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My 8 year, 8 month old kitty, Susie, has just been diagnosed with diabetes. I don't have a problem with the insulin injections but she doesn't like her current prescription diet (expensive). My Vet wants her on a prescription diet but if she isn't going to eat it I am not going to give her the shots. She was given the Hills W/D (wet) and I have also ordered the Hills W/D dry which I have not received. I also ordered the wet Purina DM and wet Royal Canine Glycobalance. If she won't eat these foods I am going to be devastated. I have read, in other sites, that the prescription diets are not necessary and that the Fancy Feast Classic are a good alterative. She like Fancy Feast and has been eating it for years. What do I do if my Vet will not allow it?

 

Welcome! Hills W/D is not an appropriate food for a diabetic cat. It's 25% carb!!! It's like a diabetic person eating cookies all day. The glyco balance is also too high at 14%.

Most of us feed fancy feast classic or Friskies pate foods. I feed weruva foods because she needs low phosphorus as well. This is a good chart. You want foods under 10 percent carb (under 7 is even better). https://catinfo.org/docs/CatFoodProteinFatCarbPhosphorusChart.pdf

Simply tell your vet she doesn't like it and that you are going with other low carb choices. There is nothing nutritionally better in these perscription foods and no healthier than store brands.

 

Janet, thank you so much for this information! My cat does like the Fancy Feast Classic and it is so much cheaper than all this prescription medicine. I'm not sure if my Vet is going to agree with your comments but to me it is very important that my cat eat before I administer the insulin injections. Thanks for the link, too. I will certainly pull it up. I am overwhelmed with this diagnosis but she seems like a normal happy cat so maybe I got it before it has destroyed her system. Again, I can't thank you enough for your quick response to my concerns. Bless you and Merry Christmas!

 

Welcome Janet is correct there is nothing special about the prescription food
other than the high price and high carbs.
Dry is the worst food you can feed your cat.

If your vet won't allow it is crazy, it's your cat and you can feed what you want
Anything you got from your vet take it back and tell them Susie won't eat it.
They should refund your money.
If you ordered some of the other stuff off the internet, you should be able to return it

Like Janet said most of us feed Fancy Feast Classic Pates or Friskies Pate
Take a look at the link Janet gave you.

The FF Classic pates are 2 or 3 percent carbs
You couldn't have found a better place to land, many experienced , knowledgeable
members here.
My Tyler is doing amazing and it's all because of the amazing members here.
In my opinion they know more about diabetes than most vets do.

They live is 24/7 365 days a year.
Just keep asking questions.
I have a wonderful vet and she works with me and let's me do what I want
to when it comes to taking care of Tyler's diabetes.

I mean if my cat ever got sick of course I would take him in to see her
I only see her when it comes to taking Tyler for routine blood work and she's fine
with it.
Just keep asking questions, that's what we are here for

 

Are you home testing ?

• when you get a chance ,It would be helpful if you can set up your signature so we don't have to ask you the same questions over again. Members will look at this first .
• It appears after each post in gray, look at mine,

• On the left, under Settings, Click on Signature. This is where you will put information that helps us give you feedback.
• • There is a limit of two lines which may include two links; you may separate pieces with commas, dashes, | etc. This is where you paste the link for your spreadsheet, once it is set up.
  • Add any other text, such as
  • Caregiver & kitty's name (optional)
  • DX: Date
  • Name of Insulin
  • Name of your meter
  • Diet: "LC wet" or "dry food" or "combo"
  • Dosing: TR or SLGS or Custom (if applicable)
  • DKA or other recent health issue (if applicable)
  • Acro, IAA, or Cushings (if applicable)
  • Spreadsheet link. Please put the signature link on the bottom line of your signature information, on its own, so it is easy to find.
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Be sure to click the 'Save Changes' button at the bottom. If you need help urgently it is important we know these things at a glance. We don’t want to waste valuable time finding out information.


tap on your avatar where it says your name ,then hit profile page ,tap on that ,then go up to the very top, upper right hand side and tap on your name ,it will bring down a drop box, tap on signature, the signature will be under settings, tap on the signature then and you can start to add what I posted above, make sure you hit save ,
Welcome to the best place you could ever be and an awesome group of people

 

Thanks, Diane. I am not home testing yet. I do have the Alpha Trac 2 but am waiting for something called a Genteel Lancing Device to draw blood. A friend of mine, who has a diabetic dog, says this has made her testing so much easier - for her and her dog. I don't have a problem with the injections but hurting my cat's ears, to draw blood, bothers me. I think I set up my "signature" section okay. Thank you for the instructions. I'll see if it works when I post. I'll be talking to my vet today and will inform him that I will stick with the FF Classic unless I find a reasonable prescription wet food that she will eat. She has always been a medically strange cat. When I first brought her home from the shelter, in April 2019, she urinated very, very little. My vet kept looking for a blockage and actually did surgery. No blockage was found and she has continued this behavior since it all changed in late November with massive amounts of urine and lots of water drinking. She also has several other "out of reference range" results in her blood work and I will be speaking to my vet about that today. Thank you, again.

 

Are there any treats I can give Susie? She is missing her dry food and Temptations.

 

Morning Summer , I found it on you tube, you still have to poke Susie's ear whether
you use any lancing device or just use the lancets, ( the little blue things you see in the video )
Most of us just hold the lancet in our hands and prick the cats ear with it, you can see exactly where you are poking.
Believe me it doesn't hurt them
I will post a video below that Janet made , testing her kitty.


The only way to keep Susie safe is to test before each injection
to make sure the number you get is OK to give her the insulin.
Especially with using Vetsulin , it's a harsh insulin and can make their
BG dropped very quickly, you don't want a hypo episode.
That's why we test not only first thing in the morning, but we test during each
12 hour cycle. Example
2 hours after the insulin is given
4 hours. ditto
We vary the testing times to get an idea how low the insulin is taking our kitties

Same with the night time shot

We use a spreadsheet to record this , if you ever need dosing advice our members
need to see how to he testing is going in order to give you any advice

I will post the instructions for you and if you need help just ask
we have 2 wonderful members here that will set it up for you

You can take a look at mine it's at the end of my signature.
It says Tyler's spreadsheet.
Most of us have one.

 

The Alpha Trak 2 is a pet meter , the strips are very expensive, something like
50.00 for 50 strips

I used it in the beginning but it became to expensive. So I switched to the
human meter which most of us use.
The Relion Prime from Walmart or The Premier
It's 9 dollars
17.88 for 100 strips
You will go thru a lot of strips in the beginning
Also will need to buy
26 or 28 gauge lancets
Cotton rounds to put behind kitty's ear in case you poke yourself
Then just hold the cotton round on her ear to stop the bleeding about 10-20 seconds
Always have honey in the house in case she ever drops too low and you need
to bring her BG back up to safe numbers

Also Fancy Feast Gravy Lovers medium carb and high carb to bring her numbers
back up

I'm going to post a link for you to read about Vetsulin
Lantus or Prozinc is a better insulin for cats
You can try the Vetsulin and see how she does but I strongly advise you home test

 

Treats

purebites freeze dried chicken and salmon flavors. . You can get it on chewy or amazon. For the chicken flavor you can buy the dog size if it turns out she likes them.

Orijen freeze dried treats they crumble well.



Vital Essentials Minnows Freeze-Dried Raw Treats. If the minnows work, you can get the dog version which comes in a bigger size and it’s a lil less pricey.

You can Google freeze dried treats for cats and also see what you find

Here is a tip if you ever want to maybe find something go to the top where it says search
Type in treats for example and you will find other members posts about what treats they
use.
I have never used treats myself only because Tyler never asks for any

 

Always aim for the sweet spot warm the ears up first, you can put rice in a sock and put it in the microwave, test it on the inside of your wrist to be sure it's not to hot, like you would test a babies bottle. You can fill a pill bottle with warm water and roll it on the ears also

6. As the ears get used to bleeding and grow more capilares, it gets easier to get the amount of blood you need on the first try. If she won’t stand still, you can get the blood onto a clean finger nail and test from there

 

VIDEO: How to test your cat's blood sugarsugar

Here is the video that Janet made showing how to test

 

https://felinediabetes.com/FDMB/threads/beginners-guide-to-caninsulin-vetsulin.231587/

 

https://felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/




https://felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/

 

https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-chart.174147/

Here is the food chart

 

This is what you need to feed if he ever drops to low, don't have want a hypo
Such as

You should always have a few can of these on hand in case you need to bring up


Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs


Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy. 15% Med Carbs




Fancy Feast Gravy Lovers Turkey Feast in Gravy. 15% Med Carbs


Fancy Feast Gravy Lovers Chicken and Beef Feast in Gravy 15% Med Carbs

It's mostly the gravy that has the higher carbs in it

Look at the food link I gave you , you might see other ones you may want to try

 

Good job setting up your signature
If you ever want to find something just go to where it says forums , you can browse
around there

 

Welcome @Summer Devlin

This is a great website. My vet also wanted me to feed Hill's science diet M/D wet & dry. I've switched to fancy feast classic pate. I am still working on getting my cat's insulin regulated correctly, but the people here are amazing!

Gizmo doesn't really care for being tested, but she tolerates it very well. I was also very hesitant to test. I ended up getting the Alphatrak 2 and the Relion. We have gone to just using the relion. If you look at my spreadsheet you can see there is a difference between the 2, but as you scroll through these forums you'll learn that just about everything on this website is for a human meter with a description of how Alpatrak 2 is different.

I know most people say they just use the lancet without the lancing device. I am still using the lancing device I got with the Alphatrak 2, and have learned that the relion lancets fit it.

 

Cat's ears are not as sensitive as you think. Think of cat fights and how often the ears get scratched.
When you touch a cat's ear and the cat responds by flicking, that is because the cat does not want your finger or anything else shoved in the ear. It's not about poking the skin.

 

Thank you for all the information, Diane. It is overwhelming but very helpful. I will think about trying to test her tomorrow after her shot. I know you want me to test before but I am just going to start this slowly so as not to overwhelm myself and pass those feelings to my cat. I am confused about this statement:

• Mid-Cycle: The BG tests that are done between the two shots. Getting tests at different times is important to creating a full picture of how your cat is responding. So some days you can get a +6 test, some days a +4 test, some days a +9 test, etc...

Where are these numbers coming from? The +6, +4, etc.

Susie goes back to the vet for a brief check this Thursday and then we will do the curve sometime the week after Christmas. I will stay in touch and thank you, again!

 

Yes, this does appear to be an invaluable website. Will have to get up the nerve to start the testing. Shots are not a problem.

 

Thanks, Red & Rover. So sorry to hear you have a cat with acute kidney failure. I too had one two years ago and was also doing the subcu fluids. My girl went very quickly. Is yours still alive since being diagnosed in 2016?

 

Sadly, no. He went from chronic to acute in the blink of an eye. That is what the (GA) after some the monikers stands for – Guardian Angel, Gone Ahead …

 

This will explain it




https://felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/


+2. Means you will test 2 hours after giving insulin in the AM (AMPS) means AM Pre-Shot This is when you test them first thing in the morning , then you feed , wait 30 minutes then give insulin
+4. testing 4 hours after giving insulin ditto
+6. testing 6 hours (Mid- Cycle)
+7. And so on up until +11

Then same thing starts over when you give her her night time shot (PMPS) means PM Pre-Shot. This is your night time test (12 hours after your morning test) So if you test at 8:00 AM
your night test would be at 8 PM. Test, feed , wait 30 minutes then give insulin


One important thing are you waiting 30 minutes after he finishes eating to shoot the Vetsulin
You have to with Vetsulin

 

I'm so sorry. Kidney Disease is the worst. I was grateful that Susie did not have it but the diabetes is a major challenge for me. I'm going to try and test her blood this morning and I know she will not sit still for it. I might have to wrap her in a towel which will make her more paranoid. Wish me luck.

 

I had been waiting an hour after she finished eating until I read I should shoot 20 - 30 minutes after. I started that last night. Thanks for the explanation on the spreadsheet. I haven't looked at that yet.

 

Success! Three hours and 13 minutes after her am shot I got blood but not without many problems. I almost gave up until I wrapped her in a towel and just used the lancet - not the lansing device. She had a glucose level of 299 last Wednesday morning and this morning it is 241 so I guess I am making progress. It is her fructosamine I'm really worried about and don't know how this blood result relates to the glucose. Last Wednesday her blood fructosamine was 778 with the normal range being 143 - 373. Can someone explain the relationship between the fructosamine and the glucose result?

 

Diane, I got Susie's Spreadsheet loaded on to my signature page but how do I get back to the spreadsheet to update it from this site?

 

I can't, but see this: Reference Ranges for Fructosamine Test

(Congrats on the successful test!)

Enid

 

You have to sign in thru Google docs. I think

To be honest a member created it for me ,did it work?
On your SS on the top you should have the year 2020 and a new one for
2021

Do you need help with that?
I can tag someone who can help you with that and how to add the numbers to your SS

Good job at your first test
So you will be staying with the Alpha Trak 2 , just want to be sure
You can get rid of in your signature where you have haven't started testing yet

Also get a copy of the blood work, in case you have a question for us.
You mentioned she had some out of range results

 

The fructosamine test will take into account the cat's blood glucose ranges over a period of a few weeks before the test and it's not affected by the stress levels caused by a visit to the vet unlike the blood test. It is a more reliable way of diagnosing a diabetic cat, and also will tell you later on how well regulated she is. So until you get Susie regulated with BG levels around 70-120, her fructosamine results are going to be high.

 

Thanks for the info!

 

Yes, I need help going to the SS from this site or wherever I need to go to upload info. I'll be staying with the Alpha Trak 2 and updated my signature site. I have a copy of the blood test and will try to upload it for you.

 

Thanks for the info. It is still confusing. By the way, I am impressed with your kitties spreadsheet. Look like you have gotten a handle on her diabetes. Please remind me what the AMPS and PMPS #'s mean. I know one is morning and one is afternoon. Is the AMPS the very first testing result number you get in the morning, after they have eaten? Where do you put in the time that they eat then?

 

@Bandit's Mom Hi Bhooma Summer is having trouble with her SS, do you think
you can help her out and I see there is no year listed up top, might as well add 2021
Just realized it's 2 AM by you

@Chris & China (GA) Chris do you think you can help her out
See #29. Thank you so much

 

This will explain it




https://felinediabetes.com/FDMB/threads/understanding-the-spreadsheet-grid.156606/


+2. Means you will test 2 hours after giving insulin in the AM (AMPS) means AM Pre-Shot This is when you test them first thing in the morning , then you feed , wait 30 minutes then give insulin
+4. testing 4 hours after giving insulin ditto
+6. testing 6 hours (Mid- Cycle)
+7. And so on up until +11

Then same thing starts over when you give her her night time shot (PMPS) means PM Pre-Shot. This is your night time test (12 hours after your morning test) So if you test at 8:00 AM
your night test (PMPS) would be at 8 PM. Test, feed , wait 30 minutes then give insulin


One important thing are you waiting 30 minutes after he finishes eating to shoot the Vetsulin
You have to with Vetsulin

Do not feed anything 2 hours before AMPS and PMPS
You then can feed smaller meals either FF Pate or the treats I mentioned above. at any time

Perhaps 2 hours after giving insulin, then 4 hours after insulin , orv6 hours after giving insulin

Same with the PMPS

On the SS there is a remarks column you can list what time you fed the smaller meals

Example
@+2. FF Pate
@+4. Treats or FF Pate
@+6. FF Pate
Usually 2 or 3 teaspoons or some treats

We do +2 , +3 because we are all in different time zones, so putting 10:30 isn't helpful

Look at my SS and see how I do it

I tagged 2 members about helping you with your SS

You want to test a couple times after the AMPS to see how the
insulin is working and how low it's dropping Susie's BG number

Same with the night time PMPS , you want to scatter the times of the
tests , so it's like a puzzle being filled in.

Look at mine

 

Summer what did the vet say about any if the test results that were out if
range
I am going to tag
@Wendy&Neko

@Marje and Gracie

@JanetNJ sorry if I tagged you and you couldn't help her out with the labs

Hi ladies I hope you don't mind that I tagged you, do you
think you can take a look at Summers cats labs.
Cats name is Susie
Summer is new here and I have been helping her get set up
Is there anything she should be concerned about, she also just posted the labs from March 2020, #47. the latest is from 12-16-20 #34

Thank you so much

 

Summer with using the Alpha Trak meter if Susie's BG ever drops to 68 that is when you have to feed to bring her numbers up, or if its a big drop from one test to the next
You would have to feed either medium or high carbs food.
If it happens you can start a new post on the feline health board something like
this

Here is an Example
HELP NEEDED BG dropped to 56
We will then help and guide you

This is why it's so important to home test

 

Vet said nothing about all the other out of range results. Could be that he was worried about me handling the diabetes diagnosis and didn't want to approach other concerns at this time. I do plan on asking him but I am overwhelmed with the diabetes results. My cat, Susie, has been an anomoly since the day I brought her home from the shelter in 4/19. She only urinated in drops. There was nothing normal about her urination and the vet actually did surgery on her looking for a blockage. He did not find a blockage but thought maybe it was scar tissue from a previous surgery. She continued, since then, to only urinate in really small portions. She stayed happy and healthy ( I thought) all this time until the end of November when she started drinking a lot of water and urinating a lot. This was quite a change. We have never understood why she doesn't urinate like a normal cat. I have blood test results from her other appt. in March 2020 if that will help. I have a lot of concerns about her but she seems very happy and content - and always has. Never a sign of sickness other than the occasional throwing up and some "hacking". I don't know what do to or what to think about her very strange clinical history. I just love her and want to do the best for her.

 

Just hang in there we are all here to help you and Susie
If you want to you can upload the March 2020 results also

I tagged 2 members to help with your spreadsheet
and 3 members to take a look at the labs
Just hang in there
Have you tested anymore today since this morning

I posted a few new things for you above, just so I know you read them please
hit the like button , we all do this so we know that the person has read it

 

Hopefully @Diane Tyler's Mom 's post clarified what the spreadsheet is about. We don't put specific times in the spreadsheets because this is a very international group of people and the specific hour is never important, only the time that has passed since each shot is relevant. I give Ruby her shots at 7 AM and 7 PM, and you can see in the Remarks all the way on the right side of the sheet that I keep track of everything she eats (and poops!) as AMPS, +1, +2, etc.

There's no miracle involved in how I got Ruby to be tightly regulated. I read every sticky I could on the board so I could learn about diabetes, read other conversations and studied a lot of other cats' spreadsheets to see how they went OTJ (off the juice) to know that remission is possible. I kept adjusting Ruby's dosage with the help of the fine and experienced people here until one day her liver stopped overreacting to low numbers and she stopped bouncing high and has remained in blues and greens for about the last month. She's made huge strides and it shows in how healthy her coat looks now and her playful energy.

 

Thanks for the help Katherine , I was running out of steam typing lol
I hope someone helps her straighten out her SS and read her labs
Thanks again ♥

 

You are a great Mom, Katherine, and Ruby is lucky to have you. I hope, with the absolute help of my vet, that I can get my very "clinically unusual" cat off the insulin someday. She came to me with very weird characteristics. She barely urinated - only drops. Anyway, I have explained this in another post. She had surgery in early 2019 for her lack of urine. My other vet was looking for a blockage. None were ever found and until late November of this year she was still barely urinating. Everything then changed. Thanks for all your help. I will just have to pray that what I feed her, when I feed her, when I shoot her and when I test her will all help - eventually. I'm burnt on all of this and so intimated right now. I'm sure everything will get easier as far as the shots and the food and the testing. Thanks and Merry Christmas!

 

It will get easier Summer, I'm sure you will do fine.
We all felt like this in the beginning.
I was really anal and still am
Don't forget to hit the like button so I know you read anything I wrote, in case it's really important

 

Summer, it's totally overwhelming! I feel like I've been on an emotional rollercoaster for nearly 4 months, every day my moods totally dictated by Ruby's numbers! Arm yourself with knowledge, get used to the language and methods used by the members here, follow the journeys of other cats and their caregivers and trust in the protocol. You will feel more in control of things soon enough. Remission isn't guaranteed for any cat, but one thing I can promise you is that it gets easier.

 

I'm supposed to test before the shot and after? This is overwhelming. The testing is the hardest part.

 

Yes just like I explained above and why

 

I'm done with the testing. I had my Mom hold her tonight and I jabbed her several times with no blood. She cried every single time. I will not alienate my cat for these test and will leave it to the weekly testing at the vets.

 

Don't give up yet! I CRIED every time I tried to get blood out of Ruby for 6 weeks before I bought a lancing device and it made the whole experience so much easier. Now Ruby doesn't even flinch. She hates her shot more! I love this video starring Peanut: https://www.felinediabetes.com/FDMB...to-get-a-blood-sample-starring-peanut.175369/

Not testing leaves you not knowing at all where your cat's glucose levels are. She can have a hypoglycemic episode in between vet tests. Please reconsider this. I poke Ruby about 8 times a day and trust me, she still loves me.

 

You can't do it from the link in your signature. You have to go to Google Drive and open it from there.

 

Thanks Chris , she got very over whelmed See #50 ♥

 

Good video, Katherine. I watched a few videos yesterday about how to do the testing. Each cat would sit perfectly still. Mine does not. Yesterday was a nightmare for me. I'm sure I will try again and will use a warm sock. If I could just test once a day I would be happy. She is scheduled to go in tomorrow morning for a test. I will certainly rethink my decision not to test. I know it is important. Just breaks my heart every time I have to stick her.

 

I wonder if your vet clinic would be willing to allow a vet tech to give you a hands-on tutorial? (My vet all but insisted on it.) COVID rules are changing everything so I don't know if that's still in the cards, but there couldn't be any harm in asking?

When I first started testing Lola I did so in the bathroom sink. The depression of the sink helped to keep her contained, there was great lighting overhead, it was a convenient height, and there was a shelf right there to hold the things I was going to need. But best of all, in my tiny little bathroom the sink is surrounded by walls on three sides, and I could block her attempts to escape with my body on the fourth side. I think not being able to see an escape route helped to reduce her escape attempts. Is there a place in your home like that?

For what it's worth, we've only been testing about 2 months and Lola's so blase about it now that if she's asleep on the bed and I come over and start warming up her ear for a test she doesn't even lift her head. (Although she might open one eye to give me a sidelong stinkeye.) As Lola and I both became accustomed to the process it has just become a non-issue. Here's hoping the same for you!

 

I did get a hands-on tutorial from a vet technician. Of course, I was holding Susie so she couldn't run away. It figures that she would do just fine at the vets but not at my house. I like the idea of the bathroom sink. I have been trying to do this on a low table and I need to raise her up. The lighting would be better in there too. She seemed to accept the "rice in the sock" warm up for a brief time then tried to take off. I tried this this morning. I saw blood, today, but it smeared on her fur and she would not sit still for me to try to get a drop. I have seen videos where people smear a little vassoline on the ear to get the blood to "drop" instead of smear. I'll try all of this again later today. I like your "stinkeye" statement. Funny thing is Susie doesn't hold any grudges after going through all this trauma. She comes back and wants to be loved. Do you do anything special to get the blood to form a drop so it is easy to get the strip up next to it? Thanks for your support. There are a lot of supportive people on this site.

 

It is wonderful that you have Lola OTJ! I assume that means "off the juice"?

 

Vaseline made ALL the difference for me! (That, and not trying to get blood from her paws.) Just a thin smear will allow the blood to pool into a drop instead of diffusing into her fur. Just be careful not to get any on the test strip so it can't suck up the blood!

I also don't actually plug the strip into the meter until I know I have enough blood. Then I reach over and push it all the way in (with the finger that doesn't have any vaseline on it). (I kept timing out or getting "not enough blood" error messages.) Some people "scoop" the blood drop onto a fingernail and then test from there. I've done that a few times when Lola was particularly squirmy.

Yes, Lola is Off the Juice We were very fortunate that simply a change to the low-carb diet, along with a few weeks of support with insulin injections, was all she needed at this point. Of course she's still a diabetic and therefore subject to fall out of remission, so she'll have to be monitored from here on. I'm only doing tests every other day now. My vet suggested twice a week, but I'm still too nervous for that.

I'm super lucky in that my vet is very experienced with diabetic cats and fully supported (and even suggested) home testing. I wish I had been doing it when she suggested it 20 years ago when we had our first diabetic cat. (But he managed to live a long life - albeit with one life-threatening DKA event - in spite of my clueless-ness.)

I know the whole diagnosis and testing is overwhelming, but it does get better. Really!

 

Thanks, Enid & Lola and Pookie. I'll try the vaseline this afternoon. What is a DKA event?

 

Diabetic ketoacidosis. A very, very, very scary (and expensive) thing: Ketones, Ketoacidosis, and Diabetic Cats: A Primer on Ketones

I'm going to tag a couple of experienced members and ask if they would give you a proper answer because it's too important for me to risk giving misinformation @Critter Mom @tiffmaxee

 

Wow, that sounds really scary, Pookie. I'm glad she pulled through. This diabetes thing is truly overwhelming. I thank you for your support.

 

I understand feeling heartbroken! I did too until I got the technique right. Ruby also began associating the experience with nice things--being rubbed with a warm sock, a nice meal or snack immediately after--so when I pick her up to bring her to the chair to do her testing, she now sits right down and waits for it to happen. She also knows that until we hear the beeps from the meter that no one is going anywhere. Never thought one could train a cat but this is about as close as I've come. It took me SIX WEEKS of crying, scabby ears, tons of Neosporin ointment, dozens of test strips and about 50 gray hairs that sprouted from my head but we did it! Yesterday I tested her 11 times, and trust me, she still loves me.

 

Thank you for the encouraging words. I need them! Can't believe you are testing 11 times a day. Susie went to the vet last Thursday. Her glucose was down to 220 and she dropped .3 lbs. The vet was happy. She went from a glucose reading of 299 to 220 in a week. Do you use vaseline on the ear tips? Seems her blood just smears into her fur. I take her in for her first "curve" next Wednesday.

 

Hi Summer,

Here is the testing method I used. Perhaps it might give you some ideas to add to your own testing technique.

1. For most meters you can insert a test strip part way without switching it on. Once you've done the poke you can then push the strip the rest of the way into the meter to activate it. (Reduces the likelihood that the meter will time out before you can get the blood sample onto the strip.)
   
   
2. Fold a sheet of kitchen paper in four lengthwise and cut it up into 1" strips. You will use these to cushion and support the ear during the test.
   
   
3. Apply a thin film of Vaseline or Neosporin ointment (not the cream!) onto the edge of the ear to help the blood sample bead up instead of wicking into the fur. (Wipe off any excess.)
   
   
4. To get a blood sample you need to increase the blood flow to the ear, so make sure the ear is really, really, really warm (but not hot) - especially in the early days of testing. (Note: With repeated 'poking', more capillaries form in the test area, so it becomes easier to get samples reliably.)
   
   
5. Once you have the testing area of the ear well warmed, wrap a strip of folded kitchen paper round your index finger then place finger under the sweet spot area of the ear you're testing to support it during the poke.
   
   
6. Use your thumb and middle finger to lightly but firmly grip the ear and paper strip in place so that the edge of the ear is taut but not overstretched; the little bit of tension will make it easier for the lancet to break the skin surface (and it helps to keep kitty's head from moving around too much).
   
   
7. When using a lancet 'freehand', make sure the bevelled side of the lancet is facing upwards. Hold the lancet at a slight angle to the ear similar to the way you hold a pen when writing, not perpendicular (easier to see where you're aiming and also makes skin prick easier).
   
   
8. When it comes to the actual poke, prick the sweet spot on the edge of the ear in a similar way to how you might quickly prick a balloon with the tip of a needle to make it pop. If you aim as close to the edge of the ear as possible you are less likely to hit the marginal ear vein.
   
   
9. Keep hold of the ear while you're pushing the test strip into the meter to activate it. (Kitties are prone to shake their heads after a poke, sending your precious blood sample flying across the room. Holding the ear reduces likelihood of this happening.)
   
   Note: As you become more practised in testing, you'll be able to activate the meter just before doing the poke and still have plenty of time to collect the sample on the strip before it times out.
   
   
10. When using the glucometer, bring the test strip to where it j-u-s-t comes into contact with the blood droplet and hold it there. The strip should then 'sip up' the amount it needs to run a valid test. Most meters beep or give a visual cue to let you know that enough blood has been collected on the strip.
    
    If your cat is a wriggler, try collecting the blood sample on the back of your (clean) fingernail and test it from there.
    
    If a test fails and you still have a lot of blood on the strip from the failed test, don't throw it away. Instead, you could pop another strip into the meter and test using the blood on the strip from the first test. (Saves an additional poke so also helpful for wriggly kitties!)
    
    
11. After the test, fold the paper strip over the edge of the ear and apply gentle pressure to the test area for about 20-30 seconds to minimise bruising.
    
    
12. Keep giving lots of praise throughout the process and reward with a favourite diabetic-friendly treat or favourite activity (e.g. brushing).

With a bit of time and practice you'll be able to work out a technique and a routine that works best for you and Susie.







Mogs
.

 

I used Neosporin ointment on her ears at first because I heard it would help pool the blood and it also helped with healing but now I only use the ointment on her ears at the end of the night for healing. Ruby’s ears have “learned to bleed” and so if I have the lancing device properly positioned with my finger supporting the ear with a piece of gauze, I get a nice drop of blood without any Vaseline or ointment. She does of course decide to move, flick her ear, or do a whole host of things that makes it difficult to get it into he first try, especially at 6:45 AM when I haven’t had my coffee yet!

I did not test her 11 times a day when Ruby was in higher numbers. I would get away with a minimum of 4 tests a day with SLGS. I test her more now because we’re doing TR or tight regulation and she has earned a lot of reductions very quickly and hovers around some low numbers that require more monitoring. The more I test, the more I can be confident that I am catching the times she dips below 50 and can guide her back up with food or honey and also know to reduce her dose during the next shot time. The testing has become a part of our daily rhythm. I plan the rest of my life around it as much as I can, hoping that we can get closer to remission more quickly. Another reason to test: you can adjust doses more quickly if you do it at home rather than curves every few weeks at the vet and therefore can achieve remission more quickly if that’s in the stars for your cat. The longer the cat remains a diabetic the harder that goal becomes to achieve. Please see my Ruby’s spreadsheet as an example. My vet wanted me to adjust doses every 2-3 weeks based on in office curves. She would still be unregulated if I listened to him.

 

Another few tips:

1. Stick to the one spot for testing. In the early days, try bringing Susie to the testing spot and just give fusses and diabetic-friendly treats several times a day. Only test when you actually need the readings. It may help Susie to associate the testing station more with good things happening and less with the occasional ear poke.

2. Try reframing your view of testing as a really good and loving thing to do, not as a thing that hurts (cats don't have that many nerve endings in their ears) but as a thing that protects (keeping Susie safe from hypoglycaemia).

3. Cats are notorious for picking up on our emotional states. If you're tense and upset about testing then Susie is likely to feel the same way. Whenever you bring her to her testing station, try talking in a very positive tone of voice, praising her all the way. And sing! It changes your own mental state and helps you to feel more relaxed, even if it just makes you laugh at yourself for doing it! That could help Susie feel more reassured and accepting of the activity.


Mogs
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I just wanted to say, pretty kitty.

 

Looks like you are getting some good numbers but I am confused. If the numbers are low shouldn't the insulin shot be reduced. I am still trying to wrap my mind around all of this. I was able to get a test this afternoon but only after my Mom helped hold her, I poked her several times and then finally moved her to the bathroom sink where we had better control and light. I went up from 220 last Thursday morning to 242 this afternoon. I did increase her food this morning from one (1) 3oz can to 1 1/2 3oz cans. I wonder if that is why her glucose went up. Also, it was seven hours after her morning shot.

 

Thank you and Buddy is a handsome ginger! Is Buddy still with you? I don't see anything on the spreadsheet after August.

 

Thanks for the tips. I think I'll be doing it in the bathroom sink from now on. I have better light and more control if she is wrapped in a towel. I'm sure she is picking up on my stress and I have to have my Mom hold her so that is also totally new. She is so sweet and never seems to hold a grudge - no matter how many times I stick her.

 

Buddy is still with me, I cannot seem to keep his SS up to date any more. I am going to try again in 2021 to start over with his SS. Buddy, is a true Blonde Beauty, not ginger. A lot of people see his picture and think he is a ginger kitty, but he is not.

 

Hard to tell in the picture. Whether he is ginger or blonde - he is beautiful. I am so happy your "blonde beauty" is still with you.

 

Summer wrote (in post #68):

Her glucose went up to 242 7 hours after her morning shot. I asked the vet if I could increase her food at her two feedings because she was getting very hungry. I have only been giving her one 3 oz can in the morning and at night. He said I could try one and a half cans. I'm wondering if that is why is glucose went back up or if it had just been a while since her insulin shot. Shouldn't the glucose go down when it has been a while since the shot and the food?​

With Vetsulin, typically at +7 hours after administration the effect of the dose pretty much peter's out. Here's an illustration of an 'ideal' response to Vetsulin for a feline diabetic:




As you can see, Vetsulin's typical duration in cats isn't great (lasts longer in dogs because their metabolisms are different).

Because Susie's not yet regulated her body isn't currently able to utilise the nutrients she eats hence the unusual hunger, and it's common to feed extra to unregulated cats - especially if they are underweight. A substantial feed is needed 30 minutes before insulin administration because Vetsulin typically hits hard and fast. Thereafter, it's OK to give smaller feeds, ideally before +7. The only time grub should be withheld completely (assuming the cat is not in low numbers) is in the two hour period prior to the preshot reading, since this should not be influenced by food.

Glucose gets into the bloodstream when food is digested at mealtimes and also from the liver between meals. The liver stores sugar in the form of glycogen and breaks it down into glucose again between meals to provide fuel for the body's metabolic processes (glycogenolysis). The liver can also synthesize 'new' glucose from the body's stores of fat and protein - a process called gluconeogenesis - and then release that to provide the body with fuel. Therefore, even if it's a long time after a meal has been eaten it is very much possible for BG levels to rise due to sugars released from the liver, especially when the insulin dose is wearing off.


Mogs
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I also like black and black & white kitty's. Good luck, you are getting a lot of good info from people with a lot of knowledge.

 

Don't worry, it's a TON of information to absorb and there's a huge learning curve. If you look at the U column in Ruby's spreadsheet, you will see the units of insulin I'm shooting everyday. I adjust her dosage according to her nadirs or lowest numbers in the cycle. I've chosen to increase her dose at times when her nadirs weren't getting low enough, as is happening recently where we are going back and forth between two different doses. You will see that in nearly every single case there is a lime green number on the spreadsheet, I reduce her dose by .25 units. Ideally we want Ruby to remain in the range of 50-80 in order for a strong remission to take hold and we haven't gotten there yet, hence the increases in dosage.

 

Strange how you give them insulin to lower the blood glucose but the body kicks in to provide more. I only gave her one can (3 oz) this morning at 5:30 . I would like to feed her a half a can around noon just to space out the food. I feed her again around 4:00 pm. She is always really hungry around then. Do you think that would be okay instead of giving her 1 1/2 cans all at once in the morning? Also, what diabetic treats can you recommend? I've been giving her Purebites Chicken Breast and Catnip and have on order the Purebred Beef and Liver. These are freeze dried. Thanks, Mogs.

 

Katherine, isn't 50 a really low number for the glucose. Seems dangerous. My vet said he would be happy if Susie's glucose was in the low 100's. I feel like I need to be a "rocket scientist" to understand all this. Was it a struggle for you too?

 

Is there a book like "Understanding Diabetes in Cats - for Dummies"? I would love a good reference book on feline diabetes that is easy to understand.

 

You've only been a part of this forum for 10 days. Keep asking questions, you don't need to be a rocket scientist! It was a HUGE struggle for me. I was so emotional and felt like I couldn't retain any information, I was so overwhelmed. But I read every sticky, started following the journeys of the other cats and caregivers on the Lantus forum and study their spreadsheets. I also look at the spreadsheets of cats who have gone into remission so I can understand how they got there. This board has become an important part of my daily life and the people here are my lifeline.

The vet's job is to keep your cat as safe as possible, which means assuming you don't know how to deal with lower numbers or hypoglycemic events. The people on the board can help you through it. And there's nothing wrong with numbers in the 100s, but for a strong remission to take hold we need the bg levels to be lower. There's also a wide range of opinion as to what levels of BG are "healthy" for a cat if you do a search on the web. That's why Tight Regulation is an aggressive method because it pushes for a lower bg range in order to have the greatest success. Here is a sticky on the two dosing methods that I read on a nearly daily basis so I can understand and even so I still mess it up as I did this morning! Here's the paragraph from that sticky re: getting your cat to remission (OTJ means "off the juice"):

• We've found many kitties benefit from reducing the dose from 0.25u to 0.1u before stopping insulin completely. During a two week OTJ trial, you want to see mostly green numbers (under 100) with only a few random blue numbers between 100 - 120 to help ensure a strong remission. Most kitties will be in the range of a healthy cat (50 - 80 mg/dL) overall.

 

This is called "bouncing" and your cat needs to be on insulin for it to go through "liver training school" so that it stops dumping glucose into the blood when sugar levels become lower than the cat is used to. Here is a whole conversation on bouncing that I found super helpful!

 

Good explanation and I think I actually understood it! I also printed it. Thanks!

 

Okay, folks, I need some advice. After Susie's first curve last Wednesday (12/30) her insulin was increased from 1 unit to 1.5 units. She seemed fine (although I had not been testing her) until yesterday morning when she only at 2/3 of her breakfast. This is VERY unusual for her. Last night she barely touched her dinner so I did not give her a shot. This morning she acted hungry but just ate a small portion - mostly licking the juices. I went ahead and gave her 1 unit of insulin. Her lack of appetite made me nervous so I made myself test her glucose about 3 hours after her shot. It was down to 154. A good number but I am alarmed that she has lost her appetite. I spoke to the vet. He is also concerned and said it could be something other than the diabetes. I checked her blood again 7 hours after her shot and it is up to 165. I will see if she eats tonight and check her blood before I feed her. Vet said if the numbers fall into the low 100's then I should skip the injection. Anybody else experience something similar with a lack of appetite with an increase in insulin? Thanks so much. I thought we were doing pretty good but I am more concerned that she eats than the high numbers with diabetes.

 

Hi Summer, I don't think it's the insulin that is causing a loss of appetite but rather high glucose levels. When Ruby was in high numbers she lost her appetite a lot. I gave her cerenia for nausea and mirtazapine if she went for hours without eating and that always did the trick. You can get these from your vet. Since her glucose levels became regulated her appetite has been pretty good though she has short lived moments of inappetence or just plain finickiness. You should always do a test before her shot and before feeding her. I make sure Ruby has her head in the bowl eating when I give her her shot or has eaten shortly before as you shouldn't give insulin if the cat won't eat.

Very often when a dose is increased, cats go through what we call here New Dose Wonkiness, where BG levels are elevated for a short period of time before they start to go down, but we don't know where Susie's BGs are because you're not testing enough.

 

I agree. I am not testing enough. My fear of her being ill forced me to test twice today. It gave me a little confidence to do more testing especially when she is not "normal". Hopefully, she will eat a good meal tonight and I will be able to sleep. It is strange to me that with her glucose levels being pretty good today she still has no appetite. Thanks for getting back with me, Katherine.

 

You're very welcome! It's hard to say that her glucose levels are pretty good today because you only have data for 2 out of the last 24 hours. You should try to test before every shot and at least once or twice in between shots to get a fuller picture of what's going on. She could be bouncing into very high numbers and we're just not seeing that because there aren't tests.

Did your vet rule out pancreatitis?

 

Hi Summer,

Here's a helpful page on nausea symptoms and treatments (licking the juice but leaving the rest when normally a kitty would eat everything could potentially be due to nausea). If you recognise any of the symptoms in the list then that might be helpful info for your vet.

In the interim, I'd suggest raising Susie's food and water bowls a few inches (e.g. by sticking a couple of paperbacks under them) to see whether that might make it more comfortable for her to eat (no need to bend down to the food). I'd also suggest monitoring Susie's pee for ketones as a safety precaution.

If she doesn't start eating normally overnight I'd suggest asking your vet whether it might be advisable to run a test for pancreatitis (often a fellow traveller with diabetes).


Mogs
.

 

One can only speculate about what's happening without a preshot BG reading. The 302 reading at +9.5 would have been taken after the time when a Vetsulin dose has typically petered out. It's possible that the 302 might be somewhat elevated by bouncing. It's also possible that Susie's preshot BG may have been round about the same level as the +9.5 reading. Vetsulin typically produces bucket-shaped curves.

(When you have a minute, Summer, for safety and security I'd suggest taking down the pdf with the lab results, removing your personally sensitive info (addr) and then uploading an anonymised version.)


Mogs
.

 

Summer, please look at Ruby's spreadsheet, using October 29, 2020 as an example when we were still looking for the right dose. https://docs.google.com/spreadsheet...y8i6gV3whR0ZDyqUFzRGdSl_tI/edit#gid=361360320

You will see there are numbers in all colors of the rainbow on some days. The pinks and reds are Ruby bouncing from the green numbers. Once her liver got accustomed to lower numbers, she stopped bouncing and her numbers leveled out. This could be happening with Susie.

Nothing goes in a straight line with feline diabetes it seems, so try not to worry about numbers that bounce around a lot at the beginning. With consistent dosing, Susie should be able to level out.

 

Thanks, Mogs and Katherine. I was going to get a preshot reading this morning but Susie had gone in, during the early morning hours, and eaten her left-over dinner from the previous night so I didn't feel the reading would be helpful after she had eaten. Yes, I need to remember the "bouncing" aspect. Mogs, thanks for the advice about the blood test. I guess I can be too trusting. Katherine, I see the "bouncing" on Ruby's spreadsheet for 10/29. Happily, Susie's appetite seems to have returned. I gave her a shot at 6:30 and will test around 8:30. I have two additional questions. Can you reuse the lancets if you sterilize with hot water? Seems a waste to use them once then throw them away. Also, please recommend some good diabetic treats. I have tried the Purebites freeze dried but she does not like them. I would like to reward her with a treat after I test. As always - thank you, ladies!

 

Glad to hear this.

The tips of the lancets degrade markedly after even a single use, so they wouldn't be as sharp.

You could perhaps try poaching or baking chicken breast and cutting it up into treat-sized pieces. You could then freeze the diced chicken in small portions and thaw out one portion each day to use for post-test treats.


Mogs
.

 

Thanks, Mogs. Was hoping to find a treat I could buy but will buy chicken breast the next time I shop. I just got a 125 bg reading at +5 hrs 45 minutes. She is really hungry. Will check her blood again before I feed her dinner at 4:00 pm. I don't wait the 12 hours between the meals. Normally she cannot tolerate a 12 hour wait during the day.

 

I spoke with my vet today. He told me not to do too many glucose test. He doesn't want to stress Susie or me. He also said he does not want to change the insulin dose on a whim. He said it was more important that she is not stressed and that we keep the dose the same for now and allow her to graze on her food since she is not eating like she used to. Susie had her highest and lowest blood glucose today. I guess this is the "bouncing" but I will go along with what he says. No adjustment on insulin at this time. I will remain with the dosage and not feel the pressure to stress her with a test prior to her morning food and shot. I will give her the insulin injections 20 to 30 minutes after her morning meal and will test only a couple of times the remaining day. I have to go with my vet's recommendations and will not feel pressured to test constantly.

 

New Dose Wonkiness does not occur with Vetsulin Its specific to Lantus and Levemir.

 

Thank you, Marje. She only had two, maybe three days where she lost her appetite. Strange that on 1/4 and 1/5 she had a couple of good BG readings but these were the days she did not eat well. I cannot figure out this diabetes disease. Nothing makes sense to me but I continue to follow my vet's recommendations and we will see where it leads.

 

According to AAHA: "Note: When selecting products, veterinarians have a choice among those formulated for humans and those developed and approved by veterinary use. Manufacturers of veterinary-specific products spend resources to have their products reviewed and approved by the FDA for canine or feline use. These products are specifically designed and formulated for dogs and cats and have benefits for their use; they are not human generic products. AAHA suggests that veterinary professionals make every effort to use veterinary FDA-approved products and base their inventory-purchasing decisions on what product is most beneficial to the patient". I don't think that Lantus or Levemir were developed and approved for veterinary use - were they? Maybe this is why my Vet has prescribed the Vetsulin. Marge, what kind of food did you/do you feed Gracie to get her BG under control? How much? How often? Thank you.

 

What do you feed your kitty? I'm thinking Fancy Feast Classic is not the best but she would not eat the Hill's WD (too high in carbs anyway) and will eat the Royal Canine Glycobalance but not all the time? She never seems full. She only gets one 3 oz can in the morning and one 3 oz can in late afternoon.

 

I'm in the UK so we have a different range of cat foods available. Saoirse had chronic pancreatitis so that greatly limited what she could eat. She settled on Sheba Fine Flakes in Jelly pouches (chicken and turkey only). I used to weigh her weekly, keep a log of how much she was eating (adjusting amount fed as needed), and regularly assessed her physical form against a body condition chart.

Cats will be hungrier when they're in higher numbers (body can't use the nutrients properly).

Cats may get hungrier when they're in low numbers (but there's no guarantee they will be able to seek food, hence importance of testing mid-cycle).

I think that FF classics only have about 90-ish kilocalories per can. As a very rough guide, a cat should need about 20kcals per lb of ideal weight per day (more if trying to regain weight, less if weight needs to be lost). There's helpful info on calorie requirements and weight management at this link.


Mogs
.

 

Mogs, the link you sent has a lot of good information. I had read some of the "Feline Diabetes" section recently. I just wish I could understand what is going on. Susie is up and down, up and down even though I try to be consistent with the food and the times she is fed and when her shots are given. We just increased her insulin to 1.25 because she had a score of 446 on 1/8. I had never had a score that big and it scared me. Anyway, I appreciate your help. Maybe like someone tried to explain - she is "bouncing". I'm doing so much better with the testing. I never thought I would get to the point where I was comfortable but she is more comfortable with it now so that helps me. Wish I had a really low (in carbs) dry food that I could throw around the room to get her to chase for exercise. Or a really safe treat but it seems all dry food is bad. Thank you, again!