New Member Saying “Hewwo!”

My Sonny is seven and a half years old, my husband and I have cared for him since we found him mostly starving to death as an outside stray 9week old kitten. He has always been food-oriented, and he stopped eating on Saturday night (2/6) which concerned us. He had “leftover” treats Sunday afternoon when my husband got up, and by the time I returned from work that night was feeling dumpy and not himself. (There are no such thing as “leftover” treats in our house. You can’t even say words that Sound Like treats aloud or Sonny will harass you into giving him some; ‘tweet,’ ‘trait,’ etc. He gets treats before the two of us shut him out of the bedroom at night, and if you’re not quick enough to get there before he scarfs them down you owe him a Second Helping.)

On Monday morning I noticed a LOT of urine in the laundry room floor, and he has never ever peed outside his box, ever. I called the vet for an emergency appointment and dropped him off. She called me later that afternoon to authorize a blood and urine sample, confirmed he was very dehydrated and we got the news that my boy is now diabetic.

Hubby and I went in for the consult and got shown how to give him his insulin, Lantus. The vet was AMAYSIN’ and gave me a ton of handouts and information. I got to practice giving Sonny his shot, and he also received a Convenia shot for bacteria in his urine sample. He gets 1 unit 2x a day and he’s absolutely the best boy for it.

Our vet suggested Purina Pro DM wet and dry for him, and our order from Chewy will be here tomorrow. We usually free-feed him fancy feast dry kibble and give him a wet food “dinner” when we eat, but my research tells me that’s not the best idea anymore. I’ve taken most of his dry bikkies up, (he still has 1/4 cup in the bowl, and I refill it if he empties) and he gets fed 2x a day at 7am and 7pm his wet food. Monday and Tuesday he HATED this, but he seems to be adjusting and realizing he gets to eat more wet food and more often. My hubby and I have tried schedule feeding him before and he would chase us around the house biting and swatting until he got what he wanted.

Nothing in the vet’s paperwork suggested blood sugars testing, although that seems to be pretty standard for diabetic kitty care? He has followup testing on Monday to see if what we’ve done so far has helped, and I will bring up testing then. I’ve watched a few videos and it doesn’t seem that daunting. (I work for a municipal animal shelter and sometimes have to give meds to difficult animals so at least I’m Experienced!)

Anyway, thanks for having us! This board has been a great resource so far.

 

Hello and welcome!!!!!!

Sounds like you're on top of all the major issues so far-- it's definitely A Lot when you start with FD, isn't it? I do have one question about the diagnosis, given how suddenly it seemed to come on: did the vet do a fructosamine test, or just a blood glucose test? Was this weekend the first time you noticed excessive urination? I ask because sometimes, cats' BG goes temporarily high because of stress at the vet, or even due to another illness. The urination does sound like diabetes, but if he's also fighting a UTI, wondering if that could have been the cause.... Anyway, for the remainder of this message, we'll assume it is diabetes and go from there!

Good job on researching the foods and yes, it's definitely the way to go to put him on a low-carb wet food diet. A strong word of caution, though: it can have a big influence on insulin needs when you remove carbs, so for safety, you should be doing BG testing before you complete the transition. We've seen cats whose blood sugar absolutely plummets when the carbs go!

If you're working on switching the foods now, I don't think I'd wait until next Monday to ask the vet about testing. Most of us here use human meters, with supplies purchased at local pharmacies (or Walmart-type stores) or online. The vets often recommend the pet meters like the AlphaTrak-- great meters, but the strips are extremely pricey for the amount of testing most of us do!

We have lots of tips to help get started on testing, and we love to help where we can. Welcome again!

 

That I don't know the answer to! I will have to call the vet tomorrow and ask, as I have seen others request this record and gotten help deciphering the cryptic numbers (most of that goes above my head). (I’ve asked the vet to email me the results and I’ll let you know when I get them!)

On my way home from work tonight I’m picking up a Reli-On Meter and strips from Wal-Mart and some lancets to begin testing.

This weekend was the first time he’s ever peed outside the box in probably his whole life, and it was a LOT more than usual. In addition to that he wasn’t eating, didn’t solicit attention from myself or my husband, wouldn’t respond to offers of treats, and was lying on the floor crouched down instead of lounging on the couches/beds we have for him. He was very vocally grumbling if picked up, as well. I don’t know much about UTIs as he’s never had one of them, either.

Sorry for the delayed response!

 

While you're at WalMart pick up some urine test strips to check for ketones. And some higher carb cat food with gravy and some syrup or honey in case you need it to bring his blood sugar up in a crisis. Also you might want to stop by the baby food section and get a couple of jars of baby food that is all meat (no onions or garlic) in case you need to entice him to eat.
What causes ketones is not enough insulin + not enough food + an infection or another stress. My kitty was a DKA (diabetic ketoacidosis) survivor and was in the hospital for 8 and 1/2 days. It is very dangerous, expense to treat, and not all cats survive it. I would try to check him for ketones tonight, and any other time he seems off (lethargic, not eating, vomiting, etc.). Anything above a trace in ketones needs a vet visit. Let us know what the result is.

 

I’m home with the things from the store and I am... frustrated. I’ve poked poor Sonny seven or eight times now and I just can’t seem to get it right for a reading. I want to cry. I had the purrfect blood drop and he squirmed away and wiped it on me. This is harder than I expected.

 

Ack!

Don't despair. It is hard at first, but soon you'll both get into the rhythm. Make sure he gets a treat each time, eventually he'll start to associate the pokes with treats and decide it's OK.

Getting a blood drop is a great first step. Next time you manage that, you can try collecting it on a fingernail-- that way, if he squirms away, you can still get the test!

 

I managed to get it this morning! Tested before his food and insulin was 134. I also pricked my own finger in the process. Treat reinforcement seemed to work really well!!!

 

Nice one!


Mogs
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Congrats and welcome to the kitty vampire club!

134 is pretty low for a pre-insulin number at this stage (still above the normal range for non-diabetics, 50-120). Did you shoot the 1U? Can you get a test in 3-4 hours to see how it affected the BG?

 

I did indeed give him his 1u, I won’t be home most of the day with work but I can test him when I get back.

 

Ah, I see. Will be interesting to see where he is when you get home. Does he have snacks to eat while you're gone, or is anyone at home to give him some?

 

He’s got some dry food to crunch if he wants it!

 

Couldn’t get a post-work sample tonight, trying to test the cat resulted in a spat between hubby and I over what’s really necessary for Sonny’s care. He thinks I’m hurting the cat for ‘no reason’ and putting him through ‘unnecessary tests’ since he gets ‘a teardrops worth of insulin’ and is ‘already doing loads better.’ Literally said I was “torturing” him. I’ll have to ask the vet on Monday for some literature to get him on board.

 

Some thoughts and some resources for you...

A teardrop's worth of insulin could be potentially fatal if given to a cat that only needs half a teardrop's worth.

Cats' insulin needs can vary over time. Just because a dose is safe today, it doesn't mean it will be next week. For example, a cat may start going into remission and the combination of a previously safe dose of injected insulin combined with pulses of insulin produced by the cat's pancreas - as may happen after a cat on the verge of remission has a meal - can be enough to take a cat too low.

Home monitoring of blood glucose levels and tracking of a kitty's response to their insulin treatment is far and away the best way to keep a diabetic cat safe when receiving insulin treatment. If it's the right thing to do to check a diabetic child's BG levels when giving insulin, then why not our beloved animal companions?

Attached below is the published, peer-reviewed study which is the foundation for the Lantus Tight regulation protocol (attached below). The document covers use of home BG monitoring as a fundamental part of the treatment protocol.

Also, here is another peer-reviewed journal article from the American Animal Hospital Association:

2018 AAHA Guidelines for Management of Diabetes in Dogs and Cats

From the above guidelines:

In cats, diabetic remission is a reasonable goal. Successful management of DM in cats consists of minimal or no clinical signs, owner perception of good quality of life and favorable treatment response, avoidance or improvement of DM complications, (specifically, diabetic ketoacidosis and peripheral neuropathy), and avoidance of hypoglycemia. Predictors of diabetic remission in cats include achieving excellent glycemic control within 6 mo of diagnosis, using intensive home monitoring, discontinuation of insulin-antagonizing medications, and use of insulin glargine (Lantus) or detemir (Levemir) along with a low-carbohydrate diet.

[Emphasis mine]​

As you can see, both of these professionally authored and reviewed sources consider home BG monitoring to be of great importance in the safe and successful treatment of diabetic cats. I hope the info is helpful to you, and might reassure the DH.


Mogs
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Thank you so much Moggie!

Sonny came to bother me about 15 minutes ago, and bit me to get my attention (strange for him). He was shaking a bit in the hindlegs, and he hasn’t eaten much of the DM wet food. I tested him and got a number of 144 at +4.45PM. I also tried to warm his ear with the heating pad before pricking him (my hands are always cold and don’t seem to do much) and I got a CONCERNING amount of blood. I had to wipe some off of him pretty fur. :T I went ahead and gave him some fancy feast mixed in with the DM and refilled his dry.

 

Hmmm, sounds like you might have hit the vein (we've all done it!). Just make sure to always apply some pressure after the poke to help stop bleeding and prevent soreness/bruising, it'll heal up fine. Cat's ears don't have as many nerve endings as human fingertips (or else they might be more cautious about getting into fights!) so while hubby's concern is very sweet, it's really not the case that you are 'torturing' Sonny. As Mogs explained, it's far better for Sonny to do the testing than to risk a hypo, and it gives you a much better chance to get him regulated and possibly to remission.

Since Sonny is so food- and treats-motivated, I bet it won't take him long at all to start to associate the testing equipment with yummy stuff. My cat used to come running any time I even looked like I might be going near our 'testing spot', just in case there were treats coming! Once your husband sees that testing is no big deal for Sonny, he'll come around, I'm sure.

To clarify, is that +4.45hrs after the shot, or was it 4:45pm by the clock (and if so, how many hours post-shot was that?)?

That's still a safe number and not near hypo territory, but the behavior is concerning. I wonder if he had gone lower earlier, but had started to bounce back up by the time you got the test? I'm really glad you are testing, as there are a lot of hints building up that Sonny may not need quite as much insulin as he is getting.

For the next shot time: try to get a test pre-shot. If you get another number under 200 (especially if it's under 150), stall (don't feed) and post here for help before shooting.

 

That thought crossed my mind too, Nan, particularly as Sonny hadn't eaten much of the DM food.

I've had a few gushers.




Mogs
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You're doing a great job, Ely. I'm proud of you, learning to test and set up the spreadsheet and signature so quickly, and wanting to help your Sonny.

My concern at the moment, is that I would not recommend changing the carb content of his food too soon, until you get more test data. Lantus will usually onset at about 2 hours after the shot and nadir at about 6 hours after the shot. The dosing of Lantus is determined by how low he goes, not the pre-shot test. The pre-shot tests are important too, they help determine whether his BG is high enough to need insulin that cycle. Because of the limited test data so far, and his not extremely high numbers, I would continue to leave out the dry food for him, for now, so that he can eat to bring his BGs up himself if you are at work / asleep, or unable to test.

 

Sonny is in full protest mode about the DM food. I’m mixing in some Blue Wilderness turkey now at 75% BW and 25% DM wet. He’s eaten a ton of his dry today, (probably 1/2cup, and he’s just been nibbling it for the most part this week) picking out the DM from the mixed in Fancy Feast. Sonny says this is BS.

For last night’s number, it was +4.45 after his shot. I’m trying for 7am and 7pm schedule.

Today he seems in good spirits and hasn’t acted weird aside from his food protests.

 

Sonny was a very good boy for testing this morning, and once he saw me gathering supplies he knew it was Treats Time. I was able to use the fingernail catch to avoid having to poke him too many times, and he was 106 at 7am before shot. He goes to the vet at 9 and they wanted him to have his insulin this morning so I gave it.
Overnight he ate almost 95% of the BW/DM mixture and all of his dry food. I do wonder if his numbers are affected because he’s more a ‘grazer’ than a ‘meal eater.’ He’ll eat a good amount of new food (1/4) when it’s refilled and then return to nibble consistently for 12 hours. I feel bad taking the food away if it isn’t eaten because I know he’s still hungry.

edit to add: last night he did the weird leg thing again around the same time; 4.5hours post shot at 11:30pm. His hind legs were trembling slightly and he did this weird squatty sit like he had a poop on his butt (he didn’t). I’m going to mention it to the vet because it makes me concerned.

 

My goodness!

Is he going for a glucose curve? I'll be very interested to see the results. Between this and the multiple events of hind leg shaking at +4.5 [edited because the emojis got weird; should have been just a ], I really suspect he's on more insulin than he needs but that doesn't mean he'll show that today (he could do a little 'bounce' up after last night's lows). So wait and see.

 

127 pre-vet visit at +1.45

 

We’re back from the vet! They did a glucose test there and we talked about home testing. She thinks it’s a great thing we already started and wants us to send her Sonny’s spreadsheet so she can check in on him too. I got a lot of credit for that but I think most of it should go to you fine folks! Our vet said she usually brings up at-home testing on the follow-up visit (so today’s appt) but understands that it’s not doable for everyone and can be daunting to pick up.

His BG level at the vet at 9:30a was 153. He also got microchippied while we were there. I mentioned his hindleg shakes and she said to make sure I get a reading next time he does it to make sure he’s not dropping too low.

Sonny has gained 1/2lb in the last week! He’s supposed to be losing some weight, but I guess as long as he’s eating I can’t be too mad at him. He’s now home and settling down again. Very upset we went to the Bad Mean Vet Lady again.

 

I’ve been trying to test every hour today, since I’m home on my day off. His numbers are swiftly climbing and I’m getting worried because I don’t know if that’s good or bad. Reading at 11:45am (+4.45AM) is 248!!

 

So, quick answer is that it's nothing to worry about right now. It does mean that you can probably stop testing hourly today (sorry Sonny, no more testing treats for a while!).

Longer answer: he's probably in what we call a "bounce," where his body is reacting to a lower-than-usual number sometime last night and releasing stored sugars to try to counter what it thinks was a hypo (it wasn't necessarily a hypo, just lower than his body is used to). This is just something diabetic cats do, especially early in treatment, and there's nothing to be done once you're in one other than wait it out. This can take up to three days , but often is shorter. It's just one of the frustrating things about FD, and one of the reasons we advocate so heavily for home testing and collecting lots of BG data on different days rather than doing occasional curves in the vet's office. If the curve day is a bounce day, you get a really skewed picture of what the dose of insulin is doing!

So, if he's decided to hit the trampoline today, you can probably give his ears a break until the next shot time.

One other possibility: are the treats you give for the tests high in carbs, by any chance? Not sure they'd cause him to go up to yellows, but you never know.

 

Thank you so much! That eases my anxieties a bit. As for the treats I have no idea. We got the Purina Pro Crunchy Bites, they say less than 2Kcal/treat. I also got a package of freezedried salmon treats and he won’t touch them.

 

I’ve been reading some other posts here today and I have accidentally only been giving Sonny .5 instead of 1. The vet tech told me 1 “line” was a unit, but the u30 syringes we have here at home actually have half-dose increments marked, too. I feel so stupid.

 

Don't worry about that at all, could be a happy accident! It just means that you started with 0.5U, and he's doing really well on even that small amount, spending lots of time in blue numbers. 1.0U might have been much too much...

 

But just to clarify... are these U-100, 3/10cc syringes (numbers go up to 30)?

 

Yep! We got a “prescription” for them to make sure they were the right ones.

 

Between feeling ill, and the meter being an absolute tantrum throwing baby today, I am at my wits end. Twice now I had the blood ready to test and while it was sucking it into the strip it turned off. Sonny is completely over it today, he’s reached his limit for the number of times he’s willing to let me jab him in a row. He’s eating well today, though. I wanted to get a +6 number for the SS but it’s just not in the cards today I guess.

 

Some you lose, Ely! Tomorrow's another day.

When are you switching the meter on? If it's one that gets activated when the strip is fully inserted you can partially insert the strip when you start and only insert the strip the full way when the ear's nearly warm enough. That should give you a bit longer before the meter times out. Have you tried the fingernail technique yet? Also, sometimes you might have some blood left on the strip for a failed test that would be sufficient for another test. If you pop a fresh strip into the meter you could try sipping the sample up from the first strip, no need to do another poke.


Mogs
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