Introduction and HELP! Pls

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Charlene0718

Charlene0718

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Hi everyone!

Thank goodness for this page. My name is Charlene and my lovely lovely diabetic cat is Sir Thomas. I've had Sir Thomas for about 5 years now, and he is somewhere between 10 and 12 years old. I got him form the shelter, and they said he was a skinny stray, and when he came to the shelter, he liked to eat all the other cat's food and was somewhere around 18 lbs when we got him, then we got him down to around 15 (still overweight I know). He is on atopica for a dermatis and constant sneezing and difficulty breathing through the snot that no other allergy medicine helped. I had a baby this year, and unfortunately, being preoccupied I missed some early symptoms. I noticed he was losing weight quite rapidly (suspected it was due to the atopica) so I took him in last week and they confirmed by sending of blood lab work that he was indeed diabetic, and it had nothing to do with his previous health concern. Because of covid, there really is no one except my husband to help and he works 60 hours a week.

His blood glucose was 18 and 19 at 2 vet visits. They instructed me to start doing a curve and test every 2 hours. Before insulin he was between 14 and 17 on the meter. Well I have a needle phobia (free exposure-therapy now, haha) so it really took me a while to figure this whole testing thing out but I kept poking him every two hours until now we consistently get it. It has now one and a half weeks since his diagnosis and he has received an insulin shot yesterday and today. Yesterday, his blood sugar was 17.7 and we gave him his starting dose of insulin (lantus, 3 units) as per the vet). Well by the morning he was at a 2! I panicked,called the vet and he instructed honey. I did this and we were able to get back up to 6. Eventually over the day he went back up to 15 by the time for his scheduled insulin dose at 8:30p. Now it is 1:30a and he is at 5.6. I am so affraid he is going to go hypo again, but he stopped eating and drinking sometime in the evening today. I have tried fancy feast, friskeys, lickable treat, freeze dried treats....everything. I will call his vet as soon as the office opens at 9 but any advice would be greatly appreciated!
 
Charlene0718 said:
Thank you! his blood glucose is 5.6 on the meter. I am not even sure what to do other than to give him honey when he goes below 5. But he is not eating or drinking so any advice is really appreciated! I am scared to go to sleep with that number
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You shouldn't go to sleep before you know for sure, his number is staying up. Honey wears of quickly, so just wait..
 
Charlene0718 said:
Thank you! his blood glucose is 5.6 on the meter. I am not even sure what to do other than to give him honey when he goes below 5. But he is not eating or drinking so any advice is really appreciated! I am scared to go to sleep with that number
Click to expand...
How long since you gave the shot? I can't see the SS (needs to be shared).

What diet is he on?
 
So 3 units is too high a starting dose. Especially considering that 18 or 19 mmol is not so high as far as numbers go. Especially if you throw in stress from the vet visit.

What are you feeding him? Was a food trial attempted before starting insulin? That is, if you were feeding high carb dry or canned food, was he switched to a low carb canned or raw diet to see if he can be regulated with just a diet change? Would you know if the vet tested for ketones?
 
Bandit's Mom said:
How long since you gave the shot? I can't see the SS (needs to be shared).

What diet is he on?
Click to expand...

It has been about 5 hours since the shot (2nd shot). Yesterday was his first shot at 3 units but when I woke up he was at 2 so then the vet instructed to reduce to 2 units today when he was at a reading of 14 so that is what he has had. I haven't had time to figure out the spreadsheet yet, I don't really understand the lingo but I am working on it :)
 
Bandit's Mom said:
So 3 units is too high a starting dose. Especially considering that 18 or 19 mmol is not so high as far as numbers go. Especially if you throw in stress from the vet visit.

What are you feeding him? Was a food trial attempted before starting insulin? That is, if you were feeding high carb dry or canned food, was he switched to a low carb canned or raw diet to see if he can be regulated with just a diet change? Would you know if the vet tested for ketones?
Click to expand...
No food trial was completed, the vet gave me a prescription food he wont touch (although he now has stopped eating all together but I wonder if it is because he feels crummy).

I bought some fancy feast and he has friskeys pate but he wont touch anything at the moment. He is dehydrated and struggling to use the litterbox i think because i saw him rubbing his fanny on the ground after which he never does. I was desperate for him to eat anything so I offered him treats which worked earlier in the day, but not anymore
 
Bandit's Mom said:
So 3 units is too high a starting dose. Especially considering that 18 or 19 mmol is not so high as far as numbers go. Especially if you throw in stress from the vet visit.

What are you feeding him? Was a food trial attempted before starting insulin? That is, if you were feeding high carb dry or canned food, was he switched to a low carb canned or raw diet to see if he can be regulated with just a diet change? Would you know if the vet tested for ketones?
Click to expand...

I don't even know what ketones are, but I will totally ask tomorrow! and i wondered if that was high after reading some things on here. Thank you so much for this info!
 
Charlene0718 said:
It has been about 5 hours since the shot (2nd shot). Yesterday was his first shot at 3 units but when I woke up he was at 2 so then the vet instructed to reduce to 2 units today when he was at a reading of 14 so that is what he has had. I haven't had time to figure out the spreadsheet yet, I don't really understand the lingo but I am working on it :)
Click to expand...

So 5.6 is still a safe number. No need to intervene with honey yet. Is he still refusing to eat anything at all?

For everyone to be able to view the spreadsheet, you need to go the "Share" option and choose "Anyone with link can view"
 
Bandit's Mom said:
So 5.6 is still a safe number. No need to intervene with honey yet. Is he still refusing to eat anything at all?

For everyone to be able to view the spreadsheet, you need to go the "Share" option and choose "Anyone with link can view"
Click to expand...

Thank you, I fixed it! I will figure out how to interpret it and use it (I hope! lol). Yes he is still refusing. I even tried draining the liquidy gravy out of the can he normally loves and nothing
 
Charlene0718 said:
No food trial was completed, the vet gave me a prescription food he wont touch (although he now has stopped eating all together but I wonder if it is because he feels crummy).

I bought some fancy feast and he has friskeys pate but he wont touch anything at the moment. He is dehydrated and struggling to use the litterbox i think because i saw him rubbing his fanny on the ground after which he never does. I was desperate for him to eat anything so I offered him treats which worked earlier in the day, but not anymore
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What food was he eating before diagnosis? And when did he last eat today?

I would also ask the vet about why he's dragging his butt on the floor. One of the reasons is worms. My cat was doing that a couple of months back and had to be dewormed. That is not the only reason though.

Please do ask your vet about ketones too. This is very important.
 
Bandit's Mom said:
What food was he eating before diagnosis? And when did he last eat today?

I would also ask the vet about why he's dragging his butt on the floor. One of the reasons is worms. My cat was doing a couple of moths back and had to be dewormed. That is not the only reason though.

Please do ask your vet about ketones too. This is very important.
Click to expand...

He was eating hard kibble with Satiety Support, Royal Canine. Then I bought some fancy feast and friskeys to see what he would eat along with freeze dried treats. I am not sure when he last ate (I have 3 other cats that steal) but I suspect somewhere around 5pm when I last saw him take a couple licks, but nothing significant.

He ate a treat with his insulin, and refused all food which worried me.

Oh crap, no I am in Canada...I must have the wrong sheet? I thought I clicked the right one. I will go back :)
 
Charlene0718 said:
He was eating hard kibble with Satiety Support, Royal Canine. Then I bought some fancy feast and friskeys to see what he would eat along with freeze dried treats.
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Is he still eating kibble? Royal Canin Satiety Support?

How long is it since the last test? If it's more than an hour, can you get another one please?
 
No he is not eating the kibble or anything since this afternoon.

Royal Canin Satiety Support was his old food. Now I have tried* for the last two days to swtich him to fancy feast but no luck so then I tried friskeys and had some luck and now he is refusing all food and water.

I will go and get another test right now :)
 
Charlene0718 said:
Oh crap, no I am in Canada...I must have the wrong sheet? I thought I clicked the right one. I will go back :)
Click to expand...
When you can, please enter all the readings you have from the time you started testing (even if those were before you started insulin) till now on the SS.
 
Bandit's Mom said:
When you can, please enter all the readings you have from the time you started testing (even if those were before you started insulin) till now on the SS.
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Thank you for all your guidance! I added in the readings, not sure if I did it right and I think I have the right spreadsheet?

I just poked him 3 times and no blood for some reason, maybe dehydrated? I will try again
 
First of all, the dose of 3 units is too high a dose to start a kitty on.
If you are feeding a low carb wet diet, the starting dose is around 1 unit twice a day.

Do you have any food at all that he might eat. It doesn’t matter if it is unsuitable for a diabetic cat at the moment. We just want him to eat. Try sprinkling some Parmesan cheese over some food, or do you have some ham or similar meat...not great I know but we need him to eat. Or tinned sardines or salmon?
Also you may need to syringe some water into his mouth.
To see if he is dehydrated. Feel his gums....are they slippery or tacky?
Also lift up his scruff....does it snap back up stay up?

If you don’t have any Ketostix, I’m sure you probably don’t, make sure you buy some from a pharmacy as soon as possible to test the urine for ketones. This is really important. We need to establish if ketones are in the picture or not.

Is he lethargic?
 
Bron and Sheba (GA) said:
First of all, the dose of 3 units is too high a dose to start a kitty on.
If you are feeding a low carb wet diet, the starting dose is around 1 unit twice a day.

Do you have any food at all that he might eat. It doesn’t matter if it is unsuitable for a diabetic cat at the moment. We just want him to eat. Try sprinkling some Parmesan cheese over some food, or do you have some ham or similar meat...not great I know but we need him to eat. Or tinned sardines or salmon?
Also you may need to syringe some water into his mouth.
To see if he is dehydrated. Feel his gums....are they slippery or tacky?
Also lift up his scruff....does it snap back up stay up?

If you don’t have any Ketostix, I’m sure you probably don’t, make sure you buy some from a pharmacy as soon as possible to test the urine for ketones. This is really important. We need to establish if ketones are in the picture or not.

Is he lethargic?
Click to expand...

that is all so helpful, thank you! Wow, so much more info than the vet. I am a vegetarian and have no other meat- UGH! I will try parm and sardines too! THANK YOU . I do have a syringe so I can do that. He is more lethargic, but still walking around from time to time (or to hide from me).

He won't let me near his gums (he hates his allergy medicine atopica that I force by syringe), but his scruff seems to fall back down, I'm not sure if "snap back" though
 
Charlene you are doing great! Hang in there! It’s always hard in the beginning without any other issues to add to it.
With the syringing, make sure you point the syringe into the side of the mouth...the cheek and not give too much at a time.
I’ll link a thread about syringe feeding which might help
https://felinediabetes.com/FDMB/threads/syringe-assisted-feeding-videos-and-tips.144367/

And here’s a link to stimulating the appetite
https://felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

Are you on the west or the east coast of Canada?
 
Bandit's Mom said:
I have entered the BG values in the world tab (second sheet). Please do check if I have the numbers right?
Your shot time is 8:30, so we note down values with reference to that time. So 9:30 is +1, 10:30 is +2 and so on.

Some reading when things have calmed down a bit:
How to Use the Spreadsheet
Click to expand...
Thank you that makes so much more sense!! And THANK YOU. Oh m gosh, I would not have it together (emotionally or for my cat!) if it wasn't for you guys and your kind help!
 
Bron and Sheba (GA) said:
Charlene you are doing great! Hang in there! It’s always hard in the beginning without any other issues to add to it.
With the syringing, make sure you point the syringe into the side of the mouth...the cheek and not give too much at a time.
I’ll link a thread about syringe feeding which might help
https://felinediabetes.com/FDMB/threads/syringe-assisted-feeding-videos-and-tips.144367/

And here’s a link to stimulating the appetite
https://felinediabetes.com/FDMB/threads/suggestions-on-how-to-stimulate-kittys-appetite.130770/

Are you on the west or the east coast of Canada?
Click to expand...

Thank you for the encouragement and the resources!! I will check those out now.

I am more western in Alberta!
 
@Bron and Sheba (GA) should Charlene skip the AM shot? Especially if Sir Thomas is not eating? Or go down to 1U? We will not know about ketones till she is able to speak to the vet tomorrow morning.

If no ketones, should she try a food change and only then get back on insulin?
 
Bandit's Mom said:
I have entered the BG values in the world tab (second sheet). Please do check if I have the numbers right?
Your shot time is 8:30, so we note down values with reference to that time. So 9:30 is +1, 10:30 is +2 and so on.

Some reading when things have calmed down a bit:
How to Use the Spreadsheet
Click to expand...

Okay so helpful! I just rechecked and it was 2.7 so I used the sardine trick posted above and mixed with some honey and he ate some which is more than before so I am hoping it will be okay. Do I retest in 15?

And I will ask about keytones!

Just to clarify, only one daily shot at 8:30pm. So confusingly, I did the insulin at 8:30PM not 8am...so he was low at 10am the next day. Should I not do it at night? That is just the only time I have my husband home to hold the cat and my baby is in bed not interfering :)
 
Charlene0718 said:
I am more western in Alberta!
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OK, so it’s about 3.50am there, so not too many more hours before you can contact the vet. That’s good.

Bandit's Mom said:
@Bron and Sheba (GA) should Charlene skip the AM shot? Especially if Sir Thomas is not eating? Or go down to 1U? We will not know about ketones till she is able to speak to the vet tomorrow morning.
If no ketones, should she try a food change and only then get back on insulin?
Click to expand...

The shot is due at 8.30 am and the vet opens at 9 am, so I would be inclined to hold off on the insulin, call the vet first and ask if they tested for ketones.......mind you just because he may have tested negative to ketones at diagnosis, doesn’t mean he will be negative now.
I think the dose should be reduced to 1 unit unless there are ketones the urine.
I would not try a food trial first now that he has started insulin. They are not without their dangers.....ketones need to be checked daily if insulin is not being started.

Charlene, I don’t know how you are situated as far as getting to the vet early with a baby, but if you could collect a urine sample in the next few hours that could be tested for ketones at the vet, that would be good. It needs to new fairly fresh urine so closer to the opening time would be best.
Also I would ask about an antinausea injection such as cerenia as Sir Thomas could be nauseated and nauseated cats won’t eat. Also ask for some cerenia or ondansetron tablets to bring home in case he is still nauseated after the injection wears off.
My Sheba had no appetite for a few days after diagnosis and I struggled to get her to eat.
 
Bron and Sheba (GA) said:
OK, so it’s about 3.50am there, so not too many more hours before you can contact the vet. That’s good.

The shot is due at 8.30 am and the vet opens at 9 am, so I would be inclined to hold off on the insulin, call the vet first and ask if they tested for ketones.......mind you just because he may have tested negative to ketones at diagnosis, doesn’t mean he will be negative now.
I think the dose should be reduced to 1 unit unless there are ketones the urine.
I would not try a food trial first now that he has started insulin. They are not without their dangers.....ketones need to be checked daily if insulin is not being started.

Charlene, I don’t know how you are situated as far as getting to the vet early with a baby, but if you could collect a urine sample in the next few hours that could be tested for ketones at the vet, that would be good. It needs to new fairly fresh urine so closer to the opening time would be best.
Also I would ask about an antinausea injection such as cerenia as Sir Thomas could be nauseated and nauseated cats won’t eat. Also ask for some cerenia or ondansetron tablets to bring home in case he is still nauseated after the injection wears off.
My Sheba had no appetite for a few days after diagnosis and I struggled to get her to eat.
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I have to fix the spreadsheet, it is an error, it is actually 8:30pm I have done the shot. The vet just said to stick to one time every day and didn't say more than that so we chose 8:30 when my husband is home to help but I can learn to do it on my own and change it if we need. So he got his shot at 8:30pm tonight and now it is 4am

All super helpful! Also, how does one collect a urine sample??
 
Charlene0718 said:
Okay so helpful! I just rechecked and it was 2.7 so I used the sardine trick posted above and mixed with some honey and he ate some which is more than before so I am hoping it will be okay. Do I retest in 15?

And I will ask about keytones!

Just to clarify, only one daily shot at 8:30pm. So confusingly, I did the insulin at 8:30PM not 8am...so he was low at 10am the next day. Should I not do it at night? That is just the only time I have my husband home to hold the cat and my baby is in bed not interfering :)
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yes test again in 15 mins. 2.7 is too low. How much honey did he eat?
That’s good he ate some food.

Lantus is dosed twice a day not once a day........if he was so low at 10 am after having a dose at 8.30 pm, he could have been really low before you found the 36.
I don’t think your vet knows a lot about feline diabetes.
I think he is most likely lethargic from the low BGs.
Did you give 3 units again this the last dose.....I thought you said you gave 2 units but the SS says 3 units.
 
Charlene0718 said:
Okay so helpful! I just rechecked and it was 2.7 so I used the sardine trick posted above and mixed with some honey and he ate some which is more than before so I am hoping it will be okay. Do I retest in 15?

And I will ask about keytones!

Just to clarify, only one daily shot at 8:30pm. So confusingly, I did the insulin at 8:30PM not 8am...so he was low at 10am the next day. Should I not do it at night? That is just the only time I have my husband home to hold the cat and my baby is in bed not interfering :)
Click to expand...
2.7 is low and honey was needed. It's good he ate. Please test in half an hour?

Lantus is given twice a day. Did your vet ask you to shoot 3U once a day?

Gosh! What a night for you and what a scary introduction to insulin!
 
Bron and Sheba (GA) said:
yes test again in 15 mins. 2.7 is too low. How much honey did he eat?
That’s good he ate some food.

Lantus is dosed twice a day not once a day........if he was so low at 10 am after having a dose at 8.30 pm, he could have been really low before you found the 36.
I don’t think your vet knows a lot about feline diabetes.
I think he is most likely lethargic from the low BGs.
Did you give 3 units again this the last dose.....I thought you said you gave 2 units but the SS says 3 units.
Click to expand...
Yes I think you are right. I am so scared that more damage has already been done. I love this cat and will stay up all night until the vet and he is stable. Thank goodness I stumbled upon you guys.

I double checked, lantus: "give 3 units once every 24 hours"
 
Charlene0718 said:
Yes I think you are right. I am so scared that more damage has already been done. I love this cat and will stay up all night until the vet and he is stable. Thank goodness I stumbled upon you guys.

I double checked, lantus: "give 3 units once every 24 hours"
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We just need to get him through the next several hours and keep him in safe numbers....above 3 or higher if possible to give us some leeeway.
So just keep testing and giving him snacks of food if he will eat. Someone will stay with you all the time until the insulin has worn off. That could be past 8.30am looking at yesterday’s numbers. If his BG drops low and he won’t eat you will need to rub honey on his gums.

Hopefully no damage has been done. :bighug:
 
Bron and Sheba (GA) said:
We just need to get him through the next several hours and keep him in safe numbers....above 3 or higher if possible to give us some leeeway.
So just keep testing and giving him snacks of food if he will eat. Someone will stay with you all the time until the insulin has worn off. That could be past 8.30am looking at yesterday’s numbers. If his BG drops low and he won’t eat you will need to rub honey on his gums.

Hopefully no damage has been done. :bighug:
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Thank you all from the bottom of my heart! he wouldn't eat anything, not even more honey sardines. I tried to rub on his gums but he hates his mouth being touched so much and wasnt very successful so I put some thinned honey in a syringe and gave it that way... got maybe 14mls so not much but I hope it helps.

So recheck every half hour? Keep rubbing honey on his gums if I can since he won't eat?

Many, many thanks!
 
Bandit's Mom said:
Looks like you need a new vet. But our experience has been that most of them know very little about Feline Diabetes. They should at least know that Lantus is dosed twice a day for cats! :mad:
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Yes, well I saw a fill in vet when my vet was out so I hope that is just where it went wrong and my vet knows....but it did seem like she was consulting with him :|. I will say, that he has been excellent so far so I hope I can bring this information to him and make it work. He has done wonders in other situations!

I just retook and he is only at 3.8 then thats when I did the syringe of honey
 
Charlene0718 said:
Thank you all from the bottom of my heart! he wouldn't eat anything, not even more honey sardines. I tried to rub on his gums but he hates his mouth being touched so much and wasnt very successful so I put some thinned honey in a syringe and gave it that way... got maybe 14mls so not much but I hope it helps.

So recheck every half hour? Keep rubbing honey on his gums if I can since he won't eat?

Many, many thanks!
Click to expand...
It usually only takes a drop or two of honey to bring the BG up higher. Let’s see what it is next test.
If he won’t eat, you may need to keep the honey up so that the BG doesn’t drop too much.


Charlene0718 said:
Yes it is a human meter! I will update
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Phew! Great!
 
Bandit's Mom said:
You can even apply the honey to his lips/snout so he is forced to lick it off.

ETA: I've sent you a PM asking for the test data again, so I can verify what I have entered in the SS.
Click to expand...
Great tip on the honey! Okay, so he is now at 6.6. I am going to have a cat nap for an hour but my husband will get up and test him in half an hour and then I will test him at 6am (1/2 hour increments, hope that works!). As soon as the vet opens I will call with all of your information.

Again, I just cannot thank you all enough! Will update tomorrow when the vets office opens :)
 
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