New Member! Introduction and help needed pls.

New Member!!! Please forgive me if I’m posting in the wrong place. I have been trying to figure out this site for over an hour now

My little girl MISSY is a 10 year old long hair sweetheart. She is the light of my life and I will do anything to help her live a long, happy and healthy life.

I’ve been noticing her losing weight and the hair on her ears getting thinner. I also noticed some weakness in her back legs because she was having trouble jumping as high as she used to. I took her to our vet for a checkup and blood work approx 3 weeks ago. She was diagnosed a diabetic. I live in BC, Canada so I’m not sure how I should be charting her blood sugar measurements. We measure in mmol/L.

My vet was very vague and quite frankly absolutely shocked me at how little he told me. He is so well respected and sought after in our community. He at first prescribed 0.1 unit of Humulin insulin once per day. Didn’t mention a thing about changing her diet or home testing. Thankfully I don’t always listen to doctors and did my own research. I discovered she should NOT be using the insulin so I did not give her any. I also started home testing. I spoke to my vet and told him my concerns. He was humble enough to take a few hours and research my concerns and called to tell me that I was right. Humulin is not the insulin to be given. I told him her blood glucose at home has been between 16.6 - 13.5 mmol/L. He said he doesn’t treat anything unless blood glucose is consistently over 20 mmol/L. I know this is also incorrect.

I need to start her on insulin. I am a little afraid to do this without my vet consent so I’m making an appointment to see him this week. I want to have an idea of what insulin I should be starting her on and dosage. I will be tweaking it (with your help) if I need to. I faithfully test her at least 3x’s a day so I can determine the best dosage to start at and her typical numbers throughout the day. She is usually highest in the morning before food.

When she was diagnosed her GLU was 20.48mmol/L. The highest it’s been since then is 17.8 and that was only one time. Its usually 13.8-16.0

Her FRU (2 week average was) 387umol/L

I have since changed her diet to Fancy Feast pate. She will eat 3 cans per day or more sometimes. She is a happy girl, playful and sweet. Has a good appetite as well. I started weighing her weekly. Right after she was diagnosed I stopped feeding dry food and put her on a wet diet. She went from 9.8 lbs to 9.2 lbs. For the last 3 weeks she held consistent at 9.2 lbs. I’m wondering if she lost some weight at first because she no longer is drinking as much water as she was when she was eating the dry food.

I really don’t know where to start. I’m going to try and figure out how to do this spreadsheet that everyone is talking about.

Questions:
1. Best insulin to start with
2. Dosage?
3. Will she start to put weight on again?
4. Will hair grow back on her ears?
5. Will she regain strength in her back legs?

Thank you all so much for adding me to this group. I look forward to learning lots here. Thank you for caring to help us in this journey.

 

Hello!

I believe our spreadsheet has a World and US option so you can input your mmol/L numbers and another sheet will automatically translate it for us Americans.

Unregulated diabetics will lose weight because they are unable to utilize the nutrients in the food, so that is normal. A cat on a wet food diet is going to be getting significantly more water in them than on dry so I wouldn't be concerned with her drinking less.

Lantus!

Normally you start between .5 and 1 units unless you are going to use the Tight Regulation protocol, then I believe they factor in weight as well. If you have data already and make a Spreadsheet, you can go over to the Lantus forum and ask specifically what the best starting dose would be.

When she starts to get more regulated, yes. BG needs to but somewhat under control for the body to use food properly again.

Yes, once she is feeling better she'll start grooming herself again as well.

Yes. Muscle wasting is common in the beginning. It took my little girl several months before she could just up on chairs again. If she is showing signs of neuropathy (walking on her hocks) you can give her zobaline to help, otherwise she'll just need time to get better.

Welcome to FDMB!

 

Welcome
I see Elizabeth answered some of your questions as I am typing
Thanks Elizabeth


Hi there, you are not posting in the wrong place.
We have many members here from Canada
You couldn't have found a better place when it comes to diabetes.
All the members here are wonderful, they are very knowledge , they live it 24/7
365 days a year
If it wasn't for them and their advice my cat wouldn't be doing as amazing as he is


Great job researching that insulin and not using it


I can answer a few questions for you
Lantus is one of the best insulin for cats
Since you live in Canada you can purchase Lantus at Marks Marine in Canada
I might be wrong but I don't think you need a script to purchase it in Canada
I will post the link below for you

You are already ahead of the game by testing
I will tag 2 of our members who can set up the spreadsheet for you
Then you can fill in what numbers you already have
When it comes to dosing I am not that experienced to give advice, but the
more experienced members could probably tell you what to start with
going by the numbers you already have

She should put weight back on once you get her regulated
She probably has neuropathy in her back legs, that should also get better
once she's on insulin and regulated

My cat had the same problem, his legs are 99 percent better
You can also give Methyl B-12 which will help
I will post that also for you also.

 

https://rxcanada4less.com Marks Marine pharmacy

Here is the link for Canada with the pens we use them like a vial because with the pens you can only increase or decrease by whole units, so you would just take your syringe and stick it in the little grey rubber stopper and just draw the insulin from that







Lantus Solostar Cartridges 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $159.99 USD

Lantus Solostar PEN CAN (temp. gauge. ice pack, express-air mail) *single pen open box* Brand 100iu/ml one pen 3 ml $49.99 USD

Lantus Solostar PENS 5x3ml per box (temp. gauge. ice pack, express-air mail) Brand 100u/ml 15 ml $164.99 USD

Lantus VIAL Insulin (10ml per vial) (temp. gauge. ice pack, express-air mail) Brand 100u/ml 10 ml $110.99 USD


Like I said you are better off buying the 5 pack of pens
They will last you way over a year depending on how many units you give
After your vet writes the first script you won't ever need another script.
Call them and will tell you what to do
They are very nice people

Oh when you buy the pens they will have an expiration date on them
Most likely 2022 or 2023 by now.
Put them in the frig , a middle shelf
As long as you don't puncture them they will be good until the expiration date
So you are actually saving a ton of money


We also use syringes with half unit markings.
We increase or decrease by 0.25 units at a time.
It makes it easier using the half unit syringessyringes
For Lantus you will be using U-100 syringes

 

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

Here are the instructions for the spreadsheet, if you need help I am going to
tag 2 members who will help you

@Bandit's Mom

@Chris & China (GA)

Thank you ladies

 

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

This will explain how the spreadsheet grid works
I'm going to post an example for you also
This will appear after everyones signature ( which you will create once you
know what insulin you will be using and dose, meter , date diagnosed, etc look at mine it's at the end of my post in grey)

 

Understanding the spreadsheet
Here is an Example


+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 ,
+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 the 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.




Do not feed anything 2 hours before AMPS and PMPS
We feed the bigger meals during the AMPS and the PMPS
Then we feed smaller meals in between or any freeze dried treats
Most of us feed Fancy Feast Classic Pates
We try to stay under 10 % carbs most of the classics are 2 or 3 % carbs

I will post the food chart for you to look over

Perhaps 2 hours after giving insulin, then 4 hours after insulin , or 6 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



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

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 at the end of my posts, It says Tyler's spreadsheet , I also use
Lantus

 

Learn how YOUR kitty is responding to insulin:

• Onset - the length of time before insulin reaches the bloodstream & begins lowering blood glucose
• Peak/Nadir - the lowest point in the cycle
• Duration - the length of time insulin continues to lower blood glucose
• How to do a Curve - a simple explanation

 

https://felinediabetes.com/FDMB/thr...-low-go-slow-slgs-tight-regulation-tr.210110/

Dosing methods when using Lantus

 

https://felinediabetes.com/FDMB/threads/the-basics-new-to-the-group-start-here.18139/

Basics Lantus this is when you decide to start posting on the Lantus forum if that's
the insulin you choose to use

 

Here is the link https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
For the neuropathy

Alot of members use this , I use it myself you can buy it on line from Vitacost
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules
It's 17.99 just be sure this is the one you buy
Some use Zobaline
The only difference is the Zobaline has 200 mcgs of folic acid
So I buy the folic acid at the supermarket and crush it up and add it to the B-12
If you can't find the 200 mcg get the 400 mcg and cut it in half and crush it up
The Vitacost brand is a capsule so just open it and pour the powder on the wet food and I always add some water to the wet food.
Has no taste, no need to crush it up
The Zobaline is 33.99 for 60 pills, too expensive
I saw a big improvement I'd say 3 months, could be sooner. One capsule a day.
Once you get your kitty better regulated the B-12 methyl will help


Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

• SKU #: 835003001804
• Shipping Weight: 0.23 lb
• Servings: 100

 

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





You should also have these in the house if she ever drops too low and you need to bring her BG up. Also have honey or Karo in the hiuse
Such as




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

 

On a pet meter the take action number is 68. On human meters, it's 50, so going forward, that's the number you should remember.
Take action means if your kitty falls below these numbers , that's when you would need to feed either Medium or high Carb foods to bring the BG back up to safe numbers.
At times you can start with low carb foods,
You would always post for help if this happens and we will help advise you
The post could be something like this

Example
Help low BG 42
Something like that

 

Well it's 2:40 AM and I think I'm going to hit the sack
I hope this helped you some
It sounds overwhelming but you are already testing so you are ahead of the game
Just post when you have questions
I'm sure you will get more replies tomorrow
Missy is adorable

 

Hi and welcome Tammy and Missy.

So glad you checked out things and have found out bette options.
Great you are home testing the BGs....well done.
And also feeding a low carb diet.

One other thing I would do is go out and buy a bottle of Ketostix from a pharmacy and test Missys urine each day for ketones. It is an insurance policy especially if you are not starting insulin straight away. Ketones can form in unregulated diabetic cats especially if they are not getting insulin. So by testing the urine you are keeping her safe. Ketones can be managed if caught early.

 

Hi Tammy, let me know if you aren't able to set up the spreadsheet. Will be happy to do it for you.
Welcome

 

Welcome Tammy. What a beauty! Waving from Ontario, formerly of Vancouver Island.

Lantus does not require a prescription if it is for a cat. It can be bought at any pharmacy.

The forum mainly uses US numbers. You want to use the World Spreadsheet which will automatically change the numbers on the US spreadsheet.
FYI – to see what your cat's numbers are in US numbers, multiply x 18.

Some reading for your vet.

• (2018) AAHA Diabetes Management Guidelines for Dogs and Cats
• (2018) Managing Feline Diabetes: Current Perspectives

 

Welcome to FDMB!!

If your vet is well respected, he may be wonderful for everything other than feline diabetes. Unfortunately, we see that a lot. The good news is that your vet doesn't sound like his ego is as big as all outdoors and is willing to do his research. We can help him get up to speed.

There are 2 types of insulin that are recommended by the American Animal Hospital Association -- Prozinc and Lantus. Prozinc is formulated specifically for animals. Lantus is a long-acting, human insulin that you can get at any pharmacy. Since you're in Canada, you can go anywhere to purchase Lantus. The reason Marks's Marine was recommended is that they ship to the US. They are in BC but I don't know if they are convenient to you -- from what I can tell from their website, they are a regular pharmacy (i.e., have walk-in service) as well as mail order. Lantus is very popular here. The Lantus forum is the busiest of the insulin support group boards. If you opt to use Lantus, there is great information in the posts (i.e., "sticky notes") at the top of the Lantus board. There are two dosing methods -- Start Low and Go Slow (SLGS) and Tight Regulation (TR). TR has research supporting it's use and we can supply you with the protocol which you can share with your vet. SLGS was developed here and is used with both Lantus and other types of insulin.

There I s a ton of information above. If you are feeling overwhelmed, it's completely understandable. I was overwhelmed by the amount of information and I've been here for a long time.

Let me help you to consolidate. There are 2 things to do first -- set up your signature and spreadsheet. You'll also want to put together a "hypo kit" should your cat's numbers drop once you've started insulin. This post is for new members and it's geared toward helping you to help us. The most important first steps are learning how to home test and getting your cat on a low carb diet.

You've done great with changing Missy's food. Please let us know if you need any alternatives. We have a list of low carbohydrate foods that are available in Canada.

 

Thank you Bhooma

 

Hi Tammy,

Welcome to yourself and Missy. Love the pic of her in your avatar!


Mogs
.

 

I’m in Canada as well and I found that insulin from Marks is more expensive than from a pharmacy.

 

Waving "Hi" from west (wet) coast of B.C.

Don't buy insulin from Marks if you live in Canada, way too expensive. They are a regular brick and mortar pharmacy in Vancouver about 25 minutes drive from me, but why bother going there? Just buy in a people pharmacy. I found Lantus cheapest at Safeway pharmacy of all places. Superstore and Costco were the next cheapest alternatives. I originally got mine from Save On Foods - pharmacist there had a lot of kitty diabetic clients. Get the pack of 5 cartridges, not the pens. Cartridges are pen refills, cheaper and less waste.

A fructosamine of 387 is not bad at all, not a lot above the normal range.

 

Thanks Wendy I didn't know that about Lantus if you live in Canada.
If I ever have to buy it from Marks I'll get the cartridges if it's less waste
@Wendy&Neko

 

Unfortunately, cartridges cannot be shipped to the US, so it's an option for Canada only.

 

Thanks again
@Wendy&Neko