Newbie - 3 weeks in - advice?

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Jena4277

Jena4277

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hello!
My senior cat was diagnosed with diabetes recently after quite a long haul of not knowing what was wrong with her. My vet tested her blood in the high 400s and switched her diet to wet and dry DM food, which she doesn't mind eating. She had (past tense) two wet food meals a day with each insulin shot (5am 5pm) and I left DM kibble out for her all day which she ate a lot of. She is on Vestulin, at that point 1 unit every 12 hours. Last week, we increased dose to 2units every 12 hours. Not seeing positive results after two curves were done and a fructose was sent out last Friday, my vet told me to stop dry at all costs, and to put her on strict 2x day wet food DM diet only and try not to cheat in between. Omg I thought. So Saturday after this phone call I took the dry away and fed her wet one time that evening, with nothing in between until breakfast the next day. Vet also recommended home testing. Bought a kit. Did a trial Saturday, it was 385 before her feeding and shot, which I attributed to the dry food she ate that day. Sunday was curve day. I tested her before her breakfast, and shot, it was 440. Tested at 9, it was 211. At 1:30 it was 90. At 4:30 before eating and shot, it was 189. Thinking the 440 was a fluke, I tested again Monday before breakfast and shot, it was 200. Never having been worried about hypo before since she was eating dry in between as a natural grazer, taking away that option and feeding her wet 2x and getting those readings makes me nervous. Vet said Monday to retest at end of week, and drop dose to 1 unit if she tests in the low 100s. My cat is not an easy tester so I don't want to test more than necessary, I was thinking 3x that day before each meal and one 6hr in. I am also worried about her hunger! I subconsciously think I am starving her! With numbers like that, am I? At 11am ish she gets hungry then gets over it. At 1-2ish same thing. I have been reading hypo signs and a million postings and freaking myself out. She is alert, not twitching or doing anything strange, except wanting food but when I don't give in she gets over it. I read that people give snacks during the day, but with my going back to work when school year starts, I can't do this nor do I want to start now and and stop get her all mixed up. She weighs appt 7.6lbs and gets 1/4 cup wet food at her meals which she doesn't eat entirely, I leave the bowl for 2 hours after and then take it away where she will visit no more than 2 more times in that period. I read to leave it for no more than 30 to get her accustomed to eating more at each meal, but being a grazer her whole life she doesn't eat large portions, she is a slow eater and I don't see leaving the bowl out for her to revisit a problem. I always make sure she has food for the insulin to work with though. And with her eating again I think she's safe. Any reassurance on any of these matters is appreciative. If I call my vet again I think she will start to bill me per minute!
 
I'm glad you're considering reducing the insulin dose back to 1 unit twice a day. Raising it by a whole unit is too large an increase. The large drop in BG that 2 u gave you is a sign that dose was too high. However, it's possible the good dose is somewhere between 1 and 2 u. You're right about the effect of a wet food only diet on BG - significant lowering effect.

Re feeding: most FD kitties do a lot better either grazing or having several small meals a day. You can leave food out while you're away (some people freeze small portions as tiny "pucks" of food for later day snacks while they're away from home) or use an automatic pet feeder. The strict twice a day feeding usually leaves a kitty overly hungry. Also, if she needs to gain weight, feed more low carb but in small amounts at a time. The time to remove all food is in the 2 hours prior to the before meal BG test.

Home testing of BG is the best way to keep your kitty safe and congratulations on doing it. It DOES get easier with time. This is the testing schedule we recommend:

Insulin Testing Routine

Here's how to approach finding the good dose range:

  1. test every day AM and PM before feeding and injecting (no food at least 2 hours before) to see if the planned dose is safe
  2. test at least once near mid cycle or at bedtime daily to see how low the BG goes
  3. do extra tests on days off to fill in the response picture
  4. if indicated by consistently high numbers on your SS, increase the dose by no more than 0.25 u at a time so you don't accidentally go right past a good dose
  5. post here for advice whenever you're confused or unsure of what to do.
 
Jena4277 said:
I can't do this nor do I want to start now and and stop get her all mixed up. She weighs appt 7.6lbs and gets 1/4 cup wet food at her meals which she doesn't eat entirely, I leave the bowl for 2 hours after and then take it away where she will visit no more than 2 more times in that period. I read to leave it for no more than 30 to get her accustomed to eating more at each meal, but being a grazer her whole life she doesn't eat large portions, she is a slow eater and I don't see leaving the bowl out for her to revisit a problem.
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Majority of kitties are grazers by nature. Twice daily feeding is kind of an old school of thought. Since you're not home to give her a wet food snack during the day you could 1. Leave a tablespoon or two of her meal out for her to finish through the day. (Ideally she won't eat 2 hours prior to next preshot (PS) test) OR 2. Make catfoodsicles. I put like a tablespoon of wet food in to each ice cube slot, add a little water, then freeze them in the tray. Before I head out the door, I pop one or two out for my boy to eat later. The cubes take about an hour to thaw right now :).

Just something to think about. Pretty sure my boy would try to eat me when I walked in the door if I didn't leave him 2 snacks during the day :smuggrin: and overnight.
 
Oh! I like that idea too. She usually leaves some food in her bowl, so I may pop a regular ice cube in to keep it moist, and prepare some foodsicles in case she happens to finish her whole meal some days. My question is: because I am not feeding her at exact times, like an autofeeder would (which I looked into on other forums too), how does this affect her glucose, or I should say, does this make her "bounce" too much, or because it would be around peak time she eats it (that's when I observed she is hungriest) it should be okay? I know we can't control every little thing, but if our goal for our kitties is "regulation" I want to make sure I am doing the right steps. I am going to try to do another curve this weekend, not as many, but at least 3, to see how she is handling things. I am still on the 2 units and was considering lowering it but now if I add a snack to mix I may need to keep it the same. My cat is so hard to run tests on! She was good in the beginning but then wised up. Also, I have to give her shots while she is eating because she is grumpy with those too. Again, good in beginning, but quickly realized what was happening! She gets over it fast like they all do, but she can feel the prick! I have to use a 29 gauge because of the Vetsulin. I try to rationalize that her .5 seconds of pain is for a bigger good!!
Thanks for the replies. As a teacher, I am home in summer to observe her, so trying my best to get all the hiccups settled before the new year. As we Spanish teachers say... "Caramba!"
 
Jena4277 said:
Oh! I like that idea too. She usually leaves some food in her bowl, so I may pop a regular ice cube in to keep it moist, and prepare some foodsicles in case she happens to finish her whole meal some days. My question is: because I am not feeding her at exact times, like an autofeeder would (which I looked into on other forums too), how does this affect her glucose, or I should say, does this make her "bounce" too much, or because it would be around peak time she eats it (that's when I observed she is hungriest) it should be okay? I know we can't control every little thing, but if our goal for our kitties is "regulation" I want to make sure I am doing the right steps. I am going to try to do another curve this weekend, not as many, but at least 3, to see how she is handling things. I am still on the 2 units and was considering lowering it but now if I add a snack to mix I may need to keep it the same. My cat is so hard to run tests on! She was good in the beginning but then wised up. Also, I have to give her shots while she is eating because she is grumpy with those too. Again, good in beginning, but quickly realized what was happening! She gets over it fast like they all do, but she can feel the prick! I have to use a 29 gauge because of the Vetsulin. I try to rationalize that her .5 seconds of pain is for a bigger good!!
Thanks for the replies. As a teacher, I am home in summer to observe her, so trying my best to get all the hiccups settled before the new year. As we Spanish teachers say... "Caramba!"
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Welcome! I'm a teacher too! A lot of us are. Lol. (I teach elementary art.) My cat was diagnosed last may.... Also on vetsulin. I made it my mission last summer to learn as much as I could about fd and to get my cat as regulated as possible. She had her last shot the day before school started again in September. :) knock on wood that the remission continues.


The others covered everything above but know that you aren't alone and we are here to help every step of the way.
 
Jena4277 said:
Hi! Thanks for the support. Do you have thoughts regarding my question about "bouncing?"
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It's fine to feed her anytime except for 2 hours prior to the preshot test. A bounce is when the bg goes lower than the cat is used to (usually when you see a drop of more than 50% of the preshot) and the cats body reacts by releasing stored glucose causing the next preshot to zoom up. Feeding a snack during nadir (the lowest) actually can prevent some bouncing. If she's hungry, feed her.
 
Hi Jena,
I'm able to check in every 12 hours now lol. So sorry for delayed response but like Janet said, feeding anytime except 2 hours prior to PS test is fine. Personally, I prefer scheduled feedings for my boy, although I know he doesn't eat his catfoodsicle the same time every day so I can only control when his YA snack opens :p.

For your syringes, you're using U-40 syringes correct? You do have the option to use thinner U-100 syringes with a conversion chart if she is feeling every shot. Are you tenting the skin and sticking in the base of the tent? Where are you administering the shots? Maybe I should've asked these first :smuggrin:.

Also, when you have a minute if you could setup your Signature with some information about your girl :) http://www.felinediabetes.com/FDMB/threads/editing-your-signature-profile-and-preferences.130340/

And if you were interested in setting up a Spreadsheet to track and share her BG numbers, we can help you find patterns (if there are any ;) some kitties only have a pattern of being inconsistent): http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/
 
Hi!
I set my signature but don't really have the need for a spreadsheet right now (I use a notebook) as I have only done one curve and I am trying to do a check this weekend, hopefully 4 times if she'll let me, but definitely 3.
Yes U-40 gauges. I was reading about the conversion but "they" say it's not really a consistent accurate dose? I will take a look. I tent up behind her shoulder blades in the middle or to the sides. I do it very quickly but she's always wincing so it doesn't always go smoothly but I have to do it so I can't be too emotional about it. She is NOT a nice cat when it comes to being touched anywhere beyond her face. Always been like that. I have my foodsicles in the freezer and will do a trial run tomorrow!
Another question: is it normal for cats to eat their meal have shot and immediately nap for quite some time? She looks cute comfortable and pleasant but making sure it's normal? Hopefully just catnap. After I test her this weekend I'll know better as she has been on this new diet for a good week now so hopefully the bg will be more accurate than the crazy numbers I got on the first curve. Testing her has become another nightmare. Glad to have bought a laser pointer to distract her a bit! Anything helps!
 
Jena4277 said:
I was reading about the conversion but "they" say it's not really a consistent accurate dose?
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You'd still be using marks on a syringe barrel so it's as accurate as using the marks on a U40 barrel.

Jena4277 said:
I set my signature but don't really have the need for a spreadsheet right now (I use a notebook)
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This spreadsheet is a Google doc and lives online. It can be viewed by all FDMB members and it's the first thing we look at before offering advice. Seeing your kitty's BG test history allows us to assess the dose, offer suggestions, etc.

Jena4277 said:
Another question: is it normal for cats to eat their meal have shot and immediately nap for quite some time?
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Kitties can have this sort of response to the insulin as it reaches onset and beyond. Vetsulin is known to be a faster onset insulin and it can pull BG down quickly and by quite a large amount. She might be reacting to that.
 
Jena4277 said:
Another question: is it normal for cats to eat their meal have shot and immediately nap for quite some time? She looks cute comfortable and pleasant but making sure it's normal?
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Like Kris said, some kitties respond this way. My boy is one of them :)

Good luck with catfoodsicle! :cat:

With any touch beyond her face, did something happen to her when she was younger? Just curious, I know it's very possible she just doesn't like it :smuggrin:. Be nice to have a third hand! One to keep petting her face, scratching chins while the other two tent and shoot LOL!
 
Yeah, she was indoor-outdoor cat and was attacked many many times with surgeries and absceses on her back...looking back at it now I am sorry I allowed her to continue going out. Last June something happened outside when I was at work and my mom had let her out and when she came back in she was traumatized and immobile. Ever since that day she has shown zero interest in going outside. She shut herself up in our basement and now she doesn't leave my bedroom (until now really with the Insulin she seems more active and herself!). I will never know what happened to my baby that day but whatever it was changed her forever. She could have even went into DKA outside/seized and I will never know. This all started last June and diabetes went diagnosed for a long time bc 911 vet I went to when she had a seizure last summer said it was high due to stress, basically inconclusive. We changed her diet to DM which probably saved her life for all this time. I am sick about it. I feel awful. But I am glad she is feeling and acting (grooming, jumping, walking) more like herself. To keep her getting a little exercise I encourage her to come downstairs to eat and use this laser pointer I got which she loves to chase! Who woulda thunk it LOL
I still have to figure out this grazing bit. It is easier to feed her 2 simple meals but I know she is hungry in between. I purposely added a bit extra food to her dinner so she could snack overnight but I think I added too much because I heard her eat a half hour before her big breakfast and she really didn't want to eat for me when I got up to feed her! I will make sure when I go to bed that there is a smaller snack that she can finish way before breakfast! Trial and error!
 
With any touch beyond her face, did something happen to her when she was younger? Just curious, I know it's very possible she just doesn't like it :smuggrin:. Be nice to have a third hand! One to keep petting her face, scratching chins while the other two tent and shoot LOL![/QUOTE]

oh the insulin is less than twice the battle the bg tests are! The insulin shot is a cake walk compared to the bg! She just lets out a growl and winces but I can do it every time. The bg is where she becomes a Tasmanian devil! I have to towel her bc she goes NUTS! I have four day old bruises and deep wounds in my legs from how badly she attacked me during the first curve...
I forgot to say I looked into the conversion chart for the 31 gauge u-100s. It seems simple with 1 or 2 unit doses, but does look complicated with anything in between. So hopefully if she remains at 2 or even drops to 1 it shouldn't be too bad for me to measure, but I did see crazy conversions like .8 at the end! Without exact tic marks on the syringe, that could be difficult (?)
 
Jena4277 said:
With any touch beyond her face, did something happen to her when she was younger? Just curious, I know it's very possible she just doesn't like it :smuggrin:. Be nice to have a third hand! One to keep petting her face, scratching chins while the other two tent and shoot LOL!
Click to expand...

oh the insulin is less than twice the battle the bg tests are! The insulin shot is a cake walk compared to the bg! She just lets out a growl and winces but I can do it every time. The bg is where she becomes a Tasmanian devil! I have to towel her bc she goes NUTS! I have four day old bruises and deep wounds in my legs from how badly she attacked me during the first curve...
I forgot to say I looked into the conversion chart for the 31 gauge u-100s. It seems simple with 1 or 2 unit doses, but does look complicated with anything in between. So hopefully if she remains at 2 or even drops to 1 it shouldn't be too bad for me to measure, but I did see crazy conversions like .8 at the end! Without exact tic marks on the syringe, that could be difficult (?)[/QUOTE]

__________________________________________________________________
With a U100 syringe, you can measure out 0.2/0.4/0.6/0.8 u fractions exactly using lines on the U100 syringe. Have a look at the conversion chart we use - easy-peasy!
http://www.felinediabetes.com/insulin-conversions.htm
 
That varies state by state I think. I'm in Canada so I can't give you a definite answer. I'm sure a pharmacy can tell you that.
 
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Jena4277 said:
Ok. And I can buy these at a pharmacy or do I need a Rx from vet?
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Yup it does vary by state :). I was weary to try it at first but then I became addicted to being able to more easily measure those tiny increments :D. Also try to get them with half unit markings.
 
Ok so my cat just vomited bile. She did it a week ago too, but this time seemed more extreme, she got up meowed and meowed, and vomitted twice in a row. She had her shot and ate at 5 and grazed a bit, then fell asleep for a while. This is her peak insulin time but I thought vomiting was due to DKA. Should I test her blood?? I am worried now because she is vomiting weekly.
 
I tried testing blood but the blood I was getting was not big enough for the meter to use. I have a CVS true track meter which apparently calls for 1microliter of blood and I can't ever get her to bleed that much so after 20 minutes of pricking I gave up. I will shop tomorrow for another meter. I read that relion micro is good and need only a .3 microliter drop - that sounds good to me. Any other suggestions for getting kitties ears to bleed easier? I rub and rub and use hot compress but it doesn't work. Will try a rice sock next.
 
What size lancets are you using? You'll probably want to use 26 or 28 gauge until her ears "learn to bleed" better. 1.0µ is a very big sample even for a person :eek:. Correct, the ReliOn Confirm/micro only uses 0.3µ sample. Listed the same sample size as the pet meter, AlphaTrak 2 (although I still feel like the AT2 takes less) but not by much.

Also, a one time BG high reading isn't going to tell you if she's DKA, you'll have to get some ketone test strips. You can pick some up if you go to Walmart and get the new meter and supplies :). Might want to purchase a long handled spoon to collect a fresh urine sample from her and then clearly label it, Abby's spoon :smuggrin:.

Hopefully it is not DKA. We've had too many kitties with that lately :( and maybe it's just being hungry and you're new catfoodsicles will help.
 
I used the brand it came with and then purchased "one touch soft"
I have ketone urine strips but she hasn't peed to test her. I will try to when she does.
Do you think it could be acid reflux? I can literally hear her stomach making noises as she is sleeping next to me now. I held food because I didn't want her stomach upset, and if it was DKA that would make it worse. She's not showing any of the other signs though. I will keep you updated. Off to buy a new meter and strips tomorrow and get the smaller gauge needles!
 
It could be acid reflux, it could be some form of IBS/IBD, does she have any food allergies? The catfoodsicle snacks should help if it is extra acid. There are a few kitties who can't go more than like 2.5 hours without eating something. I believe they have IBS/IBD. Definitely try to get the ketone test since you aren't able to consistently get BG, based on you Signature :). Not judging you in any way! I know it can be difficult getting started. Abby looks like she could be a little feisty girl :cat: from your avatar picture. She's a cutie though!
 
Fiesty doesn't begin to describe her attitude... It's her way or no way... Lol
I don't think she has IBS?? I just looked it up and I'm not sure it fits her.
I'm going to try to get some rest and not worry right now, as she seems ok next to me now. Thank you for replying and I will keep updating.
 
Hello!
Abby tested tbeee times today - i used a hot rice sack and the .3 relion micro meter- omg the blood was pouring out! Sooo easy to get! And she behaved!
Results:
5:10 332
Ate and 2u given
Ate again at 9:55
11:35 78
Snack tsp wet 1:45
4:10 92
Fed and will Give only 1u (vet said to drop to 1 if below 120)

What do you think of this? I am concerned about the insulin not wearing off at 8-10 hours like it should and curve back up. Vet said it should be a bell curve. I'm not seeing the second half of the curve occurring. I am calling vet on Monday with results. Maybe she needs 1.5 morning and 1 at night. If I can test her tomorrow morning I will try.
 
Jena4277 said:
Hello!
Abby tested tbeee times today - i used a hot rice sack and the .3 relion micro meter- omg the blood was pouring out! Sooo easy to get! And she behaved!
Results:
5:10 332
Ate and 2u given
Ate again at 9:55
11:35 78
Snack tsp wet 1:45
4:10 92
Fed and will Give only 1u (vet said to drop to 1 if below 120)

What do you think of this? I am concerned about the insulin not wearing off at 8-10 hours like it should and curve back up. Vet said it should be a bell curve. I'm not seeing the second half of the curve occurring. I am calling vet on Monday with results. Maybe she needs 1.5 morning and 1 at night. If I can test her tomorrow morning I will try.
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A dose that's a little too high can give longer duration and that might be the case here. If your syringes have half unit marks you can eyeball 1.75 u before dropping to 1.5 u. For now I'd keep the same dose AM and PM. I strongly recommend you set up our FDMB spread sheet.
 
My cat just vomited. It's her peak (nadir) time now, and she vomited Thursday night too at same time. Does she have too much insulin in her?
 
So sorry to make you leave early! I thought you were home when you posted the comment a few minutes ago :oops:. Please tell your brother to keep a close eye on her until you get home. Vomitting isn't a symptom I've come across with kitty's BG going too low but the best way to know is to test her BG. Have you started the catfoodsicles for her to have a snack after meals?
 
Omg please help - she tested 20!!!!!!!
I gave her sugar syrup and more food - she is walking around meowing completely aware - what is going on here?! Oh my god I'm sooo scared.
 
I gave her some (handfull) dry DM. She is gulfing it down. I'm not giving insulin tomorrow. Is that ok?? I am too afraid.
 
She doesn't eat a lot at her meals so I leave the dish out. She just gobbled up dry so I might have to leave a bit out.
 
She legit has no signs of hypoglycemia. Her tail is wagging. She is alert. I really have no idea what to do. If she's hungry should I keep giving her dry DM?
 

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She ate 1/4 cup dry DM and is laying contently. I really have no clue where to proceed from here. She tested in low 300s this morning before food and shot. I will try to test her tomorrow morning and throughout the day but I don't think I am giving insulin.
 
Sorry Jena, I had to step away to take care of my boy for evening. If you got a reading of 20 you should really retest and you'll want to give wet food (like 1 tablespoon at a time) and retest in 20 minute increments. Do you have any higher carb wet food? Dry food takes a while to kick in. You might still need to give her insulin tomorrow but reduce the dose for sure. As long as she gives a PS over 200, you might want to just try no more than 1.5U since you'll be home.
 
I just retested. It's 104. I gave syrup in a syringe so she got enough and she had the dry DM. I dont have any other high carb food in the house since she's been on DM for months.
I will retest in the morning. I will give either 1.5 or 1 in the morning depending on the number.
Please don't apologize. I was freaking out and needed an outlet so I kept posting. I will create a spreadsheet tomorrow and update the post.
 
I had to eyeball the .5. There aren't any tick marks on my syringe. I will test as I am able today. She is awful grumpy today and did not take that shot well at all.
 
I'm glad you got through this successfully. It's very scary, especially the first time. Once you have hypo supplies at home and have been through the test/feed a little bit/wait 20 minutes/ retest/feed a little bit, etc. routine a couple of times it'll be old hat to you. You can break the dose down into even smaller fractions by using U100 syringes with half unit marks and this conversion chart:
http://www.felinediabetes.com/insulin-conversions.htm
 
I asked my vet about those needles. She said they don't prefer them, they probably won't make a difference, and that I would need to buy 100 in a box and spend that money and if she doesn't like them either I wasted it...I will ask the other vet tomorrow (there are three in my office) for a second opinion.
 
Jena4277 said:
She said they don't prefer them, they probably won't make a difference, and that I
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They worry that the owner will not be able to convert the insulin volume correctly for one thing. Also, they don't seem to understand that small dose fractions make a difference and that's simply not true. Those U100s with half unit marks have saved the day for many of us on here. They aren't that expensive. Many US people order from adwdiabetes.com or buy the syringes from Walmart. Post for advice. I'm in Canada so can't help with that.
 
There are U40 syringes available with 1/2 unit markings. You might want to post a separate thread to ask other members where the cheapest place to order would be. being able to "fine dose" with 1/2 unit markings will make it much easier to get the dosing correct.


ETA: Here is a list one of the members put together for places that sell U40 syringes with 1/2 unit markings:

https://docs.google.com/document/d/1SOEzpc6T-buzPIM165bLbZdN0XP14QWIzZETUIU_zPI/edit
 
That sounds good. I will look into it. She just tested 107 at her nadir so I am much more happy with that number than the numbers she had on 2u below 100.
 
She just tested 157. I'm not administering insulin tonight. I am calling vet tomorrow to figure this out. What advice do you have?
 
Jena4277 said:
She just tested 157. I'm not administering insulin tonight. I am calling vet tomorrow to figure this out. What advice do you have?
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Thank heavens you're testing! Good call not giving insulin tonight. It looks like she needs less than 1.5 u per dose. If you get U40s with half unit marks you'll be able to eyeball 1.25 u if necessary.
 
Tested Abby just now. It's 443. I updated spreadsheet. I can't shoot until 5am. I'll give another 1.5u and then call my vet.
She is so up and down, I can't figure out the dose she needs.
 
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