? NEW MEMBER 12/1 Legion — I’m new and so lost

[Dagraffman]

Hello all — I’m so sorry that this will be long and rambling but I’m barely keeping it together here.

Legion turned 7 in April and was just diagnosed the day before Thanksgiving after taking him to the emergency vet and having to be hospitalized for Ketoacidosis. He hadn’t eaten in two days and had clearly lost weight. Turns out he’s lost almost 4 pounds! 15 down to just over 11.

I’m trying to wade through everything here but I’m just so overwhelmed as I try to care for my wife who’s also been sick and our 9 yo son.

They gave him back to us Friday but he still isn’t acting like himself. Still very lethargic and not active. He can jump up to his food okay and uses his litter box but that’s it.

The emergency vet told me 2 units of glargine every 12 hours with food and prescribed Hills urinary/metabolic. Legion’s food for years has been free feeding on Hill’s OTC urinary (after some blockages back in 2021). I went and bought the new prescription food. He ate a little? But not much. Then after doing a ton of reading here I went and got the Fancy Feast Pate. He gobbles that up pretty good, but only about half a can, which seems like not enough?

And according to Doctor Lisa Pierson’s site switching over to the low-carb like that seems dangerous?

I’m terrified I’m going to accidentally send him into hypo shock. I don’t know how to proceed.

The emergency vet put a libre patch on him, but it didn’t work and they told me they couldn’t do another one. It then fell off yesterday.

I’ve bought a glucose monitor but was in tears trying to get a blood sample — have not been successful yet.

I have an appointment with his regular vet Friday. What do I do until then? I will continue to try to get a sample. I’ve been giving him 1 unit if he only eats a little and the full 2 if he eats “well” — but he’s still not acting normal.

Do I get wet food with gravy? IE: “high carb” food to get him closer to his old baseline, at least until we can see the regular vet? Is it to be expected that he’s “worn out” from his hospital visit for days afterward?

I’m at my wits end, and I’m neurodivergent — all advice appreciated, especially if you can be specific and step-by-step. Thank you so much.

 

[Tim & Pookey]

Jesse, hang in there. You are in the right place. I was in your position 2 weeks ago, and I can tell you it gets easier! The people here are so knowledgeable and helpful, they will help you with everything you need.

 

[Wendy&Neko]

Hello and welcome.

I’ve bought a glucose monitor but was in tears trying to get a blood sample — have not been successful yet.

That sounds like me in the beginning. Hang in there, and hang in there. I promise it will get easier. Did you see this post: Hometesting Links and Tips. A couple things I found really helpful, make sure you are using a 26 or 28 gauge lancet in the beginning. Once their ears learn to bleed, you can go to the smaller ones like a size 30. The second tip is a very small smear of Vaseline on the ear where you are going to poke. Those darn dark ears! The blood hides very easily in there, but the Vaseline helps it bead up and makes it easier to see and capture. Maybe try testing yourself too, to make sure you have the steps right. Some people use a lancing device, some people free hand with the lancet. Try both and see what works best for you.

Since you are switching to low carb, I'd keep some of the higher carb available at this point, so he can eat it to keep himself safe. Once you've got a handle on the testing, that's the time to switch to all lower carb diet, but still do it gradually.

Ketones - are you home testing for them with urinary ketones sticks (such as Ketostix)? There are also ketone BG meters, but lets get the blood glucose testing first. More on ketones and DKA in general for your education: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters. This post has a link to how to use the ketones sticks.

Please put DKA on diagnosis in your signature, that is very relevant to how we do things. He needs to eat about 1.5 times his regular amount of food. Did the vet give you any anti nausea medication like ondansetron or Cerenia? Many DKA cat are nauseous and he needs to eat lots at this point. Early on it's OK if it's higher carb food, just whatever he'll eat. You should also add water to his food, as water can help flush out ketones.

I'm going to stop there for now. Most important, feed him what he'll eat and lots of it. Give anti nausea medications if you have them. Work on practice testing with the Relion, and pick up some ketone test strips if you don't have them.

 

[Diane Tyler's Mom GA]

@Dagraffman
Welcome Jesse and Legion
You couldn't have found a better group to join
Can you please add to your signature DKA and the date and New Mexico.
I will tag a member who is very knowledgeable with DKA
About testing
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.Just keep rubbing the ears with your fingers to warm them up

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 he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming

PLEASE LOOK at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with


Sorry your wife has been sick and busy caring for your son. Legion is a handsome kitty

Is the
Hill’s Urinary+Metabolic c/d wet or dry ? Can you add if it's wet or dry after that

 

[Diane Tyler's Mom GA]

Hello all — I’m so sorry that this will be long and rambling but I’m barely keeping it together here.

Legion turned 7 in April and was just diagnosed the day before Thanksgiving after taking him to the emergency vet and having to be hospitalized for Ketoacidosis. He hadn’t eaten in two days and had clearly lost weight. Turns out he’s lost almost 4 pounds! 15 down to just over 11.

I’m trying to wade through everything here but I’m just so overwhelmed as I try to care for my wife who’s also been sick and our 9 yo son.

They gave him back to us Friday but he still isn’t acting like himself. Still very lethargic and not active. He can jump up to his food okay and uses his litter box but that’s it.

The emergency vet told me 2 units of glargine every 12 hours with food and prescribed Hills urinary/metabolic. Legion’s food for years has been free feeding on Hill’s OTC urinary (after some blockages back in 2021). I went and bought the new prescription food. He ate a little? But not much. Then after doing a ton of reading here I went and got the Fancy Feast Pate. He gobbles that up pretty good, but only about half a can, which seems like not enough?

And according to Doctor Lisa Pierson’s site switching over to the low-carb like that seems dangerous?

I’m terrified I’m going to accidentally send him into hypo shock. I don’t know how to proceed.

The emergency vet put a libre patch on him, but it didn’t work and they told me they couldn’t do another one. It then fell off yesterday.

I’ve bought a glucose monitor but was in tears trying to get a blood sample — have not been successful yet.

I have an appointment with his regular vet Friday. What do I do until then? I will continue to try to get a sample. I’ve been giving him 1 unit if he only eats a little and the full 2 if he eats “well” — but he’s still not acting normal.

Do I get wet food with gravy? IE: “high carb” food to get him closer to his old baseline, at least until we can see the regular vet? Is it to be expected that he’s “worn out” from his hospital visit for days afterward?

I’m at my wits end, and I’m neurodivergent — all advice appreciated, especially if you can be specific and step-by-step. Thank you so much.

@Bron and Sheba (GA)

 

[Mikey’sDad]

Jesse, font’s fret. The people on here are great. I was so overwhelmed when I got here, and didn’t think I could monitor him or give him shots and my anxiety is off the roof.
But 4 years later , things are totally different . My cat gets the routine and likes his food and I am great with the shot and monitoring .
I did find that if you rub his ear a bit before getting a blood sample, it makes it easier.
One of the experts on here will do a spread sheet for you.
You got this !
Tom

 

[Bron and Sheba (GA)]

Hi Jesse and Legion and welcome.
It is overwhelming in the beginning and if you also have a kitty with DKA it is that much harder.
But we can help you each day to get sorted.
As well as what Wendy suggested, don’t skip any doses of insulin. Lantus doesn’t onset for 2 hours after the dose is given.
If he doesn’t eat all the meal at once, you still have the following 2 hours to get him to eat the rest of the food.

It is food, insulin and fluids that will help keep the ketones away…this is why they are so important.

So you need to concentrate on:

• Lots of food. As well as the 2 main meals, give lots of snacks of food during the day and evening.
  Give an antinausea medication if needed. Post DKA cats are often nauseated.
• Give the insulin twice a day
• Add a teaspoon of warm water to all the meals and snacks if Legion will eat it.
• Test daily for ketones. It is important we know if there are any present at all.
• Keep trying with the hometesting. You will get there! We all failed in the beginning.

I am going to tag @Bandit's Mom to help set up the spreadsheet for you.

 

[cecile & bella]

Jesse, you are in the right place, and things will get better.
I spent a lot of time at the beginning crying and being frustrated and feeling I would never be able to help my cat. Now it's all routine, I test her, she waits, I get blood every single time and if it's not enough we try again.
Something that helped me at the beginning: warm the ear. Hold it between your fingers as you poke and after, they can shake their head and the drop goes away. Prepare the testing strip just after you poke but before you work the ear to get blood, or before you poke, it does not really matter.
Try on your finger to feel how much to push. I don't use the lancing device anymore, it scared my cat and me and did not really help, I could never figure out where it was going to poke. I hold the lancet in my hand and do it directly.
Hang in there and don't hesitate to come here and ask, ask again, tell us what's going on. That helps.

 

[Bandit's Mom]

Hi Jessie and Legion! Welcome to FDMB!
I can help set up your spreadsheet. Will send you a PM with the details I need. Look for it in the Inbox at the top right corner of this page.

 

[Dagraffman]

Jesse, hang in there. You are in the right place. I was in your position 2 weeks ago, and I can tell you it gets easier! The people here are so knowledgeable and helpful, they will help you with everything you need.

thank you! — everyone is already being so wonderful and helpful

 

[Dagraffman]

Hello and welcome.

That sounds like me in the beginning. Hang in there, and hang in there. I promise it will get easier. Did you see this post: Hometesting Links and Tips. A couple things I found really helpful, make sure you are using a 26 or 28 gauge lancet in the beginning. Once their ears learn to bleed, you can go to the smaller ones like a size 30. The second tip is a very small smear of Vaseline on the ear where you are going to poke. Those darn dark ears! The blood hides very easily in there, but the Vaseline helps it bead up and makes it easier to see and capture. Maybe try testing yourself too, to make sure you have the steps right. Some people use a lancing device, some people free hand with the lancet. Try both and see what works best for you.

Since you are switching to low carb, I'd keep some of the higher carb available at this point, so he can eat it to keep himself safe. Once you've got a handle on the testing, that's the time to switch to all lower carb diet, but still do it gradually.

Ketones - are you home testing for them with urinary ketones sticks (such as Ketostix)? There are also ketone BG meters, but lets get the blood glucose testing first. More on ketones and DKA in general for your education: Ketones, Diabetic Ketoacidosis (DKA), and Blood Ketone Meters. This post has a link to how to use the ketones sticks.

Please put DKA on diagnosis in your signature, that is very relevant to how we do things. He needs to eat about 1.5 times his regular amount of food. Did the vet give you any anti nausea medication like ondansetron or Cerenia? Many DKA cat are nauseous and he needs to eat lots at this point. Early on it's OK if it's higher carb food, just whatever he'll eat. You should also add water to his food, as water can help flush out ketones.

I'm going to stop there for now. Most important, feed him what he'll eat and lots of it. Give anti nausea medications if you have them. Work on practice testing with the Relion, and pick up some ketone test strips if you don't have them.

Thank you so so much for all this — I will focus on just getting him fed and the testing for now.

They didn’t provide any nausea medication or anything, nor any real guidance on feeding/portions outside of “the bag/can should have portion sizes.”

I’ll also look into the ketone strips — can you get those all Walmart or do I need to go to the drug store?

 

[Bron and Sheba (GA)]

I’ll also look into the ketone strips — can you get those all Walmart or do I need to go to the drug store?

You can get them at Walmart but they may be called something else. You can also get them at pharmacies.
If Legion is not eating as much as normal, it is very possible he is nauseated. Some symptoms of nausea are sniffing the food and walking away, licking some of the food but not eating it all, smacking lips.
If you think he could be nauseated ask the vet for some ondansetron or cerenia. Ondansetron is better for nausea and you will need a script from the vet for this and you get them at the human pharmacy. Many post DKA cats are nauseated.

 

[Dagraffman]

That actually very much describes how he’s acting, although tonight he did better. Half a can of Kirkland wet with gravy, then a little later (within the 2 hour window of his shot) he ate a Catit lickable treat and then the other half a can of the Fancy Feast pate from this morning, which he still seems much more into than anything else. But if I can supplement with the lickables and some of the higher carb stuff for now (to get him to baseline levels again) then we should be okay?

 

[Dagraffman]

@Dagraffman
Welcome Jesse and Legion
You couldn't have found a better group to join
Can you please add to your signature DKA and the date and New Mexico.
I will tag a member who is very knowledgeable with DKA
About testing
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.Just keep rubbing the ears with your fingers to warm them up

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 he won’t stand still, you can get the blood onto a clean finger nail and test from there.
When you do get some blood you can try milking the ear.
Get you finger and gently push up toward the blood , more will appear
You will put the cotton round behind his ear in case you poke your finger, after you are done testing you will fold the cotton round over his ear to stop the bleeding , press gently for about 10 or 20 seconds until it stops
Get 26 or 28 gauge lancets
A lot of us use the lancets to test freehand not the lancing device
I find it better to see where I'm aiming

PLEASE LOOK at the lancet under a light and you will see one side is curved upward, that's the side you want to poke with


Sorry your wife has been sick and busy caring for your son. Legion is a handsome kitty

Is the
Hill’s Urinary+Metabolic c/d wet or dry ? Can you add if it's wet or dry after that

This is all amazing info, thank you! I’ll make sure I’m using the right size lancets.

Thankfully my wife is slowly getting better herself so I’m sure we’ll get a handle on things!

Oh, and the Hill’s food is dry — I may just return it and forego that route altogether.

 

[Dagraffman]

Jesse, font’s fret. The people on here are great. I was so overwhelmed when I got here, and didn’t think I could monitor him or give him shots and my anxiety is off the roof.
But 4 years later , things are totally different . My cat gets the routine and likes his food and I am great with the shot and monitoring .
I did find that if you rub his ear a bit before getting a blood sample, it makes it easier.
One of the experts on here will do a spread sheet for you.
You got this !
Tom

Thank you Tom! That’s so good to hear that things are going so much better for you now. I’m so glad I found this group!

 

[Dagraffman]

Jesse, you are in the right place, and things will get better.
I spent a lot of time at the beginning crying and being frustrated and feeling I would never be able to help my cat. Now it's all routine, I test her, she waits, I get blood every single time and if it's not enough we try again.
Something that helped me at the beginning: warm the ear. Hold it between your fingers as you poke and after, they can shake their head and the drop goes away. Prepare the testing strip just after you poke but before you work the ear to get blood, or before you poke, it does not really matter.
Try on your finger to feel how much to push. I don't use the lancing device anymore, it scared my cat and me and did not really help, I could never figure out where it was going to poke. I hold the lancet in my hand and do it directly.
Hang in there and don't hesitate to come here and ask, ask again, tell us what's going on. That helps.

thank you so much! I think I might go the freehand route as well once I’m not so overwhelmed—the pen just seems rather cumbersome for such a small target!

 

[Bron and Sheba (GA)]

That actually very much describes how he’s acting, although tonight he did better

If you think he is nauseated please go to the vet and get some antinausea medication. He will feel much better and he will improve more quickly if he can eat well.

 

[Sienne and Gabby (GA)]

Welcome to FDMB -- the best place you and your cat never wanted to be!

Every member here has been where you are -- completely overwhelmed. It really does get easier.

One additional point. Many vets will tell you to feed your cat twice a day. In other words, to feed your cat at shot time. We've found that many cats are used to grazing or prefer to eat when they want to. The insulin you're using, glargine, doesn't kick in until an hour or two after you give a shot. As a result, it's fine to let your cat graze. In fact, it's a bit easier on your cat's system to provide several smaller meals during the first half of the 12-hour cycle.

Once the information is not quite so overwhelming, there are several "sticky notes" at the top of the Lantus/glargine forum that you may want to review. The notes will provide information on how this insulin works, dosing methods, and a general orientation.

Please let us know how we can help. The members here are very generous with their time and knowledge.