Picking up newly diagnosed 16y/o cat.

Status
Not open for further replies.
L

Lcody

Member Since 2013
I am thrilled to have found this website! I had my 16y/o cat have a complete panel 6 months ago and all was normal. I went on a two week vacation and had my elderly neighbor come in and check her food ,water etc. when I returned her water dish was dry and she looked dehydrated and wobbly. Took her to vet er , blood work showed low electrolytes. Also BG was 500. Her testing showed Diabetes. (i didn't put together that she had more pee clumps in litter box etc). I will be picking her up today. A little nervous being a newbie. The vet has her on PZI twice daily. I will stop at Walmart to pick up the glocometer to test her sugars. Iam sure there will be a learning curve to get it all right.
 
Welcome to the best place you never expected to be.

Please ask questions so we know what you would like help with most of all.

Remember, this is a two way conversation and you need to give us feedback so we can help you to help your kitty better.

This is a marathon, not a sprint. It takes time. One step at a time.

What step would you like to concentrate on and learn more about right now?

ETA: and breathe. lots of deep breaths. You can get through this and we will help you.
 
The vet stress may increase glucose numbers by as much as 100-180 points. Dehydration may affect the concentration too.

How much weight, if any, did she lose? ie did your elderly neighbor actually make it over to feed and water the cat, or did her memory fail her and your cat? And if yes, maybe contact her family members to let them know, because she may need supportive services.

We encourage feeding low carb canned or raw food for both the water content and the low carb. Cat Info has a printable food list where you may select food based on the percent of calories from carbohydrates. Sticking to under 10% may drop the glucose level 100 points, so home testing is mandatory if already on insulin.

Because of the lack of water and the strain that puts on the kidneys over time, dry food is not recommended. Some cats, however, don't read well and will only eat dry. These are somewhat acceptable in that case. There are very few dry foods which are low carb - Evo/Innova Cat & Kitten dry, Wellness Original Core (tan and gold bag), and Young Again 0 carb (internet order only).
 
Thank you so much! I am on my way to pick up my Dolly from the clinic. I am sure I will have lots of questions upon returning home!
 
Dolly was eating as she I had her on an automatic feeder. Her water bowl was empty when I got home, and I do not know for how many days. The elderly caretaker says he filled her water about 5 days before I returned home, so it's hard to say. When I got her to the vet, they said she was about 5% dehydrated, so they pushed I'vs and electrolytes. I don't know if she had lost any weight though. She was strictly on dry food, but now I will try to switch her to a low carb canned food. I also am on my way to pick her up and purchase a Walmart glocometer to check her BS as she is now on PZI.
 
PZI is a good insulin so your vet has some knowledge about FD. Time will tell about the other items that are good for FD, too.

Food- don't let them push the prescription food on you as there are foods in the store that are just as good and have more flavor that what they can give you. If they press ask them about the carb count on them. "I won't be feeding my cat anything less than 5% carbs at this time!!" as the DM wet is around 8% is knocks that out- plus cats get tired of it very quickly. How often do you like to eat liver? Breakfast, lunch, dinner, plus snacks love it? :lol:

Add water to the wet and it will help re-hydrate Dolly fast.

Good luck- we are here to help!
 
Please have them start you on a LOW insulin dose (ex 0.5 units or 1.0 units), because you are changing the food to low carb. The last thing you want is a hypoglycemia attack (aka hypo).

And speaking of hypos - instuctions for handling a hypos are here: How
to treat HYPOS - THEY CAN KILL! Print this Out!!

We strongly encourage learning to home test the blood glucose, so you can evaluate your cat accurately.
 
Just returned from the Vet with Dolly. So happy to have her home. Yippee.
Good news is they were able to get her down to 1 unit PZI once a day. I did buy 6 cans of the Purina DM to start at $1.80 per can. Wow. That's crazy. And they weren't able to tell me the carbohydrate percentage. I saw the forum recommends Fancy Feasts Classics which most range 4-5% and I am sure much cheaper.
I was told to feed her 1/2 cup twice daily.
I purchased a Walmart Glucometer, strips and lancets and was shown how to use it in the vets office, Also I was told to check her BS before feeding her nighttime meal, feed her and then give her the one unit of insulin.

They want to see her back in 7-10 dys to do a curve, but I am wondering if I could do it myself? I see it requires BS readings every 2hrs for a 12hr period.
 
That is a nice dose and as you will be testing, you can be sure you have a safe number to shoot that amount (Not under 200). Yes, Fancy Feast is comparable and much cheaper. DM is liver based and lots of cats tire of the taste. Purina will take back any of their food so you can take it back and say he won't eat it. Yes, you absolutely can do the curve at home. And it will be more accurate. Stress raises levels and most cats are stressed at the vet.
 
as you will be testing, you can be sure you have a safe number to shoot that amount (under 200).
Click to expand...
I think Sue meant to say, it is safe to shoot the insulin if the number is OVER 200.
 
Than you so much.
When I picked Dolly up they told me they gave her insulin @ 3am. When I picked her up and did a BG test it was about 1:30ish and her BS was 107.
I also saw mention of a spreadsheet so as to input her daily levels. How do I go about that and the link etc?
 
That is a nice number. We like to see cats under 250 as that is the renal threshold. I would be careful to get a number before you shoot and make sure it is over 200. (if it under 200, we suggest waiting 20 minutes without food and retesting. Then if over 200 perhaps shoot a little less than usual)

Here are the directions for the spreadsheet

http://felinediabetes.com/FDMB/viewtopic.php?f=6&t=18207

It's a little tricky. If you need help, just ask.
 
Thee is not one value for glucose urine threshold:
The Animal Emergency Center of Milwaukee, WI[1] uses these renal threshold values for interpreting their lab results: dogs: 180 mg/dL, cats: 290 mg/dL. The Merck Veterinary Manual has the same 180 mg/dL value for dogs, but listes 240 mg/dL as the feline threshold[2].
http://petdiabetes.wikia.com/wiki/Renal_threshold
to the time that blood glucose exceeds the renal threshold concentration of 200 to 280 mg/dL in cats.
http://www.vetsulin.com/vet/Cats_Monitoring_About.aspx
Clinical Findings
The onset of diabetes is often insidious, and the clinical course chronic. Common signs in dogs include polydipsia, polyuria, polyphagia with weight loss, bilateral cataracts, and weakness. The disturbances in water metabolism develop primarily due to an osmotic diuresis. The renal threshold for glucose is ~180 mg/dL in dogs and ~280 mg/dL in cats.
http://www.merckmanuals.com/vet/endocri ... litus.html
 
Help!

I took Dolly's BG before feeding her and it was only 97. I fed her Purina DM and she only ate 2 Tablespoons. Imwas concerned her BS was too low for another shot so I called the vet and they told me to go ahead and give her the PZI but give half a unit instead of one. She meowed on & off all night, I am sure she was hungry. I just tried to feed her again and she still only ate a small amount?
 
Did you give her .5 this am when she was 97? that is a very low number for any insulin. You may have a problem with a potential hypo. M

I would check her levels now and see where she is. If she goes below 40, you will need to get some carbs in her body quickly.
 
Thank you for your response. Dolly is only getting PZI once daily. She got her last shot last night of which I only gave her the .5. I haven't checked her level this am
 
Scared me. Please check her levels this am.

I know we are only strangers on the internet, but it is not safe to give .5 units on a blood glucose level of 97. We suggest new diabetics not shoot under 200. She may have dropped very low overnight and that might be why she was so hungry. They feel their blood sugars low and instinctively want to eat to bring them up.

It also is not recommended to give ProZinc once daily. Cats metabolize insulin within 12 hours and need shots every 12 hours.

I am wondering what her levels will be this am. Either she will be low - meaning she had a very long cycle which indicates too high of a dose or she will be high (suggesting rebound) if she dropped very low overnight.

Rebound: Oddly, too much insulin may result in increase of blood glucose (BG). This "Somogyi effect" is often noted by pet owners who monitor their pets' blood glucose at home.
The reason: anytime the glucose level drops too far or too fast, the animal's organism may defensively dump glucose (converted from glycogen in the liver), as well as hormones epinephrine and cortisol, into the bloodstream. (If these are insufficient, hypoglycemia ensues!) The glycogen raises the blood glucose, the other two may make the pet insulin-resistant for a time. This phenomenon was first documented by a Dr. Michael Somogyi. [33]
Even when raising the insulin dose slowly and carefully, it's possible to pass the correct dose and go on to an overdose. (A typical case is increasing bidaily dosage from 1 unit to 2, passing a correct dose of 1.5 units.) This may produce a rebound—a swift jump in blood glucose up from a dangerously low reading, to beyond the previous pre-shot level. Always consult your veterinarian when changing your pet's insulin, and consider smaller dose changes.
 
Just to give you an idea of the ranges we use:

We consider a cat to be regulated if they range in the mid 200s at preshot and in double digits midcycle but not under 40, which is considered hypo range. A non diabetic cat usually ranges from 40 -120 off insulin with the majority of cats in the 50 -80 range most of the time.
 
OMG. That is the reason I called the vet clinic last night. I told them Dolly only ate two TBSP of food and her BS was only 97 and maybe she shouldn't get the insulin. I was told I needed to give it to her but cut in half. I am so mad I can't believe it.
This am she hardly ate again, maybe doesn't like that food of which I will change today. Anyway I just took her BS and it was 88. I guess I need to find a new vet.
 
Keep in mind that it can be difficult for vets to be up to date on every species and every condition that species may have. You might politely suggest you understand how difficult that can be and provide the vet with a printed copy of AAHA guidelines.
 
Well, it MAY be that you won't need a diabetic vet. 88 is a good number, but yes, I am very nervous about how low she might have gone overnight. So no insulin this am. I would concentrate on getting her to eat. Many cats don't like the Purina. It is liver based. How about getting some Fancy Feast classics - you want the pates - no gravies - and see if she will eat those.

88 and 97 are non diabetic numbers. She may go up again and may need a tiny dose of insulin but for now, I would suggest no insulin. Just get some numbers today if you can and get her to eat something.
 
I am only giving her PZI at night only. I am wondering if maybe she really isn't diabetic. But time will tell I guess. I am going to Petco today to pick her up the Fancy Feast Classic Pâtés? Hopefully she will like them. How often do you think I need to check her BS levels during the day? I am supposed to give her the PZI tonight, of course I will take a BS at that time and try to get her to eat. I am still concerned if her sugar is normal at that time if she should even get a half unit. Even though she is prescribed 1 unit.
 
Caution: Many cats go lower at night. If under 200 at pre-shot test, please don't shoot.
 
Vet stress phenomenon can cause a cats blood glucose level to rise 100-180 points within 5 minutes and stay there for 90 minutes or more. If your cat is anxious during the car ride, the stress will raise the BG numbers too.

Someone did a study where they gave cats baths and because most cats hate baths, the BG numbers would elevate. Testing was done during this process to determine how much the BG levels would be elevated. Results were dramatic, quick and long lasting.

If the diabetes was diagnosed through only a blood draw at the vets, with a glucometer, that is insufficient to diagnose diabetes. Was a fructosamine blood test done in a lab? Results?

There are other reasons for elevated blood glucose levels than diabetes.
 
I'm not sure if I have missed something. I have seen posted that this cat only gets insulin once a day. I have not used PZI, but it was my understanding that that all insulins need to be given twice a day.
 
The vet clinic said they did a fructosamine test. I just put a call in to have them call me with what that result was.

Yes, Dolly was prescribed 1 unit of PZI once daily.

According to the AAHA guidelines, after monitoring cat for one week(Dolly hospitalized last Friday night and brought home yesterday) if BS is less than 150 insulin can be decreased to 0.5U every 12hrs or consider dosing every 24hrs or suspend treatment and wait for clinical signs & glycosuria before restarting insulin at 0.5u every 12hrs.

I am wondering if Dolly's BS is below 150 tonite that I should not give her the insulin.
 
Lcody said:
...I am wondering if Dolly's BS is below 150 tonite that I should not give her the insulin.
Click to expand...

I'd say no shot.

And if you decided to shoot anyway, be prepared to stay up all night, have your hypo kit ready, have high carb foods with gravy, and lots of test strips at hand.
 
Well two,phone calls to vets office yesterday to call me back with fructosamine levels to no avail. I will call again today.
I tested Dollys BS @ 8:00pm last night and it was 125. She then ate 1-2ounces of fancy feast(chicken & liver) and and I took her BS again about an hour later and it was 114. So I did not give her any PZI last night. I left the rest of her can of food out and she seemed to eat more of it during the night. Only left a couple of TBSP. also, she didn't cry during the night.
This morning I took her BS and it was 179. I tried to get her to eat another Fancy Feast(chicken) and she only ate a TBSP or so. I elected to give her insulin, but only 0.5U. VS 1U. I hope that that is ok. How often should I check her BS levels? I
Want to make sure her BS levels don't drop too much. Also I am concerned that she didn't eat enough, maybe she doesn't like the plain chicken one?
 
You might try these things to get her to eat ( though you are right, it may just be the flavor)

Add a litte warm water and mix it up so it is gravylike
Add some Parmesan cheese or some snack she likes on top
Sometimes warming it up so it is nice and stinky helps

Good call on no shots the last two preshots. I shudder to think what would have happened if you had just gone home and shot without testing for the past two days. I think your .5 should be okay but I would monitor. Just a little insulin took her down a long way and lasted a long time. Maybe get a +2/3 and then somewhere in the +5/7 range. Just to be prepared, read the hypo thread on the top of this page and have some gravy, high carb food and syrup ready.
 
Both my cats got switched to wet when my big orange boy came home diabetic. They had been on dry all 10 years of their life up to that point. They also were not happy with the switch to wet at first. At first they insisted that wet food be fed to them mixed up nicely in warm water; the first couple days I would crunch up a treat and sprinkle it on top to get them to start eating. A few weeks in the both got the runs for a week.

Now, they both love it and will eat it straight out of the can with no complaints. The mixing with warm water was really the key at first for us I think.
 
Thank you. I just tried a mother flavor Fancy Feast, the tuna & seafood one, and she seemed to like that and ate maybe another 3 TBSP. What do you mean regarding a +2/3 etc. .
 
Great news! Finally talked with a different Vet from the clinic who sounds like he knows his stuff. He agreed that Dolly's BS results have been low and certainly not high enough to warrant insulin injections. Her fructosamine was about 475 , not that high and was prob elevated from stress etc.( leaving her home while we were on vacation). So he says not to give her anymore insulin, and ck her BS daily and call him if they go over 300. I am hoping that with her new low carb diet that she will eventually lose a little weight, (at 11lbs 5oz). And not have to go back on insulin. I still can't believe that when I took her home and tested her BS that night, and it was 97 That a vet from that clinic insisted I give her half dose. Wow. I am so glad I found this forum and became a little more educated. Thanks to everyone's input!
 
This all sounds encouraging. Just for reference, we consider a cat off the juice if they range from 40-120 without insulin for 2 weeks. Your 170 this am was a diabetic number, but nice and low. We consider the renal threshold (where the kidneys are not stressed) to be around 250. If a cat is in the mid 200s at shot time and in double digits (but above 40) at midcycle, we consider them regulated on insulin.

If she were mine, I would keep getting levels and if she is above the 200 range, give her a tiny dose of insulin. It may be that the wet food will bring her numbers down into the non diabetic range over the next few weeks, but I would monitor also.
 
:cry: ugh! I guess I was overly optimistic. Dolly's BS was 138 at 1pm yesterday, 239 @7:20pm, 292 @10:00pm,
279 @ 11:00 pm, 313 @ midnite. I was worried so I gave her 0.5U. The last Dr I spoke with said not to give her
Insilin, & call him if it gets over 300. But it was midnight . Her BS this morning is 275. I am so upset over all
this.
 
You would have been incredibly lucky if she suddenly had non diabetic numbers and then continued to remission. You are lucky that she is still in the lower ranges and shouldn't need much insulin to keep her in safe good ranges. It is hard to know how much she needs because you have so little data, but I would think, if you can monitor, that .5 would be safe for numbers above 250. I would check at +3 and +6 to see how she is doing if you decide to dose. and review about what to do if she would go under 40.

300 is a pretty high number to wait for, since it is higher than we consider the renal threshold. We consider numbers over 200 safe to shoot as long as the dose is small and you can monitor. Once you see how low the .5 takes her when she is in that 250 range, then you can adjust as needed and relax a little about giving her the insulin.

Your decision. Do what feels safe.
 
Thanks so much for your response. I am so stressed out over this I can barely think straight!.
 
Have you read this? It may give you a smile.

viewtopic.php?f=28&t=33671

You are doing all the things right to keep your sweet baby safe. You have the tools. Now that you can keep track of her numbers, you can use that info to help you make good decisions. Just take a deep breath. We'll help you help her.
 
Dolly keeps crying and keeps going into her litter box to pee, but only a little comes out, and the hair all around where she pees is all wet? Do I need to take her to the bet?
 
the good news is that it if its a UTI ( urinary tract infection) it could spike her BG and be causing the diabetes. Treated with antibiotics I think.
 
From Dr Lisa Pierson's website catinfo.org.
Cats with cystitis will often have many small urine balls in the litter box.
If the cystitis is severe enough, there will be blood in the urine but this blood is not readily apparent once the urine is voided into the litter.

Important: The presence of blood in the urine does *not* necessarily mean that an infection is present.

Cystitis can be a very painful condition! The patient will often start to associate the litter box with his/her pain. This can lead to litter box aversion which causes the patient to urinate elsewhere. In these cases, there may be fewer urine balls in the litter box than usual.

Important: These cats need pain medication such as buprenorphine (Buprenex).
Click to expand...
 
I called the vet & he is going to give her an antibiotic for uti. I hope that will take care of it. This is all just too much. I am sure that is what also spiked her BS recently.
 
Hey dont worry! Look on the bright side, she gets the antibiotic, she feels better and maybe she wont need the insulin. So keep an eye on her blood sugar levels as they may drop within a few days.
 
Thanks again for all the wonderful advice. We just love our defenseless pets so much! And of course would do anything we could to make them feel better.
 
Status
Not open for further replies.
Back
Top