Newbie needs help

Discussion in 'Feline Health - (Welcome & Main Forum)' started by Norbert’s Mom, Aug 1, 2020.

  1. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    Hello everyone,
    My name is Gretchen, and just last week, one of my kitties was diagnosed as diabetic. This is all completely new to me. We took him to the vet because he was acting a little lethargic, wasn’t grooming properly, drinking/peeing a lot, and had lost some weight. The vet ran tests and determined he was diabetic. She said we caught it early as none of his bloodwork showed abnormal values beside his BG, and his electrolytes were good. We left him at the vet’s for several days so they could get him hydrated and started on insulin. He is using Vetsulin, 1 unit twice daily. We picked him up Friday and he seemed to be happy to be home and feeling better. We have switched him to the recommended canned Fancy Feast flavors. After reading some of the threads here, we decided to check his BG with a human meter (Contour) just about an hour ago. It was 467!!
    So, here I am freaking out that I’m doing something wrong that’s going to damage my kitty’s organs, or worse! Any help would be so appreciated!!
     
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  2. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Welcome to FDMB! We are so glad you found us! Hi Gretchen! You are new to all things diabetic. Its not uncommon for numbers to be high at first. So try to give yourself a break.
    I cannot give dosing advice but there are plenty here that can.
    Hold on for more replies. And take comfort that you and your extra sweet kitty have found a safe place to land. We are dedicated to help any and all cats that come here. And we will help you too!
    Again WELCOME To the best site on this planet to help you help your kitty.
    jeanne
     
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  3. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Hi Gretchen, and welcome to you and Norbert. He is seriously cute! :cat:

    Glad you've found us. Well done on getting to grips with home testing so quickly! :cool: Being able to monitor Norbert at home will help you so much with his regulation and it will help keep him safe on insulin.

    Vetsulin works at its strongest at about 3-4 hours after the insulin injection. The general starting routine is:

    * Withhold food for 2 hours before the preshot blood glucose needs to be checked.

    * Test Norbert and give him a substantial feed then wait about 20-30 minutes before giving the insulin dose (assuming that his preshot BG number is high enough to give insulin safely).

    * Test at +3 hours after giving the dose to see how low the dose is taking Norbert's BG.

    If you go to the Vetsulin/Caninsulin support group's subforum, you'll find a helpful guide to using this insulin at the top of the board.


    Mogs
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  4. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Welcome Gretchen!

    I'm really glad you started home testing. Switching to a low carb diet could drop your kitty's numbers. In fact, I'm wondering if that's the case. If numbers drop quickly, a cat's liver and pancreas can react to the change by dumping a stored form of glucose along with counterregulatory hormones into your cat's system. This causes the numbers to spike. We refer to it as a "bounce." As you collect more data, you'll be able to tell if this is the case. It could also mean that our kitty needs more insulin.

    This is a link to the information on Vetsulin. One of the things you may notice is that Vetsulin is not recommended by the American Animal Hospital Association for the treatment of feline diabetes. This is a link to their guidelines.They recommend either Prozinc or Lantus. Vetsulin doesn't provide duration for the entire 12-hour cycle. It's also harsh and has a quick onset. You might want to discuss the choice of insulin with your vet.

    And just to add to your feeling overwhelmed by all of what you're already doing to take care of your cat, there a few things we'd ask, as well. Could you take a look at this post on helping us to help you. We ask that you have certain information in your signature, set up a spreadsheet so we can follow your cat's progress, and have everything you need on hand to prevent numbers from dropping too low (aka a "hypo kit").

    Please let us know if you have questions. People here are more than happy to help!
     
  5. JanetNJ

    JanetNJ Well-Known Member

    Joined:
    Jun 8, 2016
    sorry for the diagnosis. We all know how scary that is. Way to go starting testing at home!! Try to get a preshot number before each shot and then at least one mid cycle reading. As you gather data you will be able to if the dose needs to be raised. We can help you with dosing. :)
    It takes a while. It's a marathon.
     
  6. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    Thank you all for the quick responses!
    Critter Mom: We checked his BG and have given him his meal. Now waiting and will check his BG in a few more minutes.
    Sienne and Gabby: I’m definitely paranoid about him spiking, so we are trying to get a good curve on him. We will be changing Norbert’s insulin to the PZI next week. Thank you for the “help” link. I’m working on the spreadsheet and will add the info needed. We definitely have the hypo kit ready. My husband is a T1 diabetic, so he’s handling this way better than myself
    All: I’m so glad I found this group! I’m blown away by all the information and support there is here. My kitties are my children, and I’ll do anything to keep Norbert happy and healthy!
     
  7. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Aha! A stealth weapon! ;)

    .
     
  8. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    Happy to report that after dinner and +2 hours after the new 2 unit dose, Norbert’s BG has come down to 352! We will test again in a couple of hours when the insulin should be peaking. Thank y’all so much!!
     
  9. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    FYI - there's no reason to change from the Contour meter. The cost for strips for a pet meter is outrageous. There is a relatively small difference in the calibration of meters for a kitty vs a human. Personally, I can't see paying $1.00 per strip to use a pet meter.

    I've very glad you'll be switching insulin!
     
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  10. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    Wow! I just looked at the price for a 50 count of test strips for the AT2. You are so right... expensive! I think it will be better to stick with a human meter. I’m getting a free AT2 that comes with 25 test strips, but maybe I’ll just use that one when I need to get a curve on him.
     
    Last edited: Aug 1, 2020
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  11. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Personally, I'd think about returning the AT2 and getting your money back.
     
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  12. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    I agree with Sienne. Using one meter for everyday tests and another for curves may skew things. Now IF you cant get your money back I guess this plan, is the nest best thing.:confused:
     
  13. Critter Mom

    Critter Mom Well-Known Member

    Joined:
    Jun 16, 2014
    Erm ...

    ;)

    .
     
  14. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    Ugg... the saga continues...
    Norbert’s AMPS was a whopping 572!! 2 units of Vetsulin and his last reading at +5 hrs was 331. I’m feeling the frustration but I can hear JanetNJ’s words in my mind, “it’s a marathon”. We are going to do this! We are NOT giving up!!
    I’m also going to find a specialist. We love our vet, but my feeling is that she is not quite as experienced in dealing with diabetic cats.
    We are definitely switching him over to Lantus. I think the issue with his BG is that the Vetsulin is peaking to quickly and allowing him to go hogh by morning (y’all could certainly tell me if my thinking is correct). Also, my hubby (diabetic) was saying that it’s difficult to get high BG down with a longer acting insulin. They are more for maintaining BG rather than quickly fixing high BG. Thoughts?
     
  15. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

    Joined:
    Dec 28, 2009
    Hate to tell you this Gretchen but the first time you hit a number below "normal" you are going to panic again. But we will be here when that happens! ;):bighug:

    I prefer to think of it as a Novel other than saga.:p
     
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  16. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    Your thinking sounds solid. Also, keep in mind that you don't know how long Norbert has been diabetic. A number in the 300s may be "low" for him. As a result, his liver and pancreas may panic and shoot the numbers back up.

    Your husband is also correct. Lantus is much gentler than Vetsulin. It's also a depot type of insulin and it takes about a week for the depot to form. Unlike Vetsulin, Lantus doesn't "yank" numbers down. It tends to do better as numbers are lower and it ends up yielding a "flat" curve. If you take a look at some of the threads on the Lantus board, if you see a low pre-shot number, you're likely to see a flat cycle.

    I'd give yourself a little time before trying to find an internal medicine specialist. I've been here a long time. I've seen some of the advice IM vets have given. I wasn't impressed. If you like your regular vet, stick with her. Frankly, we can help you with the diabetes. But, it's entirely up to you. There are also wonderful vets who refer their clients here. We've actually had vets who are members because they weren't as familiar with the new insulins that are used to treat cats.
     
  17. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    @jt and trouble I hate to say it but you’re right! I always seem to worry about my babies but I have no doubt that y’all will keep us on the right path
    @ Sienne and Gabby I’m going to take your advice and just stick with her since we really do like her and she’s very convenient to where we live. We have a script in for the Lantus, so we will switch him over to that ASAP. I think it’s going to be a wait-and-see approach right now. I think you may be right about Norb having the highs for a while and his body reacting to this “new” BG level.
    Has anyone ever used a fast-acting insulin to “rescue” the highs while on the longer acting depot insulins? My hubby was saying for human diabetics, they bolus with something like Humalog if they go high and then use the longer acting insulin for a basal rate. We weren’t sure if that’s something that is done in cats.
    Thanks!
     
  18. Sienne and Gabby (GA)

    Sienne and Gabby (GA) Senior Member Moderator

    Joined:
    Dec 28, 2009
    The answer yes, we do a basal/bolus combo but not with Humalog. I've not routinely seen Humalog (lispro) used with cats. What we've used is Humulin R. R has about a 4 hour duration. It's not a strategy that we generally jump to with new members unless their cat is recovering from DKA or there is some other factor that would influence a decision to use a basal + bolus dosing strategy. We also insure that you have someone experienced in using R working with you.

    There are risks. You MUST curve the bolus insulin and you must run a curve every time you adjust a dose. A mistake with a fast aciing insulin can be disastrous. Just think if you mixed up the doses of the basal insulin with the bolus? Norbert would be on his way to the ER. (I know it sounds unlikely that this would happen but it has. It's very scary.) Using a bolus insulin can also cause more bouncing.

    IMHO, it's still a little early to be considering using R. It sounds like. your DH is thinking proactively!

    (FYI - if you want to tag someone, don't put a space between the @ and their name)
     
  19. Norbert’s Mom

    Norbert’s Mom Member

    Joined:
    Aug 1, 2020
    I understand. Yes, I would hate to do something risky like that. It’s so much easier on a human that can check BG frequently, can tell you what they are feeling, and understands what’s happening. I would definitely want to err on the high side with Norbert. We will start his Lantus tonight and give it a few days for his body to respond. I’m thinking this has been going on for a bit longer than I was aware of. Probably before I noticed his weight loss and eating/drinking/peeing habits changing. His little body needs time to adjust ☺️

    P.S. Thanks for explaining the tag. I’m kinda ignorant on message boards
     
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  20. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    You said he was in the vet's office for several days. What were his BG levels then? Did the vet test him regularly?
     
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  21. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    They told me they did, and the reading on his discharge paper said he was 222.
     
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  22. Liang & Nathan

    Liang & Nathan Member

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    May 15, 2020
    Then transfer his diet to low carbs canned food. My cat, Nathan, went into remission shortly after I completely removed dry food from his diet.

    But you need to home test him frequently to adjust the dose during the food transition.
     
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  23. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    We have just started the switch to low carb, canned food. He’s really wanting to eat a lot, but we are restricting how much we are giving him to try to get a handle on his BG.
     
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  24. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Uhhhmmmm No this is wrong thinking. An unregulated diabetic needs to eat. Their bodies cant metabolize their food properly. They are literally starving yet dont gain weight.
    Here
    @Aleluia Grugru & Minnie explains it way better that I can.;)
     
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  25. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    Dang it!! I figured the constant eating was driving his BG up. I’m going to put out the canned food and let him eat what he wants. The lower carbs shouldn’t affect his BG as much as the dry he had been on, so he should be able to eat as he needs, correct?
     
  26. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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    Dec 28, 2009
    Yes that would be correct. Once numbers are in lower ranges, Kitties find they arent AS hungry all on their own!

    Most feed two main meals a before shot time then supplement with smaller snacks during the day.
     
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  27. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    Great info!! I’m planning on getting him a microchip feeder to allow him to eat his necessary meals without my chonk stealing his food.
     
  28. jt and trouble (GA)

    jt and trouble (GA) Well-Known Member

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  29. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Tip: Be sure to withhold food just for the two hours before each preshot test is due to make sure the BG level isn't food-influenced and therefore provides a solid base for confirming it's safe to give the next dose. After that let him fill his boots. :)


    Mogs
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  30. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    Yeah agreed! Diabetic cats cannot process the nutrients in their food well so they’re constantly hungry even though they’re eating and do end up losing weight. Also they burn calories just by peeing since there’s sugar in their urine. Finally, most cat’s are grazers and don’t do well on 2 meals a day only. Most of us here feed the bulk of their food around shot times and then a few smaller meals and low carb treats, like freeze dried, throughout the day. If you know his ideal weight, a good rule of thumb is multiplying that by 20 to get the daily calorie intake he should be getting. And until the diabetes is regulated you want to feed a bit more than what that would be. As long as the food is10% or less in carbs, the calories are fine. You want to be at least around 200-300 calories a day for a diabetic cat :cat:
     
  31. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    Thank you! He’s been having a good day today. We switched him to Lantus and he seems to respond better to that. He’s actually acting more feisty and has groomed himself well. His fur looks so much better! We set up an automatic feeder to allow for small snacks without letting him completely pig out before his shots.
     
  32. Aleluia Grugru & Minnie

    Aleluia Grugru & Minnie Well-Known Member

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    Dec 21, 2019
    Great news all around! :bighug:
     
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  33. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    Norbert is on the Lantus now and after a little concerning episode last night with a low BG, he’s doing much better. He’s still high (probably from me giving the higher carb food), but his BG is coming down nice and easy. No crashes for this boy!
     
  34. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Anti-jinx!!! :nailbiting: (Some of us round here are fierce superstitious.:oops:)

    That was some drop last night! :eek: Thank goodness you're home testing, Gretchen. Good save.

    It might be an idea to post in the Lantus insulin support group subforum to get some feedback on dosing now that Norbert's on his new insulin.

    I'm really glad for both of you that Norbert is doing much better now. And I love that piccie of him in your avatar. Please give him some scritches for me.


    Mogs
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    Last edited: Aug 4, 2020
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  35. Norbert’s Mom

    Norbert’s Mom Member

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    Aug 1, 2020
    Eeek!! No whammies, no whammies!!
    I’ve been posting on the Lantus board and Wendy&Neko has been awesome, holding my hand and Norb’s paw through this process, especially the crash last night.
    Great support and suggestions!! ❤️
     
  36. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    That's good to hear, Gretchen! :)


    Mogs
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