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Discussion in 'Feline Health - (Welcome & Main Forum)' started by FelixMomRachael, Jan 15, 2021.

  1. FelixMomRachael

    FelixMomRachael Member

    Joined:
    Jan 12, 2021
    Felix is 8.5 lbs and eats HS WD dry 1/4 cp (won't eat wet) 2xs a day. This is 1/2 rec for ideal weight so like the vet said I shot 1/2 U but he was tired and has not increased what he eats. It's was only three days on the new food and meds. Yesterday he ate the same and I gave him 1 U. He had more energy and seemed to be better. Vet did not like home testing but I still want to do it. Who knows what could happen in 6 months of not knowing his levels. I look forward to learning how to best help Felix have a happy life. Thank you in advance for your help and making me feel like I am not alone in this.
     
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  2. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Hi Rachael!

    Welcome to the forum. You will find people here is very data oriented, and will be reluctant to give advice without knowing his blood glucose. I have embarked in this "feline diabetes way of life" about 6 months ago, and the most surprising thing to me is how reluctant some vets are to home testing.... I don't know if you have noticed but at the bottom of our posts there is a link to our data sheets (A.K.A SS). You can peruse through many of the members and you'll see how much kitties behaviour change from day to day, and how often one of us have a brush with a hypo.... so testing a home is a very good idea, and if your vet doesn't like it, don't tell him ;) or find one that does!
     
  3. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Thank you and I will do an SS.
     
  4. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    We can overwhelm you with information pretty quick so I'll just share one more tidbit of info...Most of us use a human glucometer because it is much cheaper to run then a human one (strip costs are very high for an alpha trak2). I hear from the USA members that the relion that can be bought in most walmarts are good. There are videos on youtube on how to prick the ear and do the test, but if you run into trouble or have any questions, just let us know!
     
    Last edited: Jan 24, 2021
  5. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Vetsulin upped to 3U 1/20 after curve w hi #s on 1/19 +2 HI +4 697 +6 516 +8 662 +10 HI. Vet won't prescribe Lantus bc she wants him regulated. They haven't even given me the scrip for Vetsulin so I can order for $58 instead of paying them $113. I'm sorry I haven't done the ss yet. Also got Felix eating more wet than dry 3/4 can & 1 tbsp dry but he is ravenous.
     
  6. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Hi! Diabetic kitties are often very hungry because they do not process their energy well when their BG is quite high. Is Felix currently overweight or underweight? this webpage has a helpful picture to help decide: https://waunakeevetclinic.com/blog/146188-feline-and-canine-weight-chart

    If he is not overweight and is hungry you could try give him more food and monitor his weight. I usually step into a scale with and without Hercules. The weight wobbles a bit, but athe telling is whether is continuously going up or down. You can adjust the total amount of food to find a spot where he stays somewhat constant.

    Hercules has been on insulin for 7 months and he is still not "regulated", so I am not sure what your vet is talking about it.... we changed from prozinc to lantus to try and get him regulated ....
    Do you live somewhere where you have choices of vets?
     
  7. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Felix is underweight. Was 15 lbs, now 7.6 and rec is 10. He gained .2 so getting.there.Yes, there are other choices. I will look into it. They are not regular vet but mine was not capable of helping when Felix went DKA.
     
  8. Hercule's mum

    Hercule's mum Member

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    Hercs lost lots of weight before I figured out what was going on.... That is why I asked, because in this case you can feed him more if he is hungry! :)
     
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  9. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Will do, thanks.
     
  10. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

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    Dec 28, 2009
    Welcome to FDMB.

    I suspect with insulin issue is that your vet is more familiar with Vetsulin than Lantus. Vetsulin is also called Caninsulin outside of the US. As the name implies, it was developed for use with dogs. It is no longer recommended for use with diabetic cats by the American Animal Hospital Assn in their most recent guidelines. I've linked a copy of the guidelines and you may want to share the paper with. your vet. The AAHA recommends either Lantus or Prozinc. The issue with Vetsulin is that it is short acting and can drop numbers hard and fast. It wears off between 8 - 10 hours after a shot. From the numbers you posted above, it's no surprise that there was an upswing at +10. Lantus has a longer duration and is not harsh. Also, I'm not sure what increment your vet is suggesting increases but going from 1.0u to 3.0u in a few days is a big jump in dose. Please get tests to make sure your cat is in safe numbers.

    I would do whatever you can to twist your vet's arm to prescribing an insulin that is appropriate to a cat's metabolism.

    The other concern is that what you're feeding your cat is very high in carbohydrates. It's likely keeping numbers high. If your cat refuses to eat a low carb, canned food diet you have two options. Young Again Zero Carb is low in carbohydrates (it's not zero but its about 5% carb) or Dr. Elsey's Clean Protein is also a low carb dry food.
     
    Last edited: Jan 24, 2021
  11. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Thank you. I am working on giving him just wet food and I may have to see a different vet. I did the spreadsheet.
     
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  12. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    I just started him on Nutrish Peak wet food and his #s are finally going down. Today was the lowest I've seen since bringing him home from the hospital. 423.
     
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  13. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Excellent news!
     
  14. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Rachel,

    Now that you're onto changing diet, for safety it's recommended to get mid-cycle BG readings in addition to the preshots for both AM and PM cycles. BG levels can drop significantly when the carb load is reduced so it's important to check how low the insulin is taking them in case the dose needs to be adjusted.


    Mogs
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  15. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    He was HI amps & 509 @ +5 & HI pmps. I need to find another vet.
     
  16. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    You may want to consider increasing the dose while you find another vet.... not that I am an expert, but I see cats here with a higher dose, so it is a possibility given he is staying so high.
     
  17. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    385 amps so I'm reducing to 2U and I can't be home today until after 10+.
     
  18. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Hi Rachael, It is great that you will be home to test and get a better picture of what is going on.
    I should say though that insulin works better with constant doses, so people here do not reccomend changing the dose very often.
    Also, the dose should be determined by how low kitty goes on a given dose, not on BG values before shooting. There is quite a lot of variation in AMPS values, as you can see in hercules SS recently, but the aim is for him to reach green numbers and stay there as much as possible. So perhaps you can see that he has been on 0.75 units for a while, and even though he touchd green here and there, it wasn't very common. So I am trying a higher dose, which might be too much since I am having to give him a lot of higher carb food to prevent him for crashing, but I am going to try and hold for 3 days to see what happens.
     
    Last edited: Jan 27, 2021
  19. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Thank you. I have seen Felix go from above 750 to 423 so I didn't want to chance him going below 100 since I can't be home today. I need to figure out the correct amount of food and a fiber supplement.
     
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  20. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Vet's response to my request for Lantus and questions about food.
     

    Attached Files:

  21. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    :eek: (Sitting here with my Dramatic Kitteh face on.)

    Unreal! What an incredibly rude and condescending person!!!

    I very much agree. You need a vet who is collaborative in style, not dictatorial. Here's a useful forum info post:

    Finding a new vet / checklist of interview topics

    Rachel, you might need more help from us while you're finding a new vet. Therefore, please can I encourage you to get Felix's spreadsheet up to date as a priority and then keep it updated going forward. The reason I ask is that members replying to your posts will need this information to be current before they can make any suggestions on how to help you both. It would also be extremely helpful to both yourself and members helping you if you could stick a brief note of the food Felix is eating each day in the remarks column (brand, carb %), along with the results of Felix's daily ketone tests.


    Mogs
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    Last edited: Jan 28, 2021
  22. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Hi Rachel. I am fairly new here too (since 12/20). Don't let your vet tell you not to test. You must test if you are to be aware of Felix's blood glucose levels to keep him safe. Everything depends on these numbers and how he is eating and his activity level. When I first joined I was terrified of the testing. I could not bring myself to prick my cat Susie's ears. We are "old hat" at it now. Do the two pre-shot test and try to test during the mid cycle if you can.. You don't want to administer insulin if his blood glucose is too low. There are many, many things to learn but this group will help you with it.
    Your vet sounds horrible. You need another one that supports home glucose testing. I don't know where you live but this group can help you find fairly reasonable prices for the Lantus in Canada.
     
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  23. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    OMG! There are reluctant vets and there are rude vets! So sorry he talked to you like this!
    He is not righ, but even if he was, this is no way for someone decent to talk with anyone. "I'll treat Felix as I see fit"!!! Just out of spite I would ask, if this comes with guarantees of full health costs for treatment if he goes into a hypo?
    I hope you have plenty of vets to choose.
     
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  24. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi again, Rachel.

    I've just been having another look at your spreadsheet and it seems that you're putting the most recent readings closer to the top of the sheet (hence the reason why I thought the latest readings were missing).

    Is there any chance that you could reorder the data so that the test dates run oldest-->newest, top-->bottom of the sheet, as is the convention for all spreadsheets? If you wish I can find one of our spreadsheet bods to reorder it for you. Otherwise I won't be the only one getting confused! :oops: In particular, if you need help in a hurry, members replying will need to be able to assimilate the spreadsheet info quickly so it kinda needs to be where they expect it to be. :)


    Mogs
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    Last edited: Jan 28, 2021
    Reason for edit: Grammar.
  25. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    He is a she and I thank them for saving Felix when he was DKA but they are not and will not be his regular vet. All the vets in the area so far have only recommended Vetsulin. Maybe I can contact The makers of Lantus to see what vets use them. Thank you for the support.
     
  26. Hercule's mum

    Hercule's mum Member

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    Jul 27, 2020
    Lantus is the usual human insulin here in the UK, so one can but it directly from a pharmacy if they have a prescription. I don't think vets are their main customers, if you see what I mean.
    Perhaps is worth putting a message out there asking if anyone is around the are you live and whether they reccomend a vet?

    Is a long shot, but you never know...
     
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  27. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    The AAHA diabetes management guidelines that Sienne linked for you above is a really helpful document (see post #10). It might be a good foundation for discussions with potential new vets, since it shows clear support for:

    * intensive home BG monitoring.

    * feeding a low carb diet.

    * using Lantus or Prozinc - longer-acting insulins than Vetsulin, thus better suited to a cat's metabolism.

    The options you are looking to choose for Felix's care are considered best practice. They're what the AAHA recommends, not "the web says this" - unless one counts that the published journal article is available via the web.

    I'm grateful that this vet got Felix safely through the DKA episode. That is most definitely a big deal and something to be very thankful for, but it does not give that vet carte blanche to speak to you in such a disgraceful and highly unprofessional fashion. I wish you success in your search for a new vet to partner you in Felix's care.


    Mogs
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  28. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Spreadsheet corrected.
     
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  29. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Great stuff, Rachel. :)

    Couple of questions for you:

    1. What's the carb level in the Nutrish food? (I'm in the UK so not familiar with it.)

    2. Are Felix's chicken patties just plain chicken? If not, do you know the carb level of the patties?

    3. Are you testing daily for ketones?

    I'm asking the above because it looks like you need to start looking at a dose increase for Felix but before suggesting anything we really need to know about the above first in light of Felix's diet change earlier this week.

    Another post to follow in a few minutes.


    Mogs
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  30. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Here's a graphic showing an 'ideal' response of a feline diabetic to a safe dose of Vetsulin (for a cycle not affected by bouncing):


    [​IMG]

    The above provides a fairly good illustration of the curve that BG levels typically follow for Vetsulin. It would be helpful to you to do as best you can to get tests somewhere in the period between +2 and +5 on each cycle because that will give you insight into how fast Vetsulin is lowering Felix's BG and also be period in which you are more likely to catch the lowest point in the cycle. It is important to note that nadir time can move around, hence the need for a spreadsheet to track your kitty's individual pattern of response.

    Note: Testing at +2 can help identify fast drops, and also early nadirs (some cats metabolise insulin faster than others so dose onset and nadir times may come earlier in the cycle as a consequence). If BG has dropped a lot between preshot and nadir then that's a signal to keep a closer eye on BG in the hours immediately following. Some caregivers give a small feed of regular low carb food at this time to steady the drop.

    Just in case you've not yet seen it yet, here's a link to the FDMB Vetsulin guide. It will help you to learn more about the insulin you're using, dosing method, etc.


    Mogs
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  31. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Carbs in Nutrish range 7-9% per Chewy. Official site of course doesn't list carbs directly, they only have:
    • Crude Protein (Min.)
      11.0%
    • Crude Fat (Min.)
      5.0%
    • Crude Fiber (Max.)
      3.5%
    • Moisture (Max.)
      78.0%
    • Taurine (Min.)
      0.05%
    Chicken patties are plain and list no carbs. Just got my keto strips delivered so I will be testing daily if possible. Saturday and Sunday I can get the +2 am BG levels on Felix. Poor baby is always hungry. I feel like maybe some fiber would make him feel fuller longer. Nutrish has 2.2 oz cups and they recommend four a day for for his weight but I have been giving him one in the am w/ 2-2.5 oz chicken, +5 2-2.5 oz chicken, +8 2-2.5 oz chicken and one cup w/ 2-2.5 oz chicken in the pm.
     
    Last edited: Jan 28, 2021
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  32. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Thanks for the additional info, Rachel. Very helpful.

    Felix is probably so hungry because his BG is high. As he's recovering from DKA it's good that you're feeding him extra - he needs it. All going well, as his numbers start to improve he'll be able to use his nutrients better and feel less hungry. On the upside, it's great that he's eating. (((Felix)))

    Would you also be able to grab tests around the +4/5 mark on Saturday and Sunday so you can see how low the dose might be taking him? It would help very much with determining the next dose adjustment.


    Mogs
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  33. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Yes, I can also test him @ +4/5. I can tell Felix is feeling more like his old self bc he has been looking at me like he wants to bite me.
     

    Attached Files:

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  34. Critter Mom

    Critter Mom Well-Known Member

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    What a face! :D That's a great picture, Rachel. :cat: It's good to hear his nibs is feeling better. (((Felix)))


    Mogs
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  35. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    BG is high again and he's negative for ketones. Here he is wanting to eat right after eating.
     

    Attached Files:

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  36. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Rachel, maybe this has already been mentioned before but I wanted to tell you one thing that really helped me get the blood test. Rub a small amount of neosporin ointment (not cream) or vaseline on the tip of his ears - where you will be pricking for blood. This will keep the blood from running into his fur and help it develop a droplet which is easier to get blood.
     
  37. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Thank you. There is another thread on here that warns of something called pryxim that could be in neosporin and is harmul to kitties. I didn't know either. I've used it on my kitties before.
     
  38. Summer and Susie

    Summer and Susie Member

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    @crittermom I have not seen that thread, Rachel. A lot of members have recommended the neosporin. Please let me know if and where you see it again.
     
  39. FelixMomRachael

    FelixMomRachael Member

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  40. Summer and Susie

    Summer and Susie Member

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  41. Summer and Susie

    Summer and Susie Member

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  42. FelixMomRachael

    FelixMomRachael Member

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    Thanks for the link. I will definitely not be putting neo on my kitties. Also, I prick the front of his ears so it's easier to see the blood. His ears are bleeding easier now and as soon as the beep goes off I give him his treat. The rice sock also makes it easier to warm up his little ears.
     
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  43. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    I'm still debating the neosporin issue. She has done just fine with it and it is hard for her to lick her ears. I tried the rice sock and she wasn't happy with it. Might try the front of Susie's ears as the outside tips have taken a beating from all the daytime testing I have been doing lately. I didn't know you could do the front of the ears. Thanks, Rachael and good luck with Felix!
     
  44. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    She may rub her paws over her ears and then lick them. Good luck (research/experience) with Susie. You can also pet her w the sock so it smells like her.
     
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  45. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    Yes, you are right about her rubbing her ears with her paw and then licking the paw. I think I'll go back to the vaseline. Good sock tip. Are you in the US Rachael. How is your kitty doing?
     
  46. FelixMomRachael

    FelixMomRachael Member

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    Jan 12, 2021
    Yep, in the US. Felix is crazy hungry and he gained a pound so that's good. He has to be in my room when the other kitties eat and he is always trying to get out when I come in. Yesterday he grabbed a pizza crust off the table and ate some, of course yeast dough is poisonous to kitties but I think it's when it's uncooked.
     
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  47. Summer and Susie

    Summer and Susie Member

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    Dec 20, 2020
    You seem pretty knowledgeable about a lot of "cat related" issues. That is good going in with a kitty with Felix's issues. Bless you for having so many cats. Cat people are my kind of people. Hang in there. This group will really, really help you. I rarely even consult with my vet anymore but he is up-to-date on my spreadsheet and has been willing to consider everything I have suggested that this group has advised. I hope you can find a more "diabetic knowledgeable" vet because you do need to have one too.
     
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