New Member - newly diagnosed

[Sepi]

Hello. My name is Sepi. My 7 year old cat, Gary, was diagnosed on Nov 1st.
A few days before he had thrown up which led to him to stop eating, which lead me to my Vet. She did blood and urine and referred me to an Emergency Hospital because he was in ketoacidosis. They admitted him and he stayed four nights - released to me on Nov 5th with a 9000 dollar hospital bill, a Lantis insulin pen and limited information.
All I was told is that I was to give Gary 1ml of insulin twice a day 12 hours apart.
I was in a daze. When I was half way home I realized all they said about was diet was to only feed him twice a day and make sure high protein and low carb. When I called back for more feeding info they said 240 calories, and repeated two meals.
Never any info about monitoring, except the warning that if he looks wobbly or drunk to rub Karo syrup on his gums and call a vet.
Prior to diagnosis, Gary was eating 2.5 to 3 ounces of wet food in morning (wellness Turkey pate or Turkey Minced) and then1/4 cup of Instinct Limited Diet Dry Turkey at night (which turns out to have 27 percent carb!)
He weighed 13 pounds in Jan, and on Nov 1 he weighed 11.5!
When I got him back home on Tues the 5th, he did manage to eat his dinner. And I gave the 1ml. But to get him to finish the wet I did sprinkle some of the dry Instinct on top.
I bought Dr Elsey Dry Chicken (under 5g carb) just to help the transition to total wet.
Let me cut to the chase. I'm so sorry I'm rambling. But he was doing fine until Friday night. He ate some but I'm thinking now that I probably shouldn't have given him the 1ml. At 5am I heard that dreaded wretching noise and I went downstairs and he had projectile vomited. It was mostly water but it was a lot! I panicked and called the Vet Hospital. They said don't give him breakfast, and NO insulin. Give him a small lunch..if he keeps it down do his 730pm meal and then insulin. Again, I have no meters! That was to be discussed next week at my Vet when they do his curve. But, they said if he continues to throw up he should come in to the hospital. Of course, he throws up liquid two more times around 8am so I call the vet and they say come immediately.
His initial BG was 343, and the Doc said he was worried that Gary could be going back into Ketoacidosis so he wanted to do additional blood and urine. Turns out he was NOT in acidosis, thank goodness. But they said he should stay overnight for fluid and to monitor.
Can anyone help me understand what I need to mange him? A way to measure seems key. When to panic. I probably should not have brought him in yesterday. Now he is probably really stressed!!! Ugh.
And it seems that this 2 giant meals a day is bull.
Thank you in advance!

 

[CORKY]

Hello. My name is Sepi. My 7 year old cat, Gary, was diagnosed on Nov 1st.
A few days before he had thrown up which led to him to stop eating, which lead me to my Vet. She did blood and urine and referred me to an Emergency Hospital because he was in ketoacidosis. They admitted him and he stayed four nights - released to me on Nov 5th with a 9000 dollar hospital bill, a Lantis insulin pen and limited information.
All I was told is that I was to give Gary 1ml of insulin twice a day 12 hours apart.
I was in a daze. When I was half way home I realized all they said about was diet was to only feed him twice a day and make sure high protein and low carb. When I called back for more feeding info they said 240 calories, and repeated two meals.
Never any info about monitoring, except the warning that if he looks wobbly or drunk to rub Karo syrup on his gums and call a vet.
Prior to diagnosis, Gary was eating 2.5 to 3 ounces of wet food in morning (wellness Turkey pate or Turkey Minced) and then1/4 cup of Instinct Limited Diet Dry Turkey at night (which turns out to have 27 percent carb!)
He weighed 13 pounds in Jan, and on Nov 1 he weighed 11.5!
When I got him back home on Tues the 5th, he did manage to eat his dinner. And I gave the 1ml. But to get him to finish the wet I did sprinkle some of the dry Instinct on top.
I bought Dr Elsey Dry Chicken (under 5g carb) just to help the transition to total wet.
Let me cut to the chase. I'm so sorry I'm rambling. But he was doing fine until Friday night. He ate some but I'm thinking now that I probably shouldn't have given him the 1ml. At 5am I heard that dreaded wretching noise and I went downstairs and he had projectile vomited. It was mostly water but it was a lot! I panicked and called the Vet Hospital. They said don't give him breakfast, and NO insulin. Give him a small lunch..if he keeps it down do his 730pm meal and then insulin. Again, I have no meters! That was to be discussed next week at my Vet when they do his curve. But, they said if he continues to throw up he should come in to the hospital. Of course, he throws up liquid two more times around 8am so I call the vet and they say come immediately.
His initial BG was 343, and the Doc said he was worried that Gary could be going back into Ketoacidosis so he wanted to do additional blood and urine. Turns out he was NOT in acidosis, thank goodness. But they said he should stay overnight for fluid and to monitor.
Can anyone help me understand what I need to mange him? A way to measure seems key. When to panic. I probably should not have brought him in yesterday. Now he is probably really stressed!!! Ugh.
And it seems that this 2 giant meals a day is bull.
Thank you in advance!

Welcome Sepi, it is overwhelming what you are going thru, but manageable, all of us have been there, the first thing you should do it take a step back breath and breath out, our cats are very sensitive to feelings, and they feel our stress, in order to help you and answer all your question we need more information about what insulin, how many doses a day feeding schedule etc, even lab work results and diagnosis, below are several links so you can create your signature and spreadsheet, this way we all can monitor the daily insulin intake and BG numbers, the sooner you create them the faster we can help to answer your concerns, You are in the right place this a Worldwide Forum with many expert that can help you along the way, in the meantime that you input the information, I will tag another member that can answer some of your concerns also, in the Main Forum are sticky notes with valuable information
@Bron and Sheba (GA)

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

[Sepi]

Welcome Sepi, it is overwhelming what you are going thru, but manageable, all of us have been there, the first thing you should do it take a step back breath and breath out, our cats are very sensitive to feelings, and they feel our stress, in order to help you and answer all your question we need more information about what insulin, how many doses a day feeding schedule etc, even lab work results and diagnosis, below are several links so you can create your signature and spreadsheet, this way we all can monitor the daily insulin intake and BG numbers, the sooner you create them the faster we can help to answer your concerns, You are in the right place this a Worldwide Forum with many expert that can help you along the way, in the meantime that you input the information, I will tag another member that can answer some of your concerns also, in the Main Forum are sticky notes with valuable information
@Bron and Sheba (GA)

https://www.felinediabetes.com/FDMB/threads/new-how-you-can-help-us-help-you.216696/
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

Thank you. I can pick Gary up at 1pm Eastern today. I will get the BG numbers and create the spreadsheet.
He is on 1/unit Lantis twice a day

 

[CORKY]

Thank you. I can pick Gary up at 1pm Eastern today. I will get the BG numbers and create the spreadsheet.
He is on 1/unit Lantis twice a day

@Suzanne & Darcy

 

[Sienne and Gabby (GA)]

First, feline diabetes is a manageable condition and many cats have a good quality of life even though they are diabetic. So, take a deep breath because we are going to inundate you with information. It's going to be overwhelming at first. That's a normal reaction. It gets lots easier.

It sounds like you've figured out the low carb diet idea. This is a link to a food chart that has information on the carbs in most canned foods available in the US. We consider low carb as under 10%. However, most members here feed their cat a food that's in the 5% range. There are lots of choices.

Your vet prescribed a good type of insulin for Gary. That's a plus. Also, call a local pharmacy to find out if you need a prescription for insulin syringes. Some states require a prescription. If so, ask your vet to write an Rx for U-100 3/10cc syringes with half unit markings. If the vet tells you to use the insulin pen, please let the vet know that you waste one unit of insulin every time you use the pen and after a $9000 vet bill, money is a bit tight. The other, better reason is that the pens allow you to dispense insulin in 1.0u amounts only. We recommend dose changes in 0.25u increments. You need a syringe to do that. You can purchase insulin syringes from Amazon without a prescription.

You will also want to pick up Ketostix or any brand of urine test strips for in order to test for ketones. We strongly recommend that any cat with a recent history of ketoacidosis be regularly tested (e.g., at least daily) for ketones. Ketones develop due to the presence of in infection or inflammation, not enough food, and not enough insulin. So, it's important that Gary eats. You do NOT need to feed him only twice a day. Given the weight loss (which is common in diabetes), you can feed him whenever he's hungry. The only exception is that you do not want to feed Gary 2 hours before shot time since you don't want the pre-shot test result to be influenced by food. It's not necessary to give Gary his entire meal at shot time. This is more the case with insulin other than Lantus since most of the other insulins have a quick onset and food needs to be onboard before you give a shot. With Lantus, the insulin takes about 2 hours for onset to occur for most cats. You have a window before the insulin kicks in. With Lantus, you test, feed, and shoot all within a few minutes. I would give my diabetic cat several small meals over the first several hours after her shot and initial meal.

With a post-ketoacidotic cat, you want to be feeding Gary about 1.5 times the amount of food he was ordinarily eating. If his appetite is still off, talk to your vet about an appetite stimulant. Also, is Gary taking any other medications? If he's prescribed an antibiotic, it may be effecting his appetite. The biggest thing to watch for is Gary's behavior. Is he lethargic? Or looking nauseated? The lethargy can be a sign of ketones developing. There are meds for nausea. This is our primer on ketones.

If you haven't already purchased a glucometer, please get one. It's the only way to know if Gary's blood glucose numbers are in a safe range. Many people here use the Walmart Relion meter since the strips are the least expensive around. However, any human meter is fine. If the vet tells you that you must use a pet specific meter, nod your head, thank the vet for the advice and then point out that the strips cost about $1.00 each. (The Relion strips are about $0.17 each.) Also, ask the vet what type of meter they used in the office about 15 years ago. (I'd bet it was a human meter and in addition, many vets are suggesting caregivers use a Freestyle Libre with their cats. This is a continuous glucose monitor and there's sensor that's attached to your cat. You can read the results on your phone. A Libre is a good option if you do not want to poke your cat's ear. It's also a human monitor.) This is a link to information on home testing. There's written information along with videos.

If you want to read more about Lantus, this is a link to the Lantus board. There are sticky notes at the top of the board that will provide a great deal of background information about Lantus and its use. There's also a sticky note on dosing methods.

Please let us know what questions you have. The members here are very generous with their time and their knowledge. We're here to help.

 

[Diane Tyler's Mom GA]

Here is the link for the meter and test strips so you don't have to search for them
Relion Premier Classic Meter at Walmart for 9 dollars
https://www.walmart.com/ip/ReliOn-Premier-CLASSIC-Blood-Glucose-Monitoring-System/552134103

The tests strips are 17.88 for 100
https://www.walmart.com/ip/ReliOn-Premier-Blood-Glucose-Test-Strips-100-Count/575088197
At least if you need more test strips you can run into Walmart and pick them up or if you're running low you can just order them from Walmart

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
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

Try putting a thin layer of Vaseline on the ear so the blood will bead up
Here's a video one of our members did ignore where she had to code her meter because she is using a pet meter. With a human meter you don't have to
VIDEO: How to test your cat's blood sugar

Here is the link to set up our spreadsheet, where you can track your cats BG numbers, it also explains howto use it. You can look at anyone's spreadsheet to see what it looks like
https://felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/


You can order the U-100 syringes with half unit markings from Amazon without a doctors script
https://www.amazon.com/UltiCare-31-Gauge-Veterinary-Insulin-Syringes/dp/B009LTE0DO


Just take the cap off the pen and use a U100 syringes and pull the insulin out of the pen! You will see a small gray rubber stopper, insert the syringe there

We use the syringes because with using the pens you can only adjust the dose by whole units with a pen so we use the syringes since we either increase or decrease by 0.25 units at a time

@Sepi

 

[Diane Tyler's Mom GA]

Can you set up your signature
Your signature should be in gray letters, do you see mine at the end of my post
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet

• Add info we need to help you:
  • Caregiver & kitty's name
  • DX: Date
  • Name of Insulin (do not include dose or frequency)
  • 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)
  • Bexacat or Senvelgo (if applicable) and dates
  • 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.
  • Please do not put any information about your location in the signature for security reasons. If you wish to add your country location, please add it to your profile.

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.

@Sepi

 

[Sepi]

Thank you all so much. I will get the meter this morning.
The only other med is an appetite enhancer and a few doses of anti nausea in case he throws up.
If he eats any amount , do I give him the Insulin? So it doesn't have to be the full 122 calories a meal that they said?

 

[CORKY]

Thank you all so much. I will get the meter this morning.
The only other med is an appetite enhancer and a few doses of anti nausea in case he throws up.
If he eats any amount , do I give him the Insulin? So it doesn't have to be the full 122 calories a meal that they said?

a good appetite enhancer you can ask your Vet he should have it in the office here in Miami Fl is $37.89, is a small tube but it goes a long way for is called MIRATZ, it's applied inside the upper fold of the ear a small amount, rub and exchange ears for 5 days, most likely he'll be starving on the first application, you're doing great!! keep asking

 

[Diane Tyler's Mom GA]

@Sepi
When you get the meter can you add the name of it on your signature, and I would also add
recent history of ketoacidosis.
When you get your spreadsheet set up fill in the top where it asks you Date Dx
Insulin
Dosing method
Meter

You can read all the yellow stickys here about Lantus
https://felinediabetes.com/FDMB/forums/lantus-levemir-biosimilars.9/

If you are feeding any dry food you will have to follow the SLGS dosing method
Add that to your signature and Spreadsheet up top

 

[Sepi]

Hi I'm at Walmart and got the Relion. But they don't have the Control Solution. I'm guessing I do need to call around to get that before I can use the monitor?

 

[Diane Tyler's Mom GA]

Hi I'm at Walmart and got the Relion. But they don't have the Control Solution. I'm guessing I do need to call around to get that before I can use the monitor?

@Sepi
I've never used the control solution at all
If you want it I googled it


To get control solution for a ReliOn blood glucose meter, you can call customer service or request it online:

• ReliOn Premier CLASSIC: Call customer service at 1-833-256-3561 or request online at supplies.relionbgm.com
• ReliOn Platinum: Call customer service at 1-800-819-1097 or request online at supplies.relionbgm.com

 

[Sepi]

@Sepi
I've never used the control solution at all
If you want it I googled it


To get control solution for a ReliOn blood glucose meter, you can call customer service or request it online:

• ReliOn Premier CLASSIC: Call customer service at 1-833-256-3561 or request online at supplies.relionbgm.com
• ReliOn Platinum: Call customer service at 1-800-819-1097 or request online at supplies.relionbgm.com

Thank you. I think I got the wrong Lancets. It appears I got the pressure activated. I used one on me this morning and I can't imagine Gary tolerating that. Can you tell me which brand you all use to free hand the poke? Mine are ReliOn 50 Single use safety lancets. 25g x 1.8 mm depth.
Thank younagain.

 

[Diane Tyler's Mom GA]

Thank you. I think I got the wrong Lancets. It appears I got the pressure activated. I used one on me this morning and I can't imagine Gary tolerating that. Can you tell me which brand you all use to free hand the poke? Mine are ReliOn 50 Single use safety lancets. 25g x 1.8 mm depth.
Thank younagain.

Get 26 or 28 gaugel lancets any brand will do
I always did it freehand
@Sepi