Hi All, My cat Thomas was diagnosed last week, 10 days ago. I've been slowly increasing his insulin from the 3 IU of Humulin N he was originally put on to now giving 7 IU twice daily. Thomas was a bottle baby that was given to me when he still had his umbilical cord...probably no more than 48 hours old. He turned 10 in April. I've been using urine glucose strips and each time I've checked he's been anywhere from 500 to 1000 mg/dl which shows he is not even close to a correct dose. I have not checked it for 2 days since increasing from 5 to 7 IU of insulin. Thomas does seem to be feeling better and is starting to play again. I was able to borrow a glucometer for the weekend and hope to have a better idea of how he's really doing by being able to do blood glucose testing over the next few days. Since we have a multi-cat household it isn't possible to put all food away but I've had success with feeding him mostly canned food twice daily (Friskie's, Merrick and Wellness). He is still occasionally pushing the 19 year old CRF cat out of her extra meals which is what led me to have bloodwork done on him last week. Wish us luck!
Diagnosed 10 days ago. Trouble regulating.
- Thread starter Cherie B.
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Ry & Scooter
Member Since 2011
Hi, could you get a blood glucometer like the ones humans use? If youre in the USA and have a Walmart nearby, their Relion Confirm or Micro are good cheap meters with cheap strips. I am just heading to bed but there are tons of resources on the net about testing cats at home. You will also want to buy some Ketostix from the pharmacy, they are for testing ketones, they are urine dip sticks like the glucose ones, I think Ketodiastix do both in one.
a few possibilities are he has a high dose condition like IAA or Acromegaly, your insulin is bad, he has an infection/bad teeth/etc. or there is high carb dry in the house keeping his #'s up. 7u is a huge dose that has the potential to be deadly. We don't recommend using Humulin N here because it is fast acting and only lasts about 8 hrs.
a few possibilities are he has a high dose condition like IAA or Acromegaly, your insulin is bad, he has an infection/bad teeth/etc. or there is high carb dry in the house keeping his #'s up. 7u is a huge dose that has the potential to be deadly. We don't recommend using Humulin N here because it is fast acting and only lasts about 8 hrs.
squeem3
Member Since 2009
Be patient :smile: Regulation doesn't happen in 10 days, though some diabetic cats do have an improvement this quickly with diet and the right insulin.
Urine glucose testing isn't accurate. This is because glcose builds up in the urine over time. Once the cat uses the litter box and you get a reading, the glucose will always be high and not at all reflective of what the glucose leve is right then and there.
Urine testing for ketone is important. You can use KetoStix or KetoDiastix for this. Both are used by Human diabetics and avaiable at any pharmacy.
Do get a blood cluose meter so that you can more accurately know how well your diabetic cat is doing. Any brand that you can find at the pharmacy will work except the FreeStyle brand and any generic brand that has True or Tru in the name.
Humulin N isn't the best insulin to use. It hits hard and lasts a few hours at most. Here's the info on how to use N: http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=303
Ask your vet about better insulins to use: Lantus (glargine), Levemir (determir), and ProZinc. Lantus and Levemir are Human insulins that you can buy at the pharmacy with a prescription. ProZinc is a pet insulin that your vet may have or you can buy at an online pet pharmacy web site.
Twice a day feeding isn't enough for a diabetic cat. Until the blood glucose levels are in more normal ranges, your diabetic will literally be starving. Small frequent meals are best. There are many people here who have multiple cats and free feed canned food all day using a programmabe timed feeder or two (or three...)
Urine glucose testing isn't accurate. This is because glcose builds up in the urine over time. Once the cat uses the litter box and you get a reading, the glucose will always be high and not at all reflective of what the glucose leve is right then and there.
Urine testing for ketone is important. You can use KetoStix or KetoDiastix for this. Both are used by Human diabetics and avaiable at any pharmacy.
Do get a blood cluose meter so that you can more accurately know how well your diabetic cat is doing. Any brand that you can find at the pharmacy will work except the FreeStyle brand and any generic brand that has True or Tru in the name.
Humulin N isn't the best insulin to use. It hits hard and lasts a few hours at most. Here's the info on how to use N: http://felinediabetes.com/FDMB/viewtopic.php?f=19&t=303
Ask your vet about better insulins to use: Lantus (glargine), Levemir (determir), and ProZinc. Lantus and Levemir are Human insulins that you can buy at the pharmacy with a prescription. ProZinc is a pet insulin that your vet may have or you can buy at an online pet pharmacy web site.
Twice a day feeding isn't enough for a diabetic cat. Until the blood glucose levels are in more normal ranges, your diabetic will literally be starving. Small frequent meals are best. There are many people here who have multiple cats and free feed canned food all day using a programmabe timed feeder or two (or three...)
Thank you both for your help. Thomas was tested this morning at 4:30 and was 287. I have not been waiting after he eats but am giving the insulin as long as I see he is eating. I won't be able to test today at 6 hours post but will do so at 4 hours and can probably get it at 7 to 8 hours. The info on the blood glucose meters was really helpful, there is such a wide range in prices for the strips that it's good to know the less expensive Walmart ones will work ok. The link regarding Humulin N was extremely helpful. It was chosen for him because there has been trouble with availability of other insulins and cost is a factor these days. I found that calling around locally it was anywhere from $25.88 to over $114.00 depending on which store or pharmacy I called.
Thomas does have access all day to food. We do meal feed twice daily canned to everyone but DH is home all day and will give more canned or treats to anyone that follows him into the kitchen. They have him more well trained than I will ever be able to. There also is low and high carb dry available....Innova and Science Diet and Purina Naturals.
Thomas does have access all day to food. We do meal feed twice daily canned to everyone but DH is home all day and will give more canned or treats to anyone that follows him into the kitchen. They have him more well trained than I will ever be able to. There also is low and high carb dry available....Innova and Science Diet and Purina Naturals.
mihaelamiha
Member Since 2012
Hi,
7 ui is a hudge dose, my cat was put on Humuline 30 and we start with a dose of 2 ui, and for 3 weeks he obtain great results, lowering the BG figures and lowering also the dosage (1 ui and 1.5 ui from 2 ui).
Very important is the food, to be wet and below 10% carbs, I could see the difference.
7 ui is a hudge dose, my cat was put on Humuline 30 and we start with a dose of 2 ui, and for 3 weeks he obtain great results, lowering the BG figures and lowering also the dosage (1 ui and 1.5 ui from 2 ui).
Very important is the food, to be wet and below 10% carbs, I could see the difference.
Phoebe_TiggyGA_NortonGA
Member Since 2009
Your vet started you out at too high a dose -- 3 units is a LOT of insulin.
Excess insulin can CAUSE high blood sugar in the short term as the liver dumps extra sugar to absorb the overdose. Please start over at 1u every 12 hours, learn to test blood sugar at home and try to get a more gentle insulin like Lantus or Levemir.
We advocate the "start low, go slow" insulin dosing -- Many cats do not need very much insulin and starting at 3u is dangerous.
My diabetic cat Tiggy only need 0.5u BID to be regulated on the right low carbohydrate diet.
Excess insulin can CAUSE high blood sugar in the short term as the liver dumps extra sugar to absorb the overdose. Please start over at 1u every 12 hours, learn to test blood sugar at home and try to get a more gentle insulin like Lantus or Levemir.
We advocate the "start low, go slow" insulin dosing -- Many cats do not need very much insulin and starting at 3u is dangerous.
My diabetic cat Tiggy only need 0.5u BID to be regulated on the right low carbohydrate diet.
Now I'm more confused than before. I lowered his dose of insulin this morning to 5IU, thinking I should back off more slowly? Went this afternoon and bought the ReliOn Prime meter. Tested just now PMPS, I got a reading of 524 on the ReliOn and tested with the Freestyle meter I had borrowed for the weekend and got a reading of 270. How can they be soooo different? Thomas has seemed to feel great all day. Not asking for food excessively and is playing.
Elizabeth and Bertie
Member Since 2010
Cherie B. said:
Hi, and (((hugs))) to you. We all know how hard it is to start caring for a diabetic cat. It's such a steep learning curve.
This (see quote above) really jumped out at me from your post... I'm really sorry but if you have a diabetic cat in your household you really should NOT have dry food available for him to eat. This could push your cat's BG levels much higher than they'd otherwise be and could totally negate the valiant efforts you are making to try to regulate him.
I do understand how hard it is to change a feeding routine. I've been there. I have a multi-cat household (5 cats at present), one of whom was diagnosed with diabetes five and a half years ago. I was feeding all the cats Science Diet because I thought it was good for them, and because it's so clean to use, and no waste! I thought it was fantastic! But I had to switch all the cats to the food that was best for my diabetic cat - low carb canned food. It wasn't easy. They protested. A lot. And I felt really mean not giving them what they wanted. But I kept some dry food on hand and sneaked the non-diabetics a few pieces now and then while I weaned them off the stuff. I still have some available - but I use it only for emergencies when my diabetic cat's BG is dropping too low. I still give the cats treats, but only those that are made out of pure chicken (no carb).
NOTE!: Taking the dry food away might make a significant difference to a diabetic cat's BG levels. So, for cats on insulin, it's vitally important that you monitor the BG levels carefully during the switchover to (only) canned low carb. Don't remove all the dry food at once. Phase it out gently for safety's sake. But be firm; once it's gone, it's gone for good...
Re your meter readings (on the two different meters) being SO different, well, yes that is really odd. Did you do the two meter readings one straight after the other? If so, then something is clearly amiss. Does the meter you bought have test solution with it? If so you can use it on one of your test strips to see whether it is working correctly.
Re your insulin dosage: I have no experience of the type of insulin that you are using, but please be guided by others on this site who do have that experience. The consensus is that the dosage is way too high to start out with. And his insulin needs could decrease further if/when you remove the dry food. Too much insulin could cause your cat to hypo and you really don't want to be dealing with that at this stage of the game. You have quite enough to deal with already! There's a saying often quoted on this site regarding cat's BG levels; "Better high for a day than low for a minute." Memorize it. I've lost count of the times that bearing that quote in mind has prevented me from making bad choices...
You've only just begun this journey with your newly diagnosed diabetic cat. Slow down. It's a marathon, not a sprint. And it does get easier. I promise.
All good wishes to you,
Elizabeth
BJM
Member Since 2010
Cherie B. said:
The FDA allows the glucometers to be within 20% of the 'true' lab value.
To check if the values are about the same, compare the low value +20% vs the high value - 20%.
270 + 20% = 324.0
524 - 20% = 419.2
The ranges don't overlap, so the values are different.
Reasons why this could happen:
Contamination of test strips -> did you wash your hands before preparing the meter and testing? Did you lay the stips on an unwashed surface that might have been contaminated?
Do you have the right strips for each meter? Were they stored properly? Are they expired? Have you checked for recalls on the strips? Could it be a bad batch of strips?
Is the meter working properly? Many have calibration solutions so you can test to see if they are working correctly. If the solution does not give the expected result, you could need a new meter.
You can drive yourself nuts comparing 2 meters all the time. It is more useful to use 1 meter consistently, with a backup meter to use when values are extremely high or low or the first meter doesn't work. Note it to the side of your spreadsheet whenever you change meters.
montyislay2
Member Since 2012
Hello there - just thought I'd post and say that you are not the only one in this situation and, from what I can gather both from vets and from the lovely people here, its not unusual.
Our beloved Monty was diagnosed on 2 Sept and we were scared rigid in the first week or so when he didn't respond to insulin. It takes time for their bodies to adjust both to the insulin and to the new diet. Getting to the right dose of insulin with the right amount of food is a balancing act and takes time to get right - so don't do as I did (and panic)!!!
Monty now seems to have hit vaguely the right level of insulin and is mostly below 10 (UK units) for most of the day. But he's still high in the mornings and evenings as the insulin wears off (though that gets lower each day). Before this he was rummaging wildly between 20 and 35!! We bought an alphatrak glucose tester which is great (albeit not desperatley cheap) - but it does allow testing with a tiny tiny amount of blood - and it has been massively helpful in enabling us to see how he is doing and to feed that information back to our (very helpful) vet. Its great to see them start to feel and look better too.
We are still very new to this and every day is a school day - and am sure there are more ups and downs to come before we get to any sort of regulation. I can't offer any tried and tested advice as I'm almost as new to this as you - but can assure you that you're not alone and we're all caring and interested to see how you get on - also there are many people here who have vast experience to help when you need it - pretty much 24/7!!
Hope to hear how you're doing soon.
Catherine, Shaun & Monty, Islay and Hennycat.
xx
Our beloved Monty was diagnosed on 2 Sept and we were scared rigid in the first week or so when he didn't respond to insulin. It takes time for their bodies to adjust both to the insulin and to the new diet. Getting to the right dose of insulin with the right amount of food is a balancing act and takes time to get right - so don't do as I did (and panic)!!!
Monty now seems to have hit vaguely the right level of insulin and is mostly below 10 (UK units) for most of the day. But he's still high in the mornings and evenings as the insulin wears off (though that gets lower each day). Before this he was rummaging wildly between 20 and 35!! We bought an alphatrak glucose tester which is great (albeit not desperatley cheap) - but it does allow testing with a tiny tiny amount of blood - and it has been massively helpful in enabling us to see how he is doing and to feed that information back to our (very helpful) vet. Its great to see them start to feel and look better too.
We are still very new to this and every day is a school day - and am sure there are more ups and downs to come before we get to any sort of regulation. I can't offer any tried and tested advice as I'm almost as new to this as you - but can assure you that you're not alone and we're all caring and interested to see how you get on - also there are many people here who have vast experience to help when you need it - pretty much 24/7!!
Hope to hear how you're doing soon.
Catherine, Shaun & Monty, Islay and Hennycat.
xx
hmjohnston
Member Since 2011
Cherie B. said:
I know this is a bit late- but that Freestyle meter- did the strips have a butterfly on them? It was noted before on the board that the Freestyle Lite meters RARELY tested above 299 for cats- no matter if they were higher (as yours was).
That is one reason why we do not recommend that version to buy- several owners had very sick kitties because they were testing lower and allowed the cats to go into DKA (EXPENSIVE to treat!!!) all the while thinking they were doing great.
As there has been some discussion if the brands we tell people to stay away from are still bad for us, this is a good indication that the Freestyle Lite with the butterfly strips are still a bad meter for cats. human it is fine, felines it is not.
I hope this helps.
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