Probable New Diagnosis

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DeeniesDad

DeeniesDad

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Hello everyone. I've recently taken my 10 year old female cat Deenies to the vet after coming home from a weekend out of town and noticing she had a faint meow. It was not extremely alarming but I did schedule an appointment for the vet.

I have been feeding her Hills Science Diet Adult 7+ dry food for the past year and a half, and have been keeping her to a semi strict diet for her to lose weight. She weighed in at 7.5 lbs from 11 lbs last vet visit. My vet recommended blood work which I agreed to. She has been urinating semi frequently but has always been obsessed with her food and water. She has taken a liking to the shower running within the past year.

I received a call on Wednesday about her blood work -- glucose level was at 405 and diabetes was suspected. The vet explained that stress can cause the spike in glucose so she wanted to complete a fructosamine test to check if they are consistently elevated. I took her into the vet again today for the test and the results should be back on Monday. I have another appointment with my vet Monday.

After the initial panic has somewhat subsided I find myself here.

Deenies seems to be alright currently. She is eating and drinking. I am sure she is a bit stressed from the vet visits. I am having a hard time figuring out the severity of her situation right now. I have been doing research on the treatment process, but from now until her next visit to the vet on Monday - how much should I be worried for an emergency? Is she in the state of an emergency right now? What can I do from now until the formal diagnosis? I have been reading of DKA, and while I believe she is okay currently, when should I be worried, or when should I be considering emergency care? It has been about a week since the initial blood panel.

Thank you anyone who can provide some clarity and support.
 
The only emergency would be if ketones are present. One way to determine if ketones are there is to pick up a packet of Ketostix at any pharmacy. These are urine test strips that you dip in your cat's urine stream. Of course, this means stalking your cat to the litter box. You follow the instructions on the package. There is a fiber swatch on the end of the strip that turns color depending on whether ketones are present. If a cat is in DKA, you would very likely notice an acetone (like nail polish remover) smell on your cat's breath. If Deenies is eating and her energy level is normal, it's likely all is fine.

One other proactive thing you can do is consider your cat's diet. All cats are obligate carnivores. Regardless of whether a cat is diabetic or not, a good diet is one that's low in carbohydrates. This is a link to information on feline nutrition. We consider low carb as under 10%. The website I linked had a chart that lists most of the canned foods available in the US. The author of the website, Lisa Pierson, DVM encourages canned food due to its higher moisture content. Cats don't have a high thirst drive so a food that has a high moisture content is important.

This may be getting ahead of things but another option is to start to home test your cat's blood glucose. You can get a glucometer. Many people here use the Walmart Relion glucometer. The strips are the least expensive available. However, any glucometer is fine. You do not need to buy a pet specific meter -- the strips are outrageously expensive. If Deenies is diabetic, we encourage (strongly) home testing. It sounds challenging but most cats adapt quickly especially if treats are involved. You would also want to get some low carb treats like any freeze dried protein or if your kitty prefers something like cooked chicken, that works too! Testing now will tell you where your cat's blood glucose numbers are in her normal environment where she's not as stressed as when she's at the vet's office. Many cats experience higher numbers with stress so this is a good way to get a sense of how she's doing now.

Please let us know if you have more questions. We're here to help.
 
Sienne and Gabby (GA) said:
The only emergency would be if ketones are present. One way to determine if ketones are there is to pick up a packet of Ketostix at any pharmacy. These are urine test strips that you dip in your cat's urine stream. Of course, this means stalking your cat to the litter box. You follow the instructions on the package. There is a fiber swatch on the end of the strip that turns color depending on whether ketones are present. If a cat is in DKA, you would very likely notice an acetone (like nail polish remover) smell on your cat's breath. If Deenies is eating and her energy level is normal, it's likely all is fine.

One other proactive thing you can do is consider your cat's diet. All cats are obligate carnivores. Regardless of whether a cat is diabetic or not, a good diet is one that's low in carbohydrates. This is a link to information on feline nutrition. We consider low carb as under 10%. The website I linked had a chart that lists most of the canned foods available in the US. The author of the website, Lisa Pierson, DVM encourages canned food due to its higher moisture content. Cats don't have a high thirst drive so a food that has a high moisture content is important.

This may be getting ahead of things but another option is to start to home test your cat's blood glucose. You can get a glucometer. Many people here use the Walmart Relion glucometer. The strips are the least expensive available. However, any glucometer is fine. You do not need to buy a pet specific meter -- the strips are outrageously expensive. If Deenies is diabetic, we encourage (strongly) home testing. It sounds challenging but most cats adapt quickly especially if treats are involved. You would also want to get some low carb treats like any freeze dried protein or if your kitty prefers something like cooked chicken, that works too! Testing now will tell you where your cat's blood glucose numbers are in her normal environment where she's not as stressed as when she's at the vet's office. Many cats experience higher numbers with stress so this is a good way to get a sense of how she's doing now.

Please let us know if you have more questions. We're here to help.
Click to expand...

I will work on checking her urine for ketones. Luckily her breath does not smell like acetone. I purchased fancy feast pate and she seems to enjoy it thankfully. I do want to make sure I am okay with switching her diet immediately, and not weening off her dry kibble?

I also have a glucometer on the way and will check her glucose level here at home. I will request the vet to send a copy of the blood panel.

I will update on Monday after her visit with the vet.

Thank you so much for the direction!
 
Bron and Sheba (GA) said:
Hi and welcome to the forum.
Please let us know the result of the fructosamine test.
Click to expand...

I wanted to give a quick update - fructosamine test confirmed the diabetes diagnosis.

No ketones are present thankfully. We tested glucose with a glucometer at the vet which came up as 270.

The prescribed Lantus at 1 unit every 12 hours. After researching the slow and low method I am inclined to start at .5 units.

I am picking up the Lantus tonight from the pharmacy and plan on starting tomorrow morning - unless it is best for me wait to gather more information.

Please, any input is greatly appreciated.
 
DeeniesDad said:
I wanted to give a quick update - fructosamine test confirmed the diabetes diagnosis.

No ketones are present thankfully. We tested glucose with a glucometer at the vet which came up as 270.

The prescribed Lantus at 1 unit every 12 hours. After researching the slow and low method I am inclined to start at .5 units.

I am picking up the Lantus tonight from the pharmacy and plan on starting tomorrow morning - unless it is best for me wait to gather more information.

Please, any input is greatly appreciated.
Click to expand...
Sounds like a good plan. Yes I would start at 0.5 units. Hold the dose for 7 days unless the BG drops under 90. I think you could start tomorrow morning.
Keep posting here for advice and support a you learn
Are you going to hometest the blood glucose. I would really recommend you do. You can get a ReliOn Premier glucose meter from Walmart cheaply. You will also need a box of test strips, a box of lancets size 26 or 28 and some cotton balls to hold behind the ear.
Also set up a spreadsheet and signature. Link how to do it HERE
The routine is to test/ feed/ then give the insulin. Also give snacks during the cycle a well. A snack is a teaspoon or 2 of normal low carb food.

Do you have a hypo kit set up? I recommend you get one set up asap.
 
Bron and Sheba (GA) said:
Sounds like a good plan. Yes I would start at 0.5 units. Hold the dose for 7 days unless the BG drops under 90. I think you could start tomorrow morning.
Keep posting here for advice and support a you learn
Are you going to hometest the blood glucose. I would really recommend you do. You can get a ReliOn Premier glucose meter from Walmart cheaply. You will also need a box of test strips, a box of lancets size 26 or 28 and some cotton balls to hold behind the ear.
Also set up a spreadsheet and signature. Link how to do it HERE
The routine is to test/ feed/ then give the insulin. Also give snacks during the cycle a well. A snack is a teaspoon or 2 of normal low carb food.

Do you have a hypo kit set up? I recommend you get one set up asap.
Click to expand...

Hello!

I do not have a hypo kit yet. I will work on getting that set up tonight.

I started with .5 units of lantus this morning, the BG level before giving the dose of lantus was 332. I just now did another BG check and it has dropped to 166. Am I still okay to continue with the .5 for the second dose today?

As a general update -- Deenies is eating normally with the new FF. She seems to be less thirsty possibly due to the moisture in the food. She does have weakness in her hind legs the past few weeks.
 
Can you set up a spreadsheet please?and a signature? We need both of those to be able to help you.
I will ask @Bandit's Mom to check in one you to see if you are managing to set up the SS.
How many hours after the dose was the 166? Did you take another test after the 166 to see if it went lower?
Are you giving snacks during the cycle?
The back leg weakness is due to neuropathy which is common in diabetic cats. It will improve as the BGs come back to normal range. You can give Zobaline tablets as well. You can get them at lifelink.com
 
Bron and Sheba (GA) said:
Can you set up a spreadsheet please?and a signature? We need both of those to be able to help you.
I will ask @Bandit's Mom to check in one you to see if you are managing to set up the SS.
How many hours after the dose was the 166? Did you take another test after the 166 to see if it went lower?
Are you giving snacks during the cycle?
The back leg weakness is due to neuropathy which is common in diabetic cats. It will improve as the BGs come back to normal range. You can give Zobaline tablets as well. You can get them at lifelink.com
Click to expand...

Yes absolutely, I will get a spreadsheet started. I have started her on the FF for the past couple days, with using the FF as snack and not giving a full portion. I have not been giving high carb snacks.

I could give her some of her old Hills dry kibble as a high carb snack if necessary.

I have not checked the BG level after the 166 reading. I will check again shortly. The current readings that I know was 405 from initial vet bloodwork pre lantus, 270 a week later at the vet from a spot check pre lantus, 332 this morning at 7:30am before first dose of lantus, and 166 at 7pm today after first .5 dose of lantus. I see why we need a spreadsheet!

Will update shortly after testing BG again.
 
Bron and Sheba (GA) said:
Can you set up a spreadsheet please?and a signature? We need both of those to be able to help you.
I will ask @Bandit's Mom to check in one you to see if you are managing to set up the SS.
How many hours after the dose was the 166? Did you take another test after the 166 to see if it went lower?
Are you giving snacks during the cycle?
The back leg weakness is due to neuropathy which is common in diabetic cats. It will improve as the BGs come back to normal range. You can give Zobaline tablets as well. You can get them at lifelink.com
Click to expand...

Hope all is well!

I have my spreadsheet set up now. Please let me know if anything needs to be tweaked or doesn't make sense. I will update it shortly here before Deenies' PM dose.

I ended up reducing the dose to .25 units yesterday when I saw the 166 reading. I got a little nervous and wanted to play it safe.
 
Bandit's Mom said:
Hello and welcome to FDMB! :)

I can help set up your spreadsheet and signature. Will take me no time. Let me know if you need help.
Click to expand...

Hello and thank you! It has been such a relief finding such helpful and passionate people here :)

I have my spreadsheet set up now -- please if you see anything that needs to be adjusted let me know!

I have been dosing 12 hours apart, 7:30am & 7:30pm
 
DeeniesDad said:
Hope all is well!

I have my spreadsheet set up now. Please let me know if anything needs to be tweaked or doesn't make sense. I will update it shortly here before Deenies' PM dose.

I ended up reducing the dose to .25 units yesterday when I saw the 166 reading. I got a little nervous and wanted to play it safe.
Click to expand...
Thanks for setting up the SS and adding data.
A couple of comments…
Are you able to get tests in during the day or are you at work?
If you can get tests in around +4 to +7 (vary it), that will tell us how well the dose is working. Lantus dosing is based on how low the dose is taking Deenies.
Also it is important you get tests in during the pm cycle as well as that is half the data. Even a before bed test is helpful. If the before bed test is lower than the preshot BG you would do well to set the alarm a get up and test a few hours later (time depending on how low the before bed test has dropped).
In the beginning of using Lantus, the dose needs to be held for 5 to 7 days for the depot to fill. So don’t change the dose again unless the BG drops under 90.
Information on The depot
And just a couple of housekeeping comments…
Can you set up your signature please? That gives us information about Deenies. People who will help you with Deenies will need to be able to look at her SS and signature. Info how to do that is in link in post 9.
Can you also write in the top line of the SS on the right side if Deenies has had any ketones please. The vet should have told you at diagnosis if she had any when the vet tested her urine.

Are you testing/feeding/ shooting insulin in that order?
Are you giving snacks during the cycles?
Do you have a hypo kit set up?
 
Last edited:
Bron and Sheba (GA) said:
Thanks for setting up the SS and adding data.
A couple of comments…
Are you able to get tests in during the day or are you at work?
If you can get tests in around +4 to +7 (vary it), that will tell us how well the dose is working. Lantus dosing is based on how low the dose is taking Deenies.
Also it is important you get tests in during the pm cycle as well as that is half the data. Even a before bed test is helpful. If the before bed test is lower than the preshot BG you would do well to set the alarm a get up and test a few hours later (time depending on how low the before bed test has dropped).
In the beginning of using Lantus, the dose needs to be held for 5 to 7 days for the depot to fill. So don’t change the dose again unless the BG drops under 90.
Information on The depot
And just a couple of housekeeping comments…
Can you set up your signature please? That gives us information about Deenies. People who will help you with Deenies will need to be able to look at her SS and signature. Info how to do that is in link in post 9.
Can you also write in the top line of the SS on the right side if Deenies has had any ketones please. The vet should have told you at diagnosis if she had any when the vet tested his urine.

Are you testing/feeding/ shooting insulin in that order?
Are you giving snacks during the cycles?
Do you have a hypo kit set up?
Click to expand...

I could definitely get a test in during my lunch break. I am getting better at the testing but I do think I need a larger gauge lancet. Lots of pricks with no blood but luckily it doesn't bother her too much.

Currently I can comfortably test AMPS, +5, +10, PMPS, +1, +2, +3, +4 during weekdays. I work from home but it would be very tough to get tests in throughout the day. I could maybe squeeze 1 in throughout the work day, outside of my lunch break, on a regular basis. My work schedule is 8am-4:30pm M-F with a 1 hour lunch break in between. Luckily if it is ever an emergency I could stop what I am doing to test or help her.

I think I was just frightened to give the full .5 dose after the reading because I do not have a great grasp on what is regular for her. Again tonight I did not give the full .5 dose. is it too late to increase since I am in the depot period?

I have been giving snacks throughout the day today and throughout the BG testing process now.

I will update the ketones section -- I was not sure if that meant no ketones in urine, or blood ketones. I know the vet confirms no ketones in the blood but am not 100% on urine.

I have been testing, feeding, and shooting insulin while she is eating. Snacks during the cycles and during BG testing.

I still do not have a hypo kit set but plan on doing so ASAP.

Thank you!
 
DeeniesDad said:
I could definitely get a test in during my lunch break. I am getting better at the testing but I do think I need a larger gauge lancet. Lots of pricks with no blood but luckily it doesn't bother her too much.
Click to expand...
Best ones to start with are the 26 or 28 gauge. 26 are the biggest.
DeeniesDad said:
Currently I can comfortably test AMPS, +5, +10, PMPS, +1, +2, +3, +4 during weekdays. I work from home but it would be very tough to get tests in throughout the day. I could maybe squeeze 1 in throughout the work day, outside of my lunch break, on a regular basis. My work schedule is 8am-4:30pm M-F with a 1 hour lunch break in between. Luckily if it is ever an emergency I could stop what I am doing to test or help her.
Click to expand...
great you work from home. Makes it much easier and less stressful for you. When you get a +5 during the day, if that BG is low or much lower than the Preshot you might like to get another one an hour or two later just to check, otherwise a +10 is fine.
For the PM cycle…there is no need to get a +1, +2, +3 and +4 every night. If the preshot is lower than normal you might get a +2 to see how the cycle is going otherwise maybe just a +4 or before bed test.
DeeniesDad said:
I think I was just frightened to give the full .5 dose after the reading because I do not have a great grasp on what is regular for her. Again tonight I did not give the full .5 dose. is it too late to increase since I am in the depot period?
Click to expand...
I would stick with the 0.25 units now since you have given a couple of doses of that. If needed you can increase after the 5 or 7 days.
DeeniesDad said:
I will update the ketones section -- I was not sure if that meant no ketones in urine, or blood ketones. I know the vet confirms no ketones in the blood but am not 100% on urine.
Click to expand...
Great no ketones in the blood. If there is no ketones in the blood, there is none in the urine…same thing…just 2 ways of testing for them. If there had been ketones, I would have been concerned about you dropping the dose. When you are next at the shops, I would get a bottle of Ketostix from Walmart or a pharmacy so you can test for the ketones in the urine. It’s a good insurance policy when diabetic cats are unregulated.
DeeniesDad said:
I have been giving snacks throughout the day today and throughout the BG testing process now.
Click to expand...
Excellent. Don’t forget about the pm cycle as well for food.
DeeniesDad said:
I still do not have a hypo kit set but plan on doing so ASAP.
Click to expand...
good!
 
Bron and Sheba (GA) said:
Best ones to start with are the 26 or 28 gauge. 26 are the biggest.

great you work from home. Makes it much easier and less stressful for you. When you get a +5 during the day, if that BG is low or much lower than the Preshot you might like to get another one an hour or two later just to check, otherwise a +10 is fine.
For the PM cycle…there is no need to get a +1, +2, +3 and +4 every night. If the preshot is lower than normal you might get a +2 to see how the cycle is going otherwise maybe just a +4 or before bed test.

I would stick with the 0.25 units now since you have given a couple of doses of that. If needed you can increase after the 5 or 7 days.

Great no ketones in the blood. If there is no ketones in the blood, there is none in the urine…same thing…just 2 ways of testing for them. If there had been ketones, I would have been concerned about you dropping the dose. When you are next at the shops, I would get a bottle of Ketostix from Walmart or a pharmacy so you can test for the ketones in the urine. It’s a good insurance policy when diabetic cats are unregulated.

Excellent. Don’t forget about the pm cycle as well for food.

good!
Click to expand...

Thank you so much. This cleared up a lot of anxiety. I am so grateful for you! :)

I will keep steady at .25 units for the remainder of the week cycle.

Ketostix and a hypo kit are next.

I will keep adding to my spreadsheet and update when I have some more regular readings.
 
Very happy to help.
I’m going to suggest you start posting over on the Lantus page now, where we sent Lantus kitties once they are set up with everything. You will get lots a help over there.
Tomorrow when you post you can start if you like. Or you can stay here a bit longer. Up to you. I’ll tag @Bandit's Mom and @tiffmaxee to keep an eye out for you.
I’ll post below the Lantus page and also how to post over there.
 
Welcome Dennies Dad
This is where you can set up what we call your signature, it's at the end of everyone's post in gray letters. Just tap on your name up top then tap on signature and add this information. You will link it to your spreadsheet


  • 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)
    • Bexacat or Senvelgo (if applicable) and dates
    • 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.

Thank you

Have a hypo kit ready if needed
Med and High Carb food and have honey in your house



Fancy Feast Gravy Lovers Gourmet Beef Feast in Gravy 20% High Carbs

Fancy Feast Gravy Lovers Gourmet Chicken Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Turkey Feast in Gravy 15% Med Carbs

Fancy Feast Gravy Lovers Chicken and Beef in Gravy 15% Med Carbs

Good idea to mark the cans with magic marker how many carbs

Or any on the food chart. Doesn't have to be Fancy Feast just an example about the med and high carb foods



https://felinediabetes.com/FDMB/threads/dr-pierson-new-food-

10% and under is low carb
11% -15 is medium carbs.

16- 24 is high carb.
 
DeeniesDad said:
She does have weakness in her hind legs the past few weeks.
Click to expand...
I see Bron suggested Zobaline which is fine. I used to use that in the beginning with Tyler but it got to expensive. A member turned me on to this and it worked just fine

used to give Tyler
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-100-capsules-6
the Vitacost brand another member told me about
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

Same as Zobaline , but the Zobaline is so expensive as you know
This is the same thing
The only difference is the Zobaline has 200 mcgs of folic acid
So I bought the folic acid at the supermarket and crush it up and added it to the Vitacost brand
If you can't find the 200 mcg get the 400 mcg and cut it in half and crush it up and add it, some members didn't even add the folic acid and the neuropathy improved
The Vitacost brand is a capsule so just open it and pour the powder on the wet food
Has no taste, no need to crush it up, I still give it to Tyler every now and then and he has never tasted it in his food , I always add water to his food and just stir up the methyl B-12 good
I switched to the vitacost brand because the zobaline was too expensive,
Even though the vitacost brand is 5000 mcgs and the zobaline is 3000 mcgs
What they don't need they will pee out because it's water soluble.

The Zobaline is expensive for 60 pills, 30.00 some other places want 33.00
I used to use the Zobaline when I joined, then a member told me about the Vitacost brand .

It took about 2 months for Tyler to get back to walking normal, jumping on to the couch, running around
But every few weeks I did see a slight improvement
Some members didn't even add the folic acid to the vitacost brand and it still helped and the neuropathy was gone

The vitacost brand is 14.49
@DeeniesDad
 
Last edited:
Diane Tyler's Mom GA said:
I see Bron suggested Zobaline which is fine. I used to use that in the beginning with Tyler but it got to expensive. A member turned me on to this and it worked just fine

used to give Tyler
https://www.vitacost.com/vitacost-vitamin-b-12-methylcobalamin-5000-mcg-60-capsules-5
the Vitacost brand another member told me about
Vitamin B-12 Methylcobalamin -- 5000 mcg - 100 Capsules

Same as Zobaline , but the Zobaline is so expensive as you know
This is the same thing
The only difference is the Zobaline has 200 mcgs of folic acid
So I bought the folic acid at the supermarket and crush it up and added it to the Vitacost brand
If you can't find the 200 mcg get the 400 mcg and cut it in half and crush it up and add it, some members didn't even add the folic acid and the neuropathy improved
The Vitacost brand is a capsule so just open it and pour the powder on the wet food
Has no taste, no need to crush it up, I still give it to Tyler every now and then and he has never tasted it in his food , I always add water to his food and just stir up the methyl B-12 good
I switched to the vitacost brand because the zobaline was too expensive,
Even though the vitacost brand is 5000 mcgs and the zobaline is 3000 mcgs
What they don't need they will pee out because it's water soluble.

The Zobaline is expensive for 60 pills, 30.00 some other places want 33.00
I used to use the Zobaline when I joined, then a member told me about the Vitacost brand .

It took about 2 months for Tyler to get back to walking normal, jumping on to the couch, running around
But every few weeks I did see a slight improvement
Some members didn't even add the folic acid to the vitacost brand and it still helped and the neuropathy was gone
Click to expand...

Thank you for the warm welcome.

That is awesome advice! I will definitely look into it further. She climbed to the top of her cat condo today and it made me so happy. :)
 
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