Newly Diaganosed Kitty

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doose24

doose24

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Hello All!

My cat Nana was just diagnosed with diabetes. Nana is a 10 year old female calico cat. About 3 weeks ago I noticed she was drinking more than usually so I took her to Vet.

Intro:
Her BG level at the vet was 378. They also found glucose in the urine. So I changed her diet to wet food only. I then took her to vet so they can show me how to give the shot and measure the her BG at home. Well, at the vet, her BG was 254. I took my glucometer with me to see how my numbers compare to theirs so I can provide accurate data to the vet. My glucometer gave a very similar reading of 242.

I also decided to take Nana to a 2nd vet for another view.

Treatment Plan:
1. First vet told me to start with 2 units of Vetsulin once a day in the morning. Then check her BG every 3 hours.
2. Second vet told me the same dose once a day, but only check her BG just once. The BG should be taken 4 hours after the insulin shot.

Data:
Day 1- Feed @ 8AM, Insulin shot @ 8:15AM
BG Readings:
9AM- 258
12PM- 168
3PM- 228
6PM- 274
Day 2- Feed @ 8AM, Insulin shot @ 8:15AM
BG Readings:
9AM- 317
12PM- 212
Day 3
BG Readings:
12PM- 181
Day 4
BG Readings:
12PM- 178
3PM- 193

From all that I read, it seems Nana should be taking insulin twice a day, not once.

What do you guys think of these numbers? Any advice is greatly appreciated!!!

Thanks in advance for time and help! I really want to my Nana back to normal as fast as possible!
 
Welcome Nana and her parent. I will defer to the Vetsulin experts here on dose. I have not used that for a few years now. I will say giving it 2x a day is best. It is a short acting insulin and will not carry Nana through 24 hrs. Changing the food was smart thinking. Classic or pate style is the best. Most use Fancy Feast here. Good luck.
 
We'd all say that dosing twice a day is best. Vetsulin isn't a long lasting insulin and cats metabolize insulin quickly. It's wonderful that you're testing BG at home. I suggest you give 1 unit AM and 1 unit PM as close to 12 hours apart as possible. We have a basic testing routine that we recommend to get BG data that will help you know what the dose is doing and whether an increase or decrease is needed.

I'll just throw my new person's helpful hints doc at you:
______________________________________________________________________________________________

It would help us if you set up your signature (light grey text under a post). Here's how:
  • click on your name in the upper right corner of this page
  • click on "signature" in the men that drops down
  • type the following in the box that opens: kitty's name/age/date of diabetes diagnosis/insulin you're using /glucose meter you're using/what he eats/any other meds or health issues he has.
Another thing that will help us help you now that you've started BG testing at home is to set up a spreadsheet like the one we use here. We can all see it and look at it before offering advice: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

.................................................................................................................................................................................................................................

Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
.................................................................................................................................................................................................................................

Here's an explanation of what we call "bouncing". It explains why a kitty's BG can go from low to sky high:
  1. BG goes low OR lower than usual OR drops too quickly.
  2. Kitty's body panics and thinks there's danger (OMG! My BG is too low!).
  3. Complex physiologic processes take glycogen stored in the liver (I think of it as "bounce fuel"), convert it to glucose and dump it into the bloodstream to counteract the perceived dangerously low BG.
  4. These processes go into overdrive in kitties who are bounce prone and keep the BG propped up varying lengths of time (AKA bouncing).
  5. Bounce prone kitty repeats this until his body learns that healthy low numbers are safe. Some kitties are slow learners.
  6. Too high a dose of insulin can keep them bouncing over and over until the " bounce fuel" runs out and they crash - ie., have a hypo episode. That's why we worry so much about kitties that have had too high a starting dose prescribed by the vet and the owner isn't home testing.
.................................................................................................................................................................................................................................

Here are some tips on how to do urine ketone testing (VERY important if BG is high and kitty isn't eating well!):
  • put the end of the test strip right in his urine stream as he's peeing
  • slip a shallow, long handled spoon under his backside to catch a little pee - you don't need much
  • put a double layer of plastic wrap over his favourite part of the litter box and poke some depressions in it too catch pee.
Most test strips have to be dipped and allowed to develop for 15 seconds before viewing the colour change in very good light.

______________________________________________________________________________________________

That's a lot of info. Read it over a few times and ask questions. We're here to help! :)
 
Once a day makes no sense as vetsulin typically only lasts 8-12 hours. Your cat would have no insulin support most of the day.

The recommended starting dose is 1 unit twice a day 12 hours apart.

The good news is your cats numbers really aren't bad. Id be cautious about dosing 2 units. What kind of meter are you using?
 
Hi Janet,

I use a AlphaTrak2 and a Prodigy human meter. The numbers are close so I alternate between them. I talked to both of my vets. They are from different practices and they both said I should still dose Nana 2 units once a day.

4 hours after dosing, the 2 unit dose drops her BG between 160-180. The AMPS BG reading is between 280 and 320.

I just started Nana on Young Again Zero Mature. She was just on a wet food, but I didn't want to limit her to just that.

Since stopping Purina Beyond, and switching to just wet food, Nana has had no symptoms of diabetes (no excessive thirst or urination) even though her BG is still elevated.

Thanks!
 
doose24 said:
Hi Janet,

I use a AlphaTrak2 and a Prodigy human meter. The numbers are close so I alternate between them. I talked to both of my vets. They are from different practices and they both said I should still dose Nana 2 units once a day.

4 hours after dosing, the 2 unit dose drops her BG between 160-180. The AMPS BG reading is between 280 and 320.

I just started Nana on Young Again Zero Mature. She was just on a wet food, but I didn't want to limit her to just that.

Since stopping Purina Beyond, and switching to just wet food, Nana has had no symptoms of diabetes (no excessive thirst or urination) even though her BG is still elevated.

Thanks!
Click to expand...
Ok well that sounds good. Can you set up a spreadsheet for us?

http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Kris & Teasel said:
Here's the basic testing routine we recommend:
  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your spreadsheet, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
Click to expand...

I have a few comments about the above steps and any help would be appreciated.

For Step #1, it will be impossible for me to test everyday in the AM. And definitely not 2 hours before Nana eats because she has access to Young Again Zero Mature food at all times. I can do the PM tests, but same problem with the food.

For Step # 4, how I do accurately measure .25U on a U-40 syringe? Should I buy the Vetsulin pen?

Thanks
 
doose24 said:
I have a few comments about the above steps and any help would be appreciated.

For Step #1, it will be impossible for me to test everyday in the AM. And definitely not 2 hours before Nana eats because she has access to Young Again Zero Mature food at all times. I can do the PM tests, but same problem with the food.

For Step # 4, how I do accurately measure .25U on a U-40 syringe? Should I buy the Vetsulin pen?

Thanks
Click to expand...
You could pick up the food 2 hours before the test or get a timed feeder. So if her shot is 7 am have the feeder turn to an empty dish at 5am. Test at 6:50, let her eat again, and shoot at 7.

You'll want to pick up u40 syringes with half unit markings. Makes it easier to dose.

These are the ones I use. https://www.adwdiabetes.com/product/18553/ulticare-u40-pet-29g-3-10cc-1-2in-half-unit
 
Thanks! I will pick up some of those U40 syringes.

I am still working on getting the excel sheet together. The problem we are having is that Nana hides when the kids (4 & 2 year old) around. So it's challenging to get readings sometimes. Nana is not used to the ear pricks yet. It's been 3 weeks since this whole process started. A work in progress I guess. I do try to test as much as I can.
 
The link below states:
"The normal level of glucose in the blood is 80 – 120 mg/dl. It may rise to 250 – 300 mg/dl following a meal or when the cat is very excited. However, diabetes is the only common disease that will cause the blood glucose level to rise above 400 mg/dl. Some diabetic cats will have a glucose level as high as 800 mg/dl, although most will be in the range of 400 – 600 mg/dl."

So is it really true that cats glucose level may rise to rise to 250 – 300 mg/dl following a meal?

I am trying my hardest to learn as much about FDM as possible.

https://adamsonveterinaryservices.com/cats-diabetic-manual/
 
doose24 said:
The link below states:
"The normal level of glucose in the blood is 80 – 120 mg/dl. It may rise to 250 – 300 mg/dl following a meal or when the cat is very excited. However, diabetes is the only common disease that will cause the blood glucose level to rise above 400 mg/dl. Some diabetic cats will have a glucose level as high as 800 mg/dl, although most will be in the range of 400 – 600 mg/dl."

So is it really true that cats glucose level may rise to rise to 250 – 300 mg/dl following a meal?

I am trying my hardest to learn as much about FDM as possible.

https://adamsonveterinaryservices.com/cats-diabetic-manual/
Click to expand...
Yes that's why we say not to feed before the preshot test so the number is not food influenced. We want to make sure the number is high enough to shoot.
 
So my question is this, Since Nana is a grazer (never eats a lot in one sitting), does she really have diabetes? Her readings after eating are never over 320. One time I got a reading of 340, then tested her again 1 hour after I gave her shot and she was 220. When I took her to the Vet, she had just eaten and her BG was 250. After I started giving her insulin shots, she has become more tired than usual. I also checked her urine and the reading showed glucose at 250 before I started insulin. So I guess she does have diabetes.

I'm really confused. She's just not herself when on insulin. She has no symptoms of diabetes at all now since I took away the dry carb food.

Thank you all for guidance. As you know, it's really an emotional roller coaster right after you are told the kitty family member has diabetes.
 
doose24 said:
So my question is this, Since Nana is a grazer (never eats a lot in one sitting), does she really have diabetes? Her readings after eating are never over 320. One time I got a reading of 340, then tested her again 1 hour after I gave her shot and she was 220. When I took her to the Vet, she had just eaten and her BG was 250. After I started giving her insulin shots, she has become more tired than usual. I also checked her urine and the reading showed glucose at 250 before I started insulin. So I guess she does have diabetes.

I'm really confused. She's just not herself when on insulin. She has no symptoms of diabetes at all now since I took away the dry carb food.

Thank you all for guidance. As you know, it's really an emotional roller coaster right after you are told the kitty family member has diabetes.
Click to expand...
grazing on ya doesn't raise the bg very much.
 
I talked to my Vet again today and gave her Nana's numbers. She says to still stay at 2 units once a day and that Nana's numbers are good.
Should I start looking for another Vet? Based on Nana's numbers, she is not in the normal range for a long time.
 
doose24 said:
I talked to my Vet again today and gave her Nana's numbers. She says to still stay at 2 units once a day and that Nana's numbers are good.
Should I start looking for another Vet? Based on Nana's numbers, she is not in the normal range for a long time.
Click to expand...
. If you can fill in the spreadsheet with as many numbers as you can we can definitly help you with dosing help.
 
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