New to kitty diabetes, help needed!

Hi, all!

I’m Cloe, and my cat, Bockscar, has recently been diagnosed with Diabetes. My boyfriend and I adopted her in September 2022, and she got SUPER SICK. Took her to the vet and got the diabetes diagnosis around the holidays. The good news is once she started on insulin she got so much better, acted like a cat again! But, at all her glucose curves at all day vet visits, she seemed unresponsive to insulin.

After many of these curves, each time our vet upping her dosage by 1 unit, till she was prescribed 6 units in our U-100 syringes (forgive me, I’m not certain of how to describe the amount). Our vet said that was incredibly high for a cat and she would generally never go beyond 4 units. But, Bockscar was not responding so… here we were.

Once we started giving her 6 units, she turned evil. Being super mean and hitting her sister, Sledge, like she had never before. Growling and becoming incredibly obsessive over food. We have started using a slow feed bowl as she would eat her food so fast it seemed unhealthy. Never seen any animal inhale food like she was. She bullies Sledge and steals her food and inhales it too. She will also eat any human food we leave out, and so we hide it from her all the time. She once ate my spatula because it had sauce on it (she was fine, but worried me sick).

This is all very unlike her, as until we started giving these large amounts of insulin she seemed healthy! She went from crazy sick, not moving, chugging water, not cuddling, very concerning, to being healthy on insulin. She was jumping and cuddly and playing, not being mean to Sledge or going insane over food, or stealing anything that seemed edible. Her behavior was so bad and she was so mean to Sledge she seemed sick again in the opposite way.

After a lot of research, I learned that cats can show high blood glucose due to stress at the vet, and that can result in upping the dosage too much. I have, without consulting the vet, reduced her back down to 5 units of insulin. We give her insulin twice a day, 8pm and 8am. Even that change has seemed to make her feel better. She’s still crazy about food and steals anything she can. But she’s hitting Sledge less, and in general her disposition is calmer and she seems happier.

I’m concerned 5 units is still too much, and we have accidentally been creating this extreme high and extreme low in her blood glucose. As our vet said that even 4 units of insulin was a lot, I feel she may need even less. I’m not comfortable making more changes until I have some numbers to go on.

I would like to begin testing her BG at home, but have no idea where to begin. We can’t afford to spend lots and lots, but I want her to be healthy! I know they have the pet specific glucometer, I think Alphatrak? Is the OneTouch Ultra ok? From what I’ve seen, others have success and it is so much less expensive!

Also, any advice or resources on where to learn more about how to read the tests and what the numbers mean would be greatly appreciated. Apologies on how long this is, but I feel the entire story is important in seeking advice. My boyfriend and I have never dealt with this and are totally lost on how to help her better. Thank you all so much!!

 

Welcome Cloe and Bockstar
You couldn't have found a better group to join
There are a lot of experienced members here, if it wasn't for their advice Tyler wouldn't be in remission today

Can you tell us what insulin you are using?
If you live in the US , I would suggest you go to Walmart and pick up the Relion Premier Classic human meter for 9 dollars and the test strips 17,88 for 100 test strips, 26 or 28 gauge lancets to poke with and some cotton rounds
Our numbers are based on human meters, The Alpha Trak tests strips are about 53.00 for only 50 test strips and the Aloha Trak is also expensive
You will be testing a lot so you want test strips you can afford
That's crazy how much the vet upped the insulin ,we adjust the dose by 0.25 units at a time
Doing a curve really doesn't tell you how the insulin is working, you need to be testing her at home every day to see how the insulin is working and how low it's taking Close
We don't adjust the dose by the pre shot numbers ( this means the first test you do in the AM and the first test you do in the PM

Do you have the U-100 syringes with the half unit markings?
Cats get stressed at the vets when during a curve and most likely raises their BG
How many units did the vet start Close on?

I will tag some members for you .
I am going to ask you to give as much information you can give us about Close, I know you can't tell us what meter you will be using yet , just put what you can
This is called our signature , it's at the end of everyone's posts in gray
We also have a spreadsheet where we track our cats BG to see how the insulin is working

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 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

A video one of our members posted, she is using a pet meter ,strips too expensive plus you have to code it
A human meter is just fine, most of us use human meters ,that's what our numbers are based on
When you get your meter can you add the name of it to your signature and spreadsheet


VIDEO: How to test your cat's blood sugar

Here is another link to read
This is a link to one of our posts on home testing.

As for treats when you test or give insulin you can give them so Cleo associated getting a treat before and after you test or when you give insulin
for treats for testing
You can give any freeze dried treats they are all low carb
Tap on this blue link and read post #64 the post numbers are to the right of each post and you can read about the freeze dried treats I listed

https://felinediabetes.com/FDMB/threads/new-to-this-i-need-advice.269452/#post-3007388

You can even give plain boiled chicken pieces

 

To set up your signature which you will see is at the end of everyone's post in gray, click on your name up top and then tap on the word signature and add this information

• 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)
  • 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.

Take a look at mine


We also use a spreadsheet to track our cats BG so we know how the insulin is working and how low they are dropping so we know when to either increase or decrease the dose
We adjust the dose by 0.25 units at a time . We don't adjust the dose by going by the Pre Shots

About the spreadsheet
AMPS - means AM Pre Shot the first test you take in the AM ,you need to withhold food 2 hours before testing so it's not food influenced

Units is where you would put how much insulin you gave
+1 is one hour after giving insulin if you were to test then that's where you enter his _BG number
+2 two hours after giving insulin. ditto
+3 and so on until you get to PMPS - PM pre shot withhold food 2 hours before testing

+1 same as you do for AM cycle

We don't give times because we are all in different time zones that's why we use the + numbers
I'll give you the link to set it up , if you have trouble just ask and we have a member who will gladly do it for you


You can look at any members spreadsheet to see what it looks like, it's at the end of everyone's signature just tap on it

If you want help setting up your spreadsheet when you start testing just ask we have a member here who will be happy to do it for you just ask

Link to set up the spreadsheet
https://www.felinediabetes.com/FDMB/threads/how-to-create-a-spreadsheet.241706/

 

@Wendy&Neko

@tiffmaxee

@Suzanne & Darcy

@Bron and Sheba (GA)

@Sienne and Gabby (GA)

 

Oh my gosh thank you!! I have added a signature, and will start a spreadsheet when I can!

If I remember correctly, our vet started her at one unit- either that or two. I don't believe our syringes have half unit marks. They are marked at 5,10,15, and so on up to 30, with little marks between. "UltiCare VetRx Insulin Syringes U-100 12.7mm x 29G" are what we have. She's also on the Lantus SoloStar insulin. She's eating 1.5 cans of Purina pate, as recommended by the vet, twice daily when given insulin.

We feed her in the morning, and I'll give her food when I get home from work around 5:30, and then a treat or a tiny snack before her shot at 8. If we need to make sure she eats her entire meal before her shot we can do that, though! We are not sure how old Bockscar is, though our best guess is around 13.

I'll check out my Walmart either tonight or tomorrow to pick up the Relion Premier Classic, test strips, and lancets. Glad to know it isn't as hard to get the right stuff as I thought it would be.

I'm worried she's nearly in constant hypo mode because of this crazy high insulin dose. I feel so bad like I've made her sick trying to make her better

I am so excited to find out how to actually help her, though. I so appreciate you, and I'm so glad to know there is hope!

 

Hi Cloe and Bockscar and welcome to the forum.
I would strongly recommend you start hometesting the blood glucose (BG). That way we can see what is happening.
It is possible if he is being tested at the vet, the BG readings are higher with stress, or he could be bouncing on the days he is being tested. These are a couple of the pitfalls of just getting a test done every so often at the vet. Hometesting will tell you exactly what is happening and the dose can be adjusted as needed.
From the Basics …information about bouncing

• Bouncing - Bouncing is simply a natural reaction to what the cat's system perceives as a BG value that is "too low". "Too low" is relative. If a cat is used to BGs in the 200's, 300's, or higher for a long time, then even a BG that drops to 150 can trigger a "bounce". Bouncing can also be triggered if the blood glucose drops too low and/or too fast.The pancreas, then the liver, release glucogon, glycogen and counter-regulatory hormones. The end result is a dumping of "sugar" into the bloodstream to save the cat from going hypoglycemic from a perceived low. The action is often referred to as "liver panic" or "panicky liver". *Usually*, a bounce will clear kitty's system within 3 days (6 cycles).

With the food, it sounds as if he is very hungry. Unregulated cats can’t absorb all the nutrients in the food so are always hungry. We recommend you give a good meal before the doses and then give a couple of snacks during all the cycles. Say at 3 and 5 hours after the shots. You may find he is happier if you do this.
are you testing for ketones in the urine? If not I would recommend you get a bottle of Ketostix from Walmart or a pharmacy and test the urine following the instructions on the bottle. Read the result exactly 15 seconds after dipping the strip into the urine and compare against the colours on the side of the bottle. There should be no ketones. If there are more than a trace I would tell your vet.
once you get the spreadsheet set up and start testing we will be able to see what is happening and can help you with the dose.

 

Hello from someone who's kitty ended up going as high as 8.75 units of Lantus. We've seen even higher doses here. A saying here is "a cat needs as much insulin as they need". Having said that, there is a very real concern that the dose has to be reached safely, which means home testing to make sure the dose is not taking them too low.

I have a few comments. First is food. You don't need to give special "vet or prescription" food, any low carb wet or raw food will do. Depending where you live, and we have members world wide, we can suggest some low carb options to feed. Second, Lantus is a gentle insulin, and you can feed more than twice a day. It's good your vet started Bockscar on Lantus, not so good if they told you to only feed twice a day. The blood sugar lows of Lantus typically happen half way between the shots, and that's when she might really need more food to bring up his blood sugars. Many people feed multiple meals or leave food out for their cats so they can eat to stay safe. With blood sugar lows, she might be going crazy trying to find food to bring up her blood sugars. Starting home testing is the only way to find out what is happening.

I have a second possible theory about why your kitty might be acting up with higher doses of Lantus. Lantus has an acid base to it. Some cats start to feel a sting once the dose gets higher, and I've even heard of personality changes happening with Lantus on higher doses. There are alternatives, like Levemir insulin, which is similar to Lantus but desinged without an acid base. You'll see in my signature that I switched Neko to Levemir. She wasn't experiencing personality changes on higher doses, but was happier on Levemir.

 

Any of these half unit syringes are fine , we use half unit markings because we adjust the dose by 0.25 units at a time, even though these are 0.5 its easier when you have to adjust by 0.25 units

• .
• BD Ultra-Fine, CarePoint Vet, Monoject, GNP, UltiCare Vet Rx, Sure Comfort, and ReliOn are just some of the brands available with half unit markings.
• Syringes come in ½ inch or 5/16 inch needle lengths. Needle gauges are 29, 30 or 31 (31 being the thinnest)
• Full and half-unit syringe scales:

 

I have a video in my signature showing how I tested my cat CC at home. That does sound like an incredibly high dose. My cat was on a high dose but she had acromegaly which is a pituitary tumor. Most cats don't need more than 3 units. Which food specifically are you feeding?

 

Agree with what everyone has already said here just wanted to say, welcome and you’ve come to the best place when it comes to feline diabetes and cats and really anything in between

 

I have just created Bockscar's spreadsheet! It's linked in my signature. Please let me know if anyone has trouble accessing it. Went ahead and did a test when we got home, 7 hours after her morning shot. I see the color coding at the top of the spreadsheet for different results. Assuming green means good, so her result of 313mg/dL is bad?

I looked through the how to make and use your spreadsheet posts, and didn't notice anything about what the numbers mean (although I likely just missed it) I looked at Tyler's spreadsheet and noticed he's always in the green zone. You mentioned he's in remission (yay!), so do cats without diabetes or in remission have a different healthy number? If there's a guide on what the numbers mean, I would love to check it out!

Before her dinner and nighttime shot I'll run another test and see what's up. How long after her shot should I retest her? My boyfriend and I both work full time away from home. Planning to use the weekend to my advantage as much as I can, but during the week does anyone have advice?

Bockscar has been doing 5 units of insulin for two weeks now, so seems like plenty of time to adjust her dosage. However, because I don't have any record of what the 5 unit doses are really doing to her, should I just leave it the same until I have something to go on besides just her behavior? Whenever I end up doing it, I'll adjust by .5 units, since my syringes aren't the right ones. Gonna need another box before long, and I'll get some that you linked- thank you for that- when we order more! Is .5 units too much? Does the smaller adjustment help the kitty's body to adjust to the changes better or is the goal to find a very precise dosage? Or both lol?

I always have lots of questions! So, thanks for your patience and help. Really, this is great!! Great video you linked too. It really helped when we did her first test... Poor thing didn't love the ear prick, but she did love the lil treat she got after Gonna see about some freeze dried treats too!!

 

Thank you! This is very helpful. Is Fancy Feast pate or gravy lovers a good low carb choice? We are doing a wet food only diet. I would love to feed her more than twice daily. My boyfriend and I will both be at work and unable to feed her a middle meal. Our other cat doesn't have diabetes, and she doesn't need to have constant access to food (she's already got a lil chunky belly) but we could do a timed feeder. Would it be ok to do a little wet food lunch like that?

Also, how close to the shot should Bockscar eat her dinner. I get home from work around 5:30, and I feed her something then because she's hungry. Then, at 8, we give her the rest of her dinner and her shot. Is it better to just wait for the shot? And, if we get her a midday snack, would that make a difference?

Interesting that Lantus is acid based. Hoping she's not reacting poorly to it, and her dosage is just unregulated. If she's not starting to level out after the home testing and dosage adjustments I assume will have to be made, would I need to go back to the vet to switch her insulin? Thank you for your help

 

I can read the spreadsheet, good job. ss far as the 313, it's not idea, but has to be put in context with other numbers. Cat's can also see lower numbers than they are used to and do what we call bouncing, which takes the numbers up. Definition in post Bron did above. So keep on testing before shots, to make sure it's safe to give insulin, and those spot checks in the middle, so we can try to see how low this dose is taking here when she's not bouncing. We decide how to change the dose based on those low numbers.

Pate yes, gravy lovers not so much. Save the gravy lovers as a high carb food if you ever need to bring up her numbers. Lots of options for low carb (under 10%) in this spreadsheet. Food chart.

 

Our typical routine with Lantus is test, feed, and shoot, all within about 15 minutes or so. Many people give insulin when kitty's head is in the food bowl. And you don't need to feed all at once, it's actually better if you spread meals out. That's easier on the pancreas. Plus Lantus doesn't onset for a couple hours after the shot, giving you time to make sure she eats something. And yes, lots of us do automated pet feeders. The Petsafe 5 is the model I used. There is a spot under the rotating dish where you can put an ice pack to keep it cool, and you can add water to make it a bit soupy and stop food from getting crusty. Or leave an ice cube on top to keep it cool and add water over time.

If you feed at 5:30, try to make it as small and as low carb as possible. Feeding after nadir (the low point when insuiin is strongest) can make the insulin wear off sooner.

Insulin switches should be done in consultation with the vet and if in the US, your probably need the vet to write a new prescription. But let's first see whether the issue is dose or type of insulin.

As for a later test after the PM shot, something before your bed time, as long as it's 2-3 hours after the shot, will give us a clue what is happening at night.

 

Welcome to FDMB!

The only comment I would add to what other members have mentioned is that you do not want to give your kitty food during the 2 hours prior to shot time unless numbers are lower than desirable. You do not want your pre-shot test to be influenced by food.

As to the numbers on the spreadsheet, there are two 12-hour cycles each day the AM and PM cycles. We refer to the test prior to your giving insulin as your AMPS (or PMPS) -- AM Pre-Shot. The +numbers at the top of the spreadsheet (e.g., +1, +2) refer to how many hours after the shot you're testing. So if you test Bockscar 7 hours after you gave him his insulin, that would be a +7 test. The column that's marked "U" refers to the dose of insulin you're giving (i.e., "Units"). The color coding is a means of providing observational data. Once you're used to reading spreadsheets, it helps you to see patterns. I am rarely looking at the actual numbers. I look for trends and the colors provide that information in a shorthand fashion.

You are aiming to get Bockscar in as close to normal range numbers as possible. We regard normal range as 50 - 120. A cat that is seeing lots of green on a spreadsheet is doing great.

With syringes, they only come in either 1.0 or 0.5 unit increments. You will have to estimate to give doses in 0.25u amounts. We have photos that will help you to eyeball the dose.

If you're not already feeling overwhelmed with information, there are a series of sticky notes at the top of the Lantus/Levemir/Biosimilar board that you may find helpful. They will provide a huge amount of detail about those insulins, dosing, etc.

 

As for treats when you test or give insulin you can give them so Bockstar associates getting a treat before and after you test or when you give insulin
for treats for testing
You can give any freeze dried treats they are all low carb
Tap on this blue link and read post #64 the post numbers are to the right of each post and you can read about the freeze dried treats I listed

https://felinediabetes.com/FDMB/threads/new-to-this-i-need-advice.269452/#post-3007388

You can even give plain boiled chicken pieces

 

Here is another auto feeder that hold 5 slots and comes with 2 ice packs
https://www.amazon.com/Cat-Mate-C500-Digital-Automatic/dp/B01AUYLVU8/ref=sr_1_6?gclid=EAIaIQobChMIuM_y2p79_AIVDvrICh1_xAy6EAAYASAAEgJBDfD_BwE&hvadid=178540036693&hvdev=t&hvlocphy=9003521&hvnetw=g&hvqmt=e&hvrand=6990619631848479728&hvtargid=kwd-12652445711&hydadcr=10635_9894649&keywords=petsafe 5-meal automatic pet feeder&qid=1675560889&sr=8-6

Extra ice packs so you can keep them in the freezer ready to go
https://www.amazon.com/Cat-Mate-Rep...5c-bd5c-e23f6094563c&pd_rd_i=B091HTXNHR&psc=1

This one has 3 slots with one ice pack
https://www.amazon.com/Cat-Mate-Automatic-Feeder-Digital/dp/B01MXDFB28

Extra ice pack
https://www.amazon.com/Mate-Replace...cb-974a-deec2fb8a80c&pd_rd_i=B07KFP7PRG&psc=1

 

She gets absolutely wild about treats. Impossible to feed her from your hand, she once poked a hole in the tip of my finger when I attempted it. So, she plays treat fetch But that also means giving her treats before a test will make it impossible to actually get the test done. She moves SO MUCH. I've given her treats afterwards every time, so hopefully that will help!

Is there anything I can do to help make the ear poke process easier? Right now my boyfriend or I have to kind of hold her still, and the other one does the lancing. She moves so much, and we don't want to hurt her more than we need to, so it feels like a long process. We have only successfully completed a test three times, despite 5 attempts. It's obvious Bockscar is getting stressed, and it was taking so long, we just let her be last night. In the mornings she's so crazed before her breakfast we had to give up this morning again. I even tried to take it while she was eating, though I figured it might skew the results. Even then she's just too dang wiggly :0

I'm guessing this is normal for cats who are new to having these tests done. So, perhaps the only way to make it easier is practice. But, if anyone has a magic trick, let me know! We are using just the lancets without the lancing device currently. Would it be ok to wait till she's sleeping lol? I feel so evil having to prick her, but she needs it to feel better. I wish I could explain why she's being so poked and prodded at!

 

How frequently during the day should we be trying to test her? I may be getting a work-from-home job soon (fingers crossed) and will be able to be more attentive. How long after her AM shot do you recommend testing, if at all? Also, if I feed her at 5:30, would that mess up the results of our PMPS? It'd be like 2.5 hours before her shot, so just under the wire from what I've heard.

 

Are you warming up her ear? Have you tried humming? Also some people have luck with the burrito technique for cats what won’t stay still. It may help you to be able to test by yourself without needing a second person

 

It's true that with practice and patience it gets easier, you become more comfortable and Bockscar will pick up on this, I think many cats start to feel better and figure out that all your poking is helping them, and resist less, some eventually come to you around shot time. It's a learning process for her too!
I see you have the hometesting tips link above, it's good. I can suggest:
Rather than fetch a treat, can you plunk a few treats right in front of her, under her nose before, and then after the test? So she learns it's not playtime, it's sit still time. Same procedure with shots, to help establish a routine.
My husband and I had to tag-team Kitkat at first as well, I think this is very common. And we always gently pinned him on the floor in the same spot for everything.
After a few attempts, (usually just 2) if unsuccessful, I would leave him be for a good while before attempting again (let his eyes, flattened ears, and tail flicking subside) . It's better to get a later test rather than no test at all.
And successful or not, we always gave him a treat every time, helped with the association.
We would do some random mock tests, with no poke, just the same routine.
We did have to be a bit more aggressive for the AM preshot test and the PM, since these are time sensitive and the consistent time of injection is a necessary evil. All the rest of the daily tests were much more casual, so we tried to do as many of these as we could, just to reinforce a calmer feeling about the whole process.
I would not poke her as she sleeps, that's an ambush and I would be concerned about developing mistrust. (Most everyone asks that with the lol attached )

Others can answer this better, I commonly see a +2 is recommended as a good test time for Lantus when first starting out.
Withholding food 2 1/2hrs prior to amps/pmps is more than sufficient. No worries

 

With many Lantus cats the +2 test acts like an indicator of how the cycle will go. A preshot and +2 about the same is a normal Lantus cycle with some downward movement. A +2 higher than preshot means a quieter cycle, possibly bouncing and less testing needed. A +2 lower than the preshot means an active cycle that needs more testing. As you gather more data on Bockscar, you'll get a better idea of when you need to test next. Plus you can always ask us.

We have a saying here, ECID (every cat is different), meaning there isn't a general rule that works for all cats. Some cats (like mine), the +2 didn't tell me much and the +3 was better. For some it's closer to +1. I would start with +2 and see if that works for you, as it does for many. Also, don't forget those later tests at night, maybe right before you go to bed. Many cats go lower at night, and it's those low points that tell us how to change the dose.

As for the +9.5 meal (2.5 hours prior to preshot test), it will be far enough in advance that the preshot test will tell you if it's safe to shoot. The downside to feeding later is that Lantus action is fading in the last half of the cycle and numbers are already rising. Adding carbs later in the cycle will make those numbers rise even more to the next preshot test. So, as much as you can feed just a small meal, and as low a carb as possible, the better.

 

Great information from Melinda and Wendy. I had a cat with early onset and early nadir -- except for those times when her cycles were different. Not only is the general rule ECID but as soon as you think you can predict what your cat will do, your kitty will do something to remind you that cats don't like to be predictable.