooping, urinating ok? Does she have any other issue besides the diabetes? Has she had a history of UTI or something else ?

When was her last blood panel and urinalysis done? Do you have copy of them?

 

I always take these reviews with a grain of salt. I’ve read reviews of my vet clinic and some disgruntled clients have written horrible things. Upset people are the ones who often post a review. It’s best to judge for yourself.

 

She has never had any health issues at all. We took her to the vet when we adopted her 5 years ago, and she has always been healthy. When her labs were done February 28 and March 1 her calcium was very high (which an insensitive vet told me was almost always CANCER).

Copies of both labs are on my SS, second tab.

 

I hope it is all good. I didn't have the greatest experience with any of the three vets I've already seen. Ugh nerves. That coupled with the fact that I will be away from her for a few days is enough to drive me crazy.

 

Wow !! I wish my kitties had some results half as good as hers, I'm not an expert but with ok labs that were done barely a month ago and since she doesn't have anything else (and you do not notice anything out of the ordinary) I don't think she needs any other studies for now except for her calcium which for what I know in this cases they recommend that you get an ionized calcium test that is much more accurate before jumping into any conclusions hopefully someone with a little more experience than me on the labs may throw some light into that.

 

The only other thing I noticed is that sometimes when I pick her up she wheezes.. she snores too and she didn't prior to her diabetes diagnosis. One vet said she felt a small lump on her thyroid, but the other two vets did not feel it. She definitely sleeps more now too- but maybe that is just a sign of older age.

We adopted her from a local shelter. Someone had found her outside in a snowstorm, and no one knows how old she is. When we got her the estimate was 3-5 years, which would put her at 8-10 years now. One vet said 10 sounds right, another said there's no way to tell, and the other said she's got remarkably good teeth for a 10 year old which could mean she is a little younger. So many puzzles...

 

Kris, you were right. It was best to judge for myself. The vet was very knowledgable and said we are doing just about everything right so far. She said Nugget's numbers look GREAT for only a month in, said we need to change her dosage to 1 unit BID every 12 hours and come back in a month... to keep testing at home, keep up with the diet and she said Nugget looks like she could be a cat who does go into remission. All good news. A little pricey, but that was to be expected.

Right now my little Nugget is at my mom's house as I am going away for a few days... I hope she is okay. My mom's cat wanted to make friends (usually she is a scared, flighty, feral cat) but Nugget wanted no part. She was eating and drinking normally when I left her so I can't imagine she is too upset. I am probably more upset! I have no one to snuggle with right now and it makes me sad.

 

I'm glad your visit to the new clinic went well.

 

I asked the vet about the test you mentioned and she said yes that is absolutely the right test to do... said there is absolutely no reason to assume "cancer" like the other vet did, that she is on the high end of normal and there are no other indications of her being unwell. It could just be idiopathic high calcium, we will check again in 3 months

 

I'm glad everything went well, enjoy your little vacation.