Newbie - Head is SPINNING

Hello All,

I have a newly diagnosed diabetic cat (Tiki) whose overall health is still quite good. The only symptom he had to make me think something was off was increased urine in the box. I have my first appt with the vet tomorrow to start things rolling with the insulin. I am nervous and feel like I only understand less than a fraction of this whole condition. Tiki is acting normal and doesn't seem ill at all. I have changed his diet off 100% dry food to all canned (going with Fancy Feast) although I still keep a small dish of Iams dry out, he doesn't seem to want it at all anymore. I am praying I can regulate things quickly as we caught things early (Blood Sugar was only in the 200's, but all other tests showed positive for Diabetes).

Any support/words of encouragement/or magic silver bullets (I wish) that you can throw our way will be greatly appreciated!!

Tonya & Tiki

 

I'm heading to bed now (nearly 3 am here), but 200s is really not that high. A diet change may be all that is needed here, so PLEASE don't give any insulin just yet. Start hometesting ASAP and see if Tiki's numbers improve before considering adding insulin. I hope your vet is a proponent of hometesting and diet changes, because some are very stubborn about how they treat and monitor diabetes.

This is overwhelming and scary and we've all been there, so stick around and ask questions and we will guide you through it. There is a lot of info here, and you'll probably want to print some of it out so you can read through it again and again.

MJ&Donovan

 

Hi MJ!

Thanks for the advice. I see you are from Worcester! I went to Holy Cross, such a crazy small world it is! Good luck with the snow this weekend, they are calling for it here in DC too (gonna be a LONG winter if it's starting this early).

The Vet had also mentioned his numbers were low. It's been a month since his original diagnosis with primarily wet food since then (as he has primarily shunned the dry stuff) but there is still a huge amount of urine and he hasn't put on any additional weight. But he surely thinks he is king of the house with all the fancy food and treats he has been getting (Halo Freeze Dried Chicken).

T&T

 

Welcome. If you need any help let me know. I live by Reagan National airport.

 

Welcome to the BEST place you will find!
Please please please home test......you can pick up supplies at w. mart for really reasonable price..... I have a spreadsheet below that will show you what injecting insulin without testing can do!

My vet did not really think it neccessary to home test, this place did. So, I started testing, unsuccessful at first and when the first test was a success, you can see...My Sugar Bean was only 27!!! It was of course well after vet hours and THIS PLACE stayed with me for hours, bringing her bg back to a semi-normal range and my Bean was saved! I did promise her to NEVER ever shoot again unless I tested first!
Now, she is in remission and has been (less than 1 month on insulin). All because of giving her pancreas time to rest with the insulin and of course removing the dry food and going with wet, lo carb....GO BEAN GO.

Good luck, sounds like Tiki has a good momma to watch out for him. Keep us posted! Please join the vampire team and home test that boy.

 

My first post on FDMB was after Beauregard's second successful day of home testing. He was at 31 and if I had not decreased his insulin as suggested by the members here...OMG I shudder to think what could have happened.

After one month of reading the posts on this board, I've become totally convinced that quite a few of the members here know more about FD than most vets. No doubt about it whatsoever. The more I learn about FB in general, the more perplexing (maddening...infuriating) it is that all vets don't insist on home testing.

 

Well put Mystery & Beauregard :shock:

 

Can you elaborate on what other tests were run besides blood glucose? Was the 200s before the diet change, and he's still peeing excessively? There may be other reasons for the peeing and lack of weight gain.

MJ&Donovan

 

I was thinking the same thing.... can you tell us what the "all other tests" were? Did they do a fructosimine (sp) test, or was that 200 just the result of an ear poke? Part of that 200s might have just been vet stress. It could be that the peeing excess is being cause by something outside of diabetes.
If the diet change took place after that vet test, Tiki's BG might already be a lot lower.
As far as the weight issue, how much does he weigh, and how much is he eating on a daily basis?

Carl

 

Thanks to everyone for all of your responses...and Ohbell - I used to live in Euless too (first Worcester and now you...an even smaller world!!)

Tiki first had a general blood sugar test (late Sept) and it was in the 270's (ish) and then they continued on with more specific tests to look for more specific markers of Diabetes (sorry I have no idea what these were). The vet called and said all these additional tests indicated he is diabetic but that we caught it early so there was no need to panic. For all intents and purposes, Tiki is acting as normal as ever (other than he is HUNGRY and peeing up a storm).

The vet visit today was showing me how much insulin to give him and how to inject it. NO discussion at all on reading his numbers and no instruction on getting a reader. I am to give him 2 units of insulin (glargine) twice a day in the scruff of his neck 12 hrs apart and to come back in next Sat for a reading of his blood. No additional tests were done today. My concern is he is a major grazer (nibbles all day long and never generally eats a whole can) and will that type of eating behavior be a problem. She said no, as the type of insulin she is using has a gradual effect and doesn't cause huge spikes. I have been feeding him 2 to 3 cans of Fancy Feast per day and he has had a secondary dish of dry Iams always available to him which he never touches. Before the diagnosis he just always had a big bowl full of Iams that he came and went from as he pleased. His weight is down about a pound from his last vet visit (from 17lbs to 16lbs).

I am supposed to start with the insulin tonight with his dinner. I am also kinda concerned about the timing of his shots...my hours at work can be kind of crazy...if it's not exactly 12 hrs apart is that BAD? I would guess that doing it in LESS than twelve hours would be bad, but what if it goes longer than 12 hrs?

 

I grew up in Grafton MA, which is right door to Worcester, and used to go to Holy Cross football games, so it is a pretty small world!
Ok, do you and Tiki a big favor tonite. Since you really don't know what his blood sugar is right now, only shoot 1 unit of insulin. We need to get you set up with a glucometer and test strips asap. It is the only really safe way to treat diabetes. If he is in the 200s, then 2 units is too high a starting dose. Is there a walmart close by?
Carl

 

Grafton!!! This is crazy!

Target is closer - but I can definitely go to Walmart if necessary. Was also thinking of getting some Corn Syrup.

How do you test your cat's blood without torturing them?

 

Here's a video that shows how we do it: Video for hometesting

Here's a shopping list:
A human glucometer. Any one that sips and takes a tiny sample is fine. The meters are often free at drug stores; it’s the strips that are expensive. You can, however, buy them on ebay at less than half the price of stores. Lots of people here also like the ReliOn from Walmart. It is an inexpensive meter and its strips are the cheapest around. Try the meter out on yourself or someone else before you try it on your cat. You want to be familiar with it before you poke the cat.

Lancets and a lancet device. Usually, until the ears “learn” to bleed, a 26-28 gauge is good. Any brand will work.
Ketone strips. (Ketostix) Just like human diabetics use. You will sometimes need to test urine if the numbers are high.

Rice sack. Make this out of thinnish sock, filled with raw rice or oatmeal and then knotted. You heat this in the microwave until very warm but not hot. Then heat the ears before poking.

Also nice to have. Flashlight: so you can look at the ears and find the little capillaries that come off the vein running down the ear. Vaseline: Put a tiny smear where you want to poke. It will help the blood bead up.

And some lo carb treats to give your kitty, successful test or not Lo carb treats

We have taught hundreds of people how to test over the internet; we would love to help you.

 

Can't add to that, sue covered it all!
I would suggest the relion micro from walmart, because the strips are most affordable.
Carl

 

Wow! All hail the internet! All y'all are more helpful than my vet!

 

Another question (sorry for so many of these)...

What kind of carb numbers do you shoot for when buying catfood...I've been sticking with the classic varieties of Fancy Feast based on the info from Blinky's list....I've even gone so far as to buy him some REALLY fancy stuff at some high end pet stores but he doesn't seem to car for it (even though some of them looked good enough for ME to eat...).

I read somewhere you don't need to go so far as NO CARBS just LESS carbs....but was curious if there was a number you try to stay UNDER?

 

The magic number is less than 10%, and if you can find flavors he'll eat lower than 7%, that's even better
The seafood flavors tend to lowest, but too much of that is not good. Most FF classics are 7% or less.
Carl

 

OK, I am off to Walmart with my shopping list....

I am thinking no injection tonight - too many ducks to still get in a row!

 

No shot is a great idea! Better you know his BG before giving him his 1st shot.
Carl

 

Ok, I'm back...was able to find everything except the pee sticks (they had only one box in stock and it was open and damaged). It sounds like those aren't something I need IMMEDIATELY anyway.

I got the Reli-on Micro, which came with its own lancing device, 10 lancets (also bought an additional box of 33g lancets, hope these aren't too small. Chose the Ultra Thin ones guessing the caps in his ears are super tiny - but maybe bigger is better??? ..as in MORE blood??? And a box of 50 test strips.

I was also assisted by a super nice woman (a diabetic) who was very helpful. She was tickled to learn all of these things were for my cat and not me!!!

Also saw a whole family (Mom, Dad and 2 kids) dressed up as the smurfs (Smurfette, Papa Smurf and two little mini smurfs) for Halloween. Adorable!!!

I guess I'll start by pricking my finger until I figure out all these gadgets.

Tiki just had his dinner and is sleeping next to me - how before he totally HATES me for all the poking and proding he is about to get?

 

The lancets may make too small of a hole. At first you may need to double poke - a quick second poke in the same place. (26-28 gauge make a larger hole)

Be sure you warm the ear - it really helps at first. You can make a rice sack or you can fill a pill bottle full of hot water and put it up against his ear. Both give you a surface to poke against.

Best of luck! And be aware that it doesn't always work the first time. We poked poor Oliver for whole weekend before we got a drop. If you have trouble, come on and ask for advice. We all have tips that helped us the first time. And remember, a treat every time even if you are not successful.

 

Actually cats are incrediblely smart creatures, and will come to love their pokies and shots, as long as you remember one very important ingredient to home testing, and that is TREATS!!!! That and remembering when you are first learning to test the three strikes and you're out rule, try three times to get blood, if you still don't get it after that third time, give Tiki his treat, with lots and lots of cuddles, praise, and lovins. Then let him go, wait awhile and try again, afterall its not his fault that you didn't get blood, he has held up his end of the bargin for letting you try, so he gets his treat. Before you know it he will be purring through it all.

I just aopted Musette in late June of this year, she had no reason to trust me and here I am the very first night that she came to live with her poking her years and giving her shots Not only does she purr through it all, she actually is waiting for me in her testing spot when it is time to test, she will come and get me if I'm running a few minutes behind schedule. And she sleeps at night cuddled up on my husband's pillow, and she wakes me up with head butts...lol Now if I can test as much as I test Musette and still have her be as sweet and build a loving bond with her. Think of how much easier of a time you ar going to have it with Tiki who already knows you and trust you and most importantly....LOVES YOU?

Honestly hun, Tiki will very quickly understand that ear poke = treat, and shots equal feeling better, and you will get so quick at it, it will actually take you about about 15 mnutes tops to test, feed, shoot, and tests will take you maybe 5 minutes. It does truly get easier, so easy in fact I adopted not one but 2 cats from this board BECAUSE they were diabetics and I already had 11 non-diabetics and a 95lb drooler.... :lol: If it was really difficult do you really think I would sign up for 2 of them? Oh yeah, my Maxwell has been OTJ ( in remission and off insulin altogether) for almost a year now and he was 485 when he was first dxed and he was only on Lantus for 2 weeks. Not all cats go OTJ but it can happen and even if Tiki doesn't shots become no big deal at all. Musette is so far still insulin dependent.

Mel, Maxwell, Musette & The Fur Gang

 

Is the testing of the blood done before he eats or after? What is a typical "routine" to this process.

And how do you get them to sit still through the ear poking?

Should I have any concerns about giving him an injection of insulin in the morning and then leaving for work and not being around to see if something goes wrong?

 

is best to give no food for at least 1 hr before test...
test, feed, shot or test... feed and shot together...... soooo glad you are going to test before you give insulin!
HATS OFF TO YOU!!!! YOUR THE BEST~

 

It's test, feed, shoot. You want a true number unaffected by food.(often food raises bg levels).

It depends on the kitty. Some are just willing to sit and let you poke. With Oliver, we first wrapped him in a kitty burrito. We wrapped a towel around him so only his head was showing.

Usually, once they associate treats with pokes, it is not a problem. It's a matter of figuring out what works for you.

Will you be starting with a low dose of insulin like .5 units? That would be safest if you won't be around. And if you get a number 200 or below, don't shoot. Wait 20 minutes, test again without feeding. If the number is sure rising and above 200, you could shoot a reduced dose. With practice, you can get an out the door test and in the door test daily so you can see how the insulin is working. Some people who can't get that mid cycle number around +6, set the alarm and get it at night. The more data you get, the better you are able to dose safely.

 

The vet advised to give him 2 units twice a day 12 hrs apart - and never mentioned testing AT ALL. And said to bring him back in a week for a blood test. His blood sugar was in the 270's when they did additional testing and determined he had all the precursors for Diabetes. I am responding to others' concerns that his BG is so low to start with that I should be super careful.

 

Please dont do that!
Test him first and then ask advice if you have to. Lets be nice to your baby! and do what is right with him

 

In that case, I would get some numbers before I started giving insulin. 270 at the vet could easily be a normal number at home. Stress raises bg levels and cats are usually stressed at the vet. Maybe a wet lo carb diet will be enough to turn things around.

Unless you get some numbers in the 300+ range, I think I would want to wait on the insulin - especially if you won't be around. I certainly would not start with 2 units.

Get some numbers and post asking for dose advice.

 

What can I read to familiarize myself with the numbers? I just realized that even when I know his "number" - I still don't know what that means.

 

I have had him on a low carb diet (or at least lower) for about a month. Today at the vet they didn't draw any blood so I dont know how to compare today vs last month - but his weight has dropped about a pound and a half (ish) and the litter box is still full of urine.

I agree, I feel like I need to get my ducks in a row before I shoot him full of something I barely understand.

THANK YOU ALL FOR YOUR HELP AND GUIDANCE!!

 

Generally we say a cat is regulated if, on insulin, they are around 200 at preshot time and under 100 at nadir. (mid cycle). That kitty would, most likely, be getting a very small dose of insulin and it's owner would have lots of numbers to help guide them with dosing. A cat, off insulin, can run anywhere from 40 - 120, with the majority of the time in double digits.

 

that is your boy's blood sugar level and normal without vet stress is between 40 - 120 and others will chime in and give GREAT ADVICE....If it was my girl, I would not give any insulin just yet but I would test and see if I could be successful with it ( a bit hard at first), and post here before I would shoot insulin..... the blood sugar level you said he was at, that is low anyway, especially at the vets with all the stress!

 

I would not shoot either, not until you get more comfortable with testing. 200s is not that bad, and at this point I'd rather be safe than sorry. I just posted in the Lantus group to get more eyes on this, and I recommend you start posting there (http://www.felinediabetes.com/FDMB/viewforum.php?f=9) now that you are beginning to get blood glucose data together for TIki.

MJ&Donovan

 

So I just fed him tonight at about 9p and he has been grazing off and on since then....he has always had food available to him and has never been the type to eat the whole thing at one sitting. He eats a few bites at a time and generally never finishes the whole thing before his next feeding. Is this type of behavior problematic for testing purposes?

 

your head might be spinning, but it's still working! i can't give you enough kudos for learning all you can before you shoot insulin in. really! too many people arrive here after shooting for a while with no tests - i'm embarrassed to say that i did that for 2 months all the while knowing that this was a dangerous thing to be doing.

start with the testing. it isn't hard to poke, but for the first couple of weeks it's tough getting it to bleed. then the ears grow more capillaries and will bleed every time. in the meantime, just be persistent, be convicted that your cat NEEDS that poke to stay safe, and give a treat after every time. a warm ear bleeds much easier than a cold ear.

we stick with fancy feast classics - those are all safe, all under 10% carbs. for now, that's all you need. one less thing to worry about. although i would pick up that dish of dry food. if your kitter is eating the canned food, that's enough. add some water to it and that will help the higher blood sugars (if they are higher) not cause problems. all that peeing means that diabetic cats are dehydrated. i add almost equal amounts of water to punkin's food and he scarfs it down without hesitation. if your cat is losing weight, give more canned food. you don't want a weight loss.

the food can be left out for 12 hours easily and if you're adding water it won't get crusty.

as far as what to do next, you'll find that people from all over the world are online here pretty much all day and night. i'm on the west coast, so by the time i'm going offline, the early rising east coasters are getting up. we also have lots of people from outside of north america.

so when you have questions, just post and ask. you'll likely have an answer in no time. if you have a specific question, edit the subject line of the first post of this thread and that's the subject line that everyone will see.

if i were you, i'd spend the next couple of days gathering test information. i'd wait to shoot until you have some data - your cat's numbers are low enough that it's possible diet changes and good eating habits might be all you need. at 200ish tiki is NOT in any immediate danger.

try feeding frequent (every 2-3 hours) of small meals. test before the meals. start a spreadsheet and record the numbers on the spreadsheet. the pattern of the tests will tell us a lot about what's going on with Tiki. keep talking to us here and we will help you get tiki back on track! and breathe, we've all been in your shoes. we understand how much you want to help Tiki and will teach you what you need to know.

hugs!

just saw your last post - the grazing's fine - actually really great for helping a pancreas heal. just get rid of the dry food - it can stay in their system for a long time and even a few kibbles can send some cat's blood sugar soaring. it's better to get the tests without food being eaten within the past hour or so, though, so if you can pick up the food an hour or so before you're going to test again.

 

Ok, if I did it right I just got a blood reading of 323.

 

Welcome to FDMB. MJ asked that a few of us who routinely hang out on the Lantus (glargine) board stop by.

If Tiki likes to graze, that's fine. Your vet is correct -- Lantus does not have an immediate, harsh onset. Onset generally begins around 2 hours after you shoot. We usually suggest picking up any food 2 hours before shot time. Depending on how much food is eaten within that 2-hour, pre-shot window, it could influence your pre-shot test result.

I agree with what others have suggested. I think it would be helpful if you got a few tests so you have some idea where Tiki's numbers are when he's at home and not stressed by being at the vet's office. Most of us use the same spreadsheet to keep track of our test results. The spreadsheet template and instructions are in the Tech Support forum.

With Lantus, there is a formula for calculating the initial dose. Unless Tiki is a fairly large cat, 2.0u is a hefty starting dose. Most cats are started at approx. 1.0u. The formula for starting dose is:

initial dose = 0.25 x cat's ideal weight in kilograms​

Starting at a lower dose may make sense given your schedule. You mentioned that you have a challenging schedule. Lantus likes consistency. The closer you can stick to a 12-hour shot time the better. You were correct -- shooting early can be more of a problem than shooting late. However, if you shoot late, your next shot needs to be 12 hours later. I give myself several hours to test before I leave for work. (I also have a cat who likes to take early dives.) It may help for you to give some thought as to what shot time will work best for your schedule.

There is a great deal of information about Lantus, how it works, and how to manage dosing on the Lantus forum. Below is an outline of the content of the starred sticky notes and links to that information.

• Tight Regulation Protocol: This sticky contains the dosing protocol that we use here. There are also links to the more formal versions -- the Tilly Protocol developed by the counterpart of this group in Germany and the Queensland/Rand protocol developed by Jacqui Rand, DVM and published in one of the top vet journals.
• New to the Group: Everything you wanted to know about this forum and more. Info on our slang, FAQs, links to sites on feline nutrition and to food charts containing carb counts, how to do a curve and the components to look for, important aspects of diabetes such as ketones, DKA, and neuropathy, and most important, info on hypoglycemia.
• Handling Lantus: how to get the maximum use from your insulin and what to not do with it!
• Lantus depot/shed: This is an important concept for understanding how Lantus works.
• Lantus & Levemir: Shooting & Handling Low Numbers: What data you need in order to be able to work toward remission or tight regulation as well as information if you have a low pre-shot number or a drop into low numbers during the cycle.

I don't know what kind of syringes you purchased. You will want to get U100 3/10cc syringes with half unit markings -- they are the best to use for fine dosing. BD, Monoject, GNP, and ReliOn are some of the brands available with half unit markings. Needle gauge and length is your preference They come in ½ inch or 5/16 inch needle lengths. Needle gauges 29, 30 or 31 (31 being the thinnest).

Please let us know how we can help!

 

just stopping in to say Welcome!!

and wishing you the best of results...
this place was literally a lifesaver for my cat...

celi & binks

 

Another Worcesterite here though i have lived in Tucson for 31 years. Still have close family in Framingham.

Welcome to the board and please follow the instructions for the very best of treatment. I am a type 1 for almost 50 years and needed this board to get my kitty, Morgaine, regulated. Vets are often uninformed on the latest research which includes lots of home testing to be sure each kitty is safe and has the chance for remission.

Good luck and please think about joining us in Lantus Land.

 

Good Morning,

I took his food away 2 hrs ago and just took his first reading with NO FOOD and it was 260.

 

I will see if I can get some Lantus users to advise on dosage. You will be gone today, right?

 

No I am off today and available.

 

Good. Then wait for some specific Lantus advise.

 

I see you are also on the Lantus forum. They will guide you.