Diagnosis for Shamus

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Sherri

Sherri

Member Since 2015
Hello all and I must first say, thank you for this site. My 8 year old boy was just diagnosed this morning and is currently in care at the clinic to start the first stages of regulating his blood sugars. I am praying this critical time for Shamus and his overnight stay goes well enough that I can get him home and begin the road to maintaining a healthy and back to "normal" lifestyle for him soon. I just dropped him off at 1:30 this afternoon for fluids and the first bouts of insulin treatment. I am waiting to hear how he is responding. He had lost muscle mass so it is suspected this had been going on for a while. I just spent a month away and am also feeling the sting of guilt in not knowing he was struggling even prior to my leaving. :( His symptoms showed more prevalent when I returned home and he began turning away from his normal feeding, but the normal line of food he had been eating from the clinic had been changed and I thought he was just being finicky and perhaps there was also some stress with my absense. Unfortunately after a buffet of food options and intermittent appetite for them, we went to the vet and got our diagnosis. Your article "What is Feline Diabetes?" was the first information I was able to hear today and not cry through. I have been overwhelmed with the news and the responsibility it places on me in his survival, so also scared at the same time--I want to do everything right since his well being is going to be much more dependent on my diligence. I just wanted to say hello and find a place where I felt I could get some encouragement and support. I VERY much appreciate you all being here. <3 Shamus has a same aged brother named Oscar (they were both rescues that ended up at the clinic within a week of one another so have always been together) and we are anxiously awaiting his arrival home and back on track to feeling well again.
 
Welcome Sherri and Shamus! I'm new here too and I can truely say you've come to the right place! Everyone here has been extremely helpful and encouraging. The first thing everyone told me was 'BREATHE', and they were right. It is overwhelming, but it is doable. First read all you can. Education is important. I didn't do that, and therefore didn't know what to ask my vet, I just blindly followed. Also get a meter and learn how to test Shamus' BG. How and what you feed is important too. Most people here feed only low carb canned food not the stuff most vets recommend. There's a lot to learn, but you've come to the right place! Welcome and remember BREATHE!
 
Welcome, Sherri, to you and Shamus.

The diagnosis can be a bit of a shock, alright, and the learning curve can appear very daunting so without further ado I'm sending you some :bighug::bighug::bighug:.

Sherri said:
I just spent a month away and am also feeling the sting of guilt in not knowing he was struggling even prior to my leaving. :(
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We can very much relate to how you're feeling because so many of us have been where you are right now. I know it may be cold comfort, but try to remember that cats are extraordinarily good at concealing signs and symptoms of any illness. Also, keep reminding yourself that Shamus is a blessed kitty to have such a loving and caring mom. Not every cat is so fortunate.

As Sharon says above, diabetes is doable. Your wish is to do the right things now for Shamus, and you've already done what is probably the best thing possible: you've found FDMB, the best place you never wanted to be. You're not alone with this: we'll do all we can to help you and Shamus every step of the way on his journey back to wellness. :)

If you let us know which country you're based in we can recommend a suitable meter for you to learn to home test Shamus' blood glucose levels (the best way to help keep him safe and also to improve his regulation), and when you know which insulin Shamus is receiving if you let us know we'll be able to point you to the appropriate learning resources here on the site.

I know it's hard not having Shamus at home with you, but I suggest you try to get as much rest as possible tonight. You've had the shock of the diagnosis and the first few days on insulin can take a lot out of a body. Any rest you manage tonight will serve you well over the next few days.

Keep breathing. It will get easier. It will get better. And have a few more of these >>> :bighug::bighug::bighug:



Mogs
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Thank you so much...more tears for such love from strangers...who I know will become friends here. Thank YOU both for the encouragement. I am from Ontario, Canada--but a hop,skip and a ferry away from Michigan in the US. I have done quite a bit of reading on here--some that has made me feel like it is absolutely manageable and others that seem scary about maintaining the regiment in administering the meds and keeping it all under control (probably because a lot of it is so new I don't understand everything yet). I'm very hesitant to steer clear of what my vet (whom I trust is very knowledgeable and giving top notch care for years to my boys) suggests as far as food goes. Would you suggest a brand of low-carb canned food I can discuss with my doc? I don't have any of the details as of yet but I will be sure to post them here when I do. Last report was that they had given Shamus fluids, appetite stimulant, anti-nausea meds, his first dose of insulin and they were trying to get him to eat...anything at this point. It is possible he will be back home tomorrow. I look forward to having you all here to turn to. I have just decided on the mindset that I am going to turn myself into the best lil vet tech I can be! I know there will be some adjusting but I need to stay positive and remind myself "I've got this!" Thank you again, Sharon and Mogs! Shamus is now blessed to have this community too! :bighug::bighug::bighug:
 
Glad you're feeling a bit better Sherri, and I hope that soon Shamus too will be back to his old self! Many people here feed the Friskies Pate or the Fancy Feast pate. They are both low in carbs. There's a lot of nutritional info at catinfo.org with charts showing the carb count of various foods. I feed Colin the Fancy Feast and have never had him refuse it. Hope Shamus comes home tomorrow. Keep us posted!
 
Thanks for the info Sharon...I'm afraid the vet will turn their nose up to those department store brands, and I'm sure they'll send me with something else that is prescription food--but I don't know how the process words. I don't want to mess with sugar levels and change diet if they've got something else they have started him on? Any suggestions on how to approach the vet on that one? I know once Shamus is feeling better, he would love either of those two foods! (So would his brother...which will be another tricky situation, keeping the food separate--any tips for that are great too!) :)
 
Hi Sherri,

It sounds like your vet has things in hand in terms of helping Shamus to eat and keeping him hydrated. When he does come home, be sure to ask the vet to give you some of the appetite stimulant and anti-nausea meds to take home with you. It is much better to be able to respond to inappetence straight away than having to wait to get an Rx or make a visit back to the vets. If he still struggles, ask your vet to assist feed. It's vital that cats don't go very long without food because of the way their metabolisms work. And right now, the right food is anything Shamus can eat. Insulin can be worked around the food until he is stabilized. :)

Here is a forum sticky with links to food charts to help you find a suitable food for longer term. It needs to have less than 10% of carbs coming from carbohydrates. (Link to catinfo.org is on the destination page.) It would make things much easier if you transition both Shamus and Oscar to a suitable low carb, wet food (and it'll be better for both of them - catinfo.org is a wonderful site for learning about proper feline nutrition).

IMPORTANT: Now that Shamus has started insulin treatment, if you need to change to a lower carb food after Shamus is stabilized you MUST be home testing in order to manage the food change safely. If there is a big difference in carb content in the new food it could quickly and markedly reduce Shamus' BG levels in which case his insulin requirements would also reduce and you may need to reduce the dose of insulin in line with his changing BG numbers. (Not as tricky as it sounds: we can help you through this process.)

Most people here use human glucometers to monitor their cats' blood glucose. I'm not sure which meters have the most affordable test strips in Canada, but other members should be able to make recommendations about this. (@Robin&BB - can you tag some members from Canada to suggest meter types - it's stupid o'clock in the UK and my mind has drawn a blank. :( )

It can take a little time to get the hang of home testing, but it is the best way to help you keep Shamus safe on insulin. Key tips are to make sure the ear is warmed long enough to improve blood flow to the test area, and also to smear a thin film of Vaseline or Neosporin ointment onto the test area so that the blood droplet will bead up instead of wicking into the fur. Here are a couple of forum stickies to help you improve your testing technique, and also a link to tell you how to set up a Google spreadsheet in which to store your test results. The spreadsheet is an invaluable tool to help you monitor BG patterns and it will help you with both regulation as well as safe dosing. Sharing the spreadsheet will enable experienced members here give you better suggestions when you need help.

Home Testing Hints and Tips (includes how-to videos)

Testing and Shooting Tips (includes a very useful diagram of the ear to show the 'sweet spot' for getting samples more easily.

How to Set Up a Spreadsheet and Link it to Your FDMB Forum Signature

In addition to the spreadsheet link, it is helpful to put both of your names, insulin and glucometer type, plus brief details of any other health issues/medications. Have a look at other members' signatures to get an idea of what to include.

In addition to home blood glucose monitoring, we also recommend using urine test strips to monitor regularly for ketones (e.g. Keto-Diastix). Monitoring of urine glucose levels is very crude, and does not help with gauging whether an insulin dose is safe.

Methinks I've bombarded you with enough links for now. ;)

Sherri said:
I need to stay positive and remind myself "I've got this!"
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Yep! And we've got your back. Hope you manage to get some decent rest tonight, Sherri. :bighug::bighug::bighug:



Mogs
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I understand the Purina DM canned- NOT dry- is low in carbs. Many vets sell that. I tried it, but Colin wouldn't eat it. I brought my cans back for a refund and started with the Friskies pate. I now feed the Fancy Feast and he's never turned his nose up at that. I have 14 cats in my house at breakfast time. That's another reason to feed the Cheaper dept. store brands, everyone gets some! I still use some dry for the other cats but I put that outside where Colin can't get to it. There are also a couple of low carb dry foods Evo cat and kitten, and Young Again zero carbs, but most would agree that wet is best. The vet dry diets are way high in carbs. Most have corn too. I told my vet no corn for my cats. Check out the list on catinfo.org. Maybe show it to your vet. It shows the carb counts he may not realize how high the count is in the vet. Foods. Mine didn't. Good luck. I hope Shamus comes home tomorrow. Keep us posted!
 
Yes, lots of info, that I'm sure will make more sense as I take everything day by day--and start fresh tomorrow with a good night's rest.

Does the inappetence happen frequently with diabetes or just at the onset? Will the nausea still continue to show up once things are regulated or do you mean to make sure I have the meds for the weekend?

I happened to see a type of litter that measures PH levels by changing colours, is this the same as checking ketones? How do you check the urine with strips? I guess I'm wondering how on earth I am going to be able to get a urine sample from Shamus, as well as allow him to let me inject him with insulin twice a day AND check his sugar levels. I already have some experience with glucometers, as although I'm not diagnosed with diabetes, I do suffer from hypoglycemia which I control with diet. I had a period of time years ago where I needed one to make sure I wasn't also going high so I did use it then. I couldn't imagine using that type of glucometer on my cat's ear, but that was on old one I'm thinking about. I would have assumed there was a special one for pets, but I'm thinking no after reading some of the posts.

Thank you for staying up late to help me...it's midnight here too. I will check my messages again in the morning! Good night friends! :bighug:
 
Also, do I need to tell my vet no more dry food, I want low-carb, high protein food--grain free if possible? Where can I get this? Or is this what the Friskies and fancy feast pates are? I saw the list of foods but it was from 2008...is that still relatively reliable as far as being up to date?
 
I took some time to watch the videos regarding testing. Shamus is not a snuggly cat who likes to be handled. I'm very worried this might be difficult for me to do. On top of that, I don't do well with needles/blood myself and even watching the videos has me feeling little light headed and queasy. Please help :(
 
Sherri said:
Will the nausea still continue to show up once things are regulated or do you mean to make sure I have the meds for the weekend?
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You need to discuss the possible cause of the nausea with your vet (can be for different reasons). I'd recommend you make sure that you have the meds for the weekend. It can take a little while for nausea issues to resolve. Being able to continue the supportive anti-nausea and appetite stimulant meds over the weekend will give you greater peace of mind and act as a guard against setbacks. If Shamus eats OK you don't have to give the meds but if he's still struggling a bit appetite-wise you'll be able to respond immediately.

I'm in the UK so don't know about the exact ingredients in the Friskies and Fancy Feast foods, but hopefully other members will be able to tell you more about that, but I can say that low carb, wet food is definitely the feline diabetic way to fly. :) (Assuming the feline diabetic will eat it! ;) )



Mogs
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Sherri said:
I took some time to watch the videos regarding testing. Shamus is not a snuggly cat who likes to be handled. I'm very worried this might be difficult for me to do. On top of that, I don't do well with needles/blood myself and even watching the videos has me feeling little light headed and queasy. Please help :(
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My girl is not a snuggle cat and does not like to be held either so I was really concerned about my ability to test and inject her. I was pleasantly surprised to find that she doesn't mind testing or her shots and often comes to get me at shot time. We have a table where she gets her "beauty" treatments. Once there and brushed she would naturally lay down for a nap so I used her love of her "brushies" to get her on the table right from the beginning. Now I can just tap the table and she hops up. With a couple of petting strokes on her back, she lies down ready to be tested and get her shot. No brushie bribes required.:)

As for feeling light headed and queasy.......I am both delighted to tell you (but embarrassed to admit) that as a retired R.N. used to both blood and needles, I too experienced those feelings. :woot: I think part of those feelings come from being afraid of hurting our fur babies. Much of the fear comes from the unknown. Those feelings will pass and all of this will become second nature in a very short time. The most important thing I learned early on was that when I calmed down and had a CAN DO attitude, Menace stayed calm and became a very co-operative patient.

As for diet, I notice EVO and Young Again dry food were mentioned. EVO is no longer available in Canada. Young Again can be ordered online but is very very expensive for us and it may not be available as of September due to upcoming changes to the Canadian pet food import regulations.

There are no dry food options in Canada under 10% carb. If you can, switch Shamus to a canned diet. Fancy Feast Classic pates or Friskies are the most economical but there are other options available here. Some other Canadian members can provide more canned food options. I unfortunately have a kibble addict who continues to thwart my attempts to get her to eat canned food. :banghead:

I responded to a shout out from Robin & BatBat re: meter suggestions for you. I can attest to the expense and inconvenience of using a pet meter. The strips are more than double the price of human strips (they are taxable!) and only available through your vet or a pet pharmacy.

I provided info on a couple of human meters available here but since you are close to the US border, if you can make a trip there periodically, you might find it more economical to go with the Walmart Relion meter many of our US friends use. There are a number of Canadian folks near the border who apparently bring back strips without any hassles.

Fingers crossed Shamus gets home today!:bighug:
 
If it is relatively easy for you to pop into Michigan, stop by a walMart and pick up the Relion Confirm or Confirm Micro glucometer, matching test strips (a big box, to reduce trips!), and lancets for alternate site testing (26-28 gauge). You test before shots, snag a test before bed so you can sleep knowing your cat is safe, and whenever possible, get 1 or more between shot tests to see how low he is going.

See my signature link Secondary Monitoring Tools for other assessments you may wish to make. Key ones are water consumption, dehydration, and urine ketone monitoring.
 
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Good morning All...(bags under eyes and all--I speak for myself here!) I just heard from my vet and although Shamus had to be force fed last night via syringe, he began to eat and ate a can and a half of food this morning (on the condition that someone pet him while he eat though--such a cat!) and he will be coming home late afternoon! His sugars began at 25 and we are down to 17. When I pick him up I will learn how do his injections (eek!) which will be 2 units/day (.01 ml of Lantus). Right now the goal is to get as much nutrients as he can in his body to reverse the lipidosis and ketoacidosis. He will be coming home with some appetite stimulant and anti nausea meds. At this time, they are not concerned with perfect control of sugars because of the conditions above, but I will have to keep an eye on his behaviour to make sure he doesn't go low. I was told to pick up some corn syrup just in case of lethargy and make an emergency call if he shows any signs of that.
 
Hi Sherri,

Great news that Shamus is eating again, and coming home today! :D

I was wondering last night whether the inappetence may have been associated with diabetic ketoacidosis (DKA) but I didn't want to ask: you had enough on your plate at the time. Now that we know Shamus is ketone-prone, it's all the more important for you to check his pee regularly for ketones. You can do this with Keto-Diastix urine test strips or similar (should be able to pick some up at any pharmacy). At least there are no needles involved when checking urine. ;)

Getting sufficient food into Shamus is the goal at the moment, as your vet has indicated already. The insulin can be worked around that. Lantus is a very good insulin for cats. :)

In addition to the corn syrup, I suggest you pick up a few cans (pouches???) of wet cat food with gravy (e.g. Fancy Feast Gravy Lovers - available in US, not sure if also in Canada). The gravy food is also for your hypo kit (not everyday feeding) as it is good for helping to raise blood sugar when a cat is running on the low side.

It's great that you'll have a supply of supportive meds for the weekend. You might not realise it yet, but you're doing great! :)


Mogs
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Yes, he had a small trace of ketones in his urine. Not a lot but they were there so hopefully we can get that changed. How do you use the test trips? Do you have to catch the kitty midstream or just place them in the urine left in the litter box? Thank you Mogs...I really appreciate the encouragement. I have a friend coming with me to pick him up today so that should help too. I think I'm more worried about my reaction than his to the treatments :S...time to get tough! lol
 
You'll find strengths you didn't know you had, Sherri. :)

Some people manage to snag the urine test midstream. Some people have apparently developed the knack of collecting some urine on a spoon or somesuch! I use non-absorbent litter designed for collecting urine samples. I use wood-based clumping litter in Saoirse's litter box so when I need to obtain a sample of her urine I put a giant plastic litter tray liner over the litter in the box then sprinkle the non-absorbent litter on the top. I'm sure that other people will have some tips for you. :)

I'm glad your friend is going to the vets with you. A bit of moral support is a good thing. Fingers crossed that all goes well. By the way, when I was learning to give injections the vet recommended that I practice on an orange. It gave me a bit more confidence.


Mogs
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Sherri, one thing that I have seen suggested is to crumple some plastic wrap around the edge of the litter, or where your cat normally pees. Then once he is done, you test what is on the plastic wrap. It doesn't take much, and can help with those sneaky pee-ers.
 
Hello All! Well not only was I proud of Shamus today, I was proud of myself when I realized (at the vet mind you) that I didn't get queasy giving the saline injection! I passed the test.

Shamus has been home maybe an hour and with the help of my beautiful friend and moral support we were able to give him his anti-nausea pill. I will be on my own tomorrow for the first dose of insulin at 6am and any more oral meds.

Now, all that being said, he is back to the same behaviours about eating now that he is home. Acts like he wants to eat, meows and climbs at the cupboard but when I put the food down the most he'll do is lick some of the gravy. :( He needs to eat. It's so important. I left out two types of moist food and some dry kibble. The doc suspected because he ate at the clinic that he would be more prone to eating at home since no stress there. He recieved another appetite stimulant. (I was disappointed they didn't cut the appetite stimulants in half for me, since they tend to crush when I have to cut them in half.) Now what can I do? What can I do to get him to eat? It is critical right now that we get him some food in this next week. I have a feeling he'd eat an entire piece of lunchmeat! He really does act as though he's hungry and then it's like he's afraid to eat. Any tips would be greatly appreciated. Walmart is open for 1 more hour. Should I go get some different brands? I've heard of raw chicken and rice but have no idea how that works (e.g., what type of chicken do you boil?, white rice?) They did tell me it really should be cat food but I feel stuck right now. I won't be able to give him his first injection tomorrow morning if he doesn't eat enough. :(
 
I totally had a breakdown moment and just feed him two pieces of turkey breast lunchmeat which he devoured ravenously. I'm heading to walmart to buy chicken breasts to boil up. I know he's hungry but just won't eat anything I'm putting out!
 
Food switches need to be gradual to reduce food refusals, and reduce the chances of GI upset (nausea, vomiting, diarrhea). Changing food about 20-25% per day seems to work fairly well when switching.
 
You may try using some of the chicken broth you get when you boil the chicken breasts to pour on his canned food. Stir it up good, warm it a bit and maybe that'll entice him
 
Thank you everyone, I understand the food switching rule, but the vet is so concerned about him eating that he said let him eat anything that he will eat at this point (leave out lots of selections for him to try) because of the trace of keytones in the urine. I just can't let him starve when I see he'll eat lunchmeat and wants more of that. I diced up some chicken breasts and am boiling them with some chicken broth and rice. This is supposed to be easy on the stomach. I will try the broth on the food as well. I'm just at a loss :(...I finally felt like we were ready to get on to the road to rehabilitiation having realized how easy the injections will be and now he's home and it's the same behaviour with the food since before his stay, although now his sugars have been lowered from the original count.
 
He ate a small amount of the diced boiled chicken and rice with broth but, although he wants to eat, he is not wanting solids...which include any pate type of food. He rooted around a lot for the broth and then after he would grab my hand for the small pieces of chicken I would hand feed him from the dish, but did not want to put them in his mouth, if they did go in his mouth, they eventually fell out. I gave him the rest of the broth (no salt added was the broth I bought) that I boiled the chicken in and he went to town on that although he did not finish the entire bowl. I decided to mince the chicken in the blender to put it in with the broth hoping he'd scoop it up as he drank the broth, but he still looked around for spots where there was no type of "solid" in the mix. What do I do next? I know they syringe fed him last night. I'm very confused. I don't want to stress him out either.
 
Oh and I did try the broth mixed in a can of Friskies pate and that was a total no go as well. :/
 
I've used baby food on some of my cats before too. You can even put it in a syringe if you need too. Also tuna juice, maybe?
 
Thank you again for the ideas. They did the syringe last evening, I do have some tuna juice and I haven't tried baby food. I just know he's not feeling well. :( I have some a/d that I could put in a syringe. But he turned his nose up to the lunchmeat a bit ago so I don't know if I should even push it. He had a can and a half of food this morning at the clinic, 2 pieces of lunchmeat, a pretty small amount of chicken and rice and some broth. Do you think that is a decent amount of food intake for a 14 lb. cat? I keep opening food and wasting it :(...I don't mind. I will do whatever I can, just disheartening...
 
I've been where you are. It's been stressful for you both. When I have a cat that's sick and won't eat, sometimes they just need to rest a bit, like us when we're sick. You got some food down him and that's good. Maybe try a little more later. Is he drinking?
 
He is on the anti-nausea and appetite stimulants. He hasn't drank a lot since he's been home. Gobbled up the broth but I'm not sure that counts? I think I'm just extra worried because of the fact that his liver has been affected mildly :(...and then I'm afraid to go to sleep too...
 
Good that he had the broth. Hopefully tomorrow AM he' ll have a bit more energy and appetite. I'm guessing that he was on fluids at the vet, so probably not dehydrated, but watch for that. Both of you get some rest I imagine you're exhausted.
 
He had a deep sleep for a few minutes with me as I'm sure he is exhausted. But now he is up and been back and forth to the water dish at least 4-5 times :( He is not travelling far from there and laying near it. He went to the litter box once to pee during this. Is there anything I'm to do? And yes, he had been on fluids at the clinic.
 
We're having a very rough night. No sleep for either of us. Shamus is just drinking and lying down. At 6am I am to give my first insulin injection but it's not looking too promising for a change in appetite and energy at this stage so I think it will be a call to the emergency line. To me this is the worst I've seen him since even before the diagnosis this week. I don't know what to do. My guess is his sugars are way high. Is this what's likely making him feel so badly and if so is high blood sugar levels as life threatening as low??? :( :( :(
 
Hi Sherri,

Just surfacing over here in the UK. I'm very sorry that you've both had such a rough night and that unfortunately no-one was online to answer your thread last night. I went through similar when Saoirse had a very severe pancreatitis flare shortly after her Dx last year. I was in a complete heap when I could not get her to eat, so I've some idea of how scary things must be right now. :bighug:

Are you still awake?

Have you contacted your vet's emergency service?

Have you given any insulin? (Not sure what time it is in your part of the world.)



Mogs
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Hi Sherri. I don't have a lot of experience yet, but high sugars aren't as immediately life threatening like low sugars can be. Excessive thirst is a usual symptom though, as is lethargy. I would call my vet this AM too if I were you. Did he have insulin yesterday? I certainly wouldn't give any if he's not eating. Have you started to check his BG's on your own yet? If you have, then get a check to see where he's at. I'm sorry I don't know enough to be of much help, but I'm awake now and here for moral support if you need it.:bighug::bighug::bighug:
 
If you're still awake, Sherri, can you tell me if this status summary is correct:

Shamus was treated for diabetic ketoacidosis at the vets. Shamus received fluids, anti-nausea and appetite stimulant at vets. Vets had to assist feed initially but Shamus started eating on his own before being allowed home yesterday.

Vets started Shamus on 1.0 unit of Lantus every 12 hours. - Rx: 2.0 IU Lantus BID (per Sherri's update below).

At the vet, Shamus' BG was measured at 23.0 mmol/L and at 17.0 mmol/L (Note: not clear if these were pre-shot and nadir BG levels).

Vet has prescribed anti-nausea and appetite stimulants to carry on treatment at home.

Overnight Shamus has shown signs of being hungry but has been unable to eat. He has wanted to drink, and you have managed to get him to take some fluids (broth, water) but only a tiny amount of turkey.



Some questions (to help us get better picture):

Did Shamus still have trace ketones yesterday when the vet allowed him to go home? Or was he negative for ketones at time of discharge from the vets?

Roughly how much does Shamus weigh at the moment?

Which anti-nausea and appetite stimulants were prescribed (names of meds and doses, please).

What is the full name of the food he was eating at the vets and do you still have some at home?

Did you administer any insulin since leaving the vets? Evening dose/morning dose?/both? If yes, how much Lantus in each dose?

Have you any ketone test strips at home yet?

.
 
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Sherri said:
Yes, he had a small trace of ketones in his urine. Not a lot but they were there so hopefully we can get that changed. How do you use the test trips?
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Hi Sherri, I used to do quite a bit of urine testing and found that - as someone else suggested - the easiest way to get a sample is to crumple plastic food wrap in the litter tray. You only need a tiny amount, just enough to dip the end of the test strip into. You also need a means of timing the test (number of seconds) accurately.
Here's some more info from the Sugarpet website:
http://www.sugarpet.net/urine.html

Have you managed to test his ketones since he showed that 'trace' reading?
My concern is that the ketone reading you see in the urine test may not accurately reflect the ketone level in his blood. There is always a time delay between the blood ketone level and the urine ketone level. So it is important to continue to get tests.

If he is currently showing any ketones at all it is very important that he does receive some insulin if at all possible. But obviously if you give insulin you will also need to monitor his blood glucose to ensure it doesn't drop too low. And if it does look like it's dropping low then you'll need to be prepared to administer food/glucose as necessary to raise the level.
If he is still off his food and you don't feel comfortable managing the situation then do please take him back to the vet. Or at the very least, phone the vet for advice ASAP.

Keeping everything crossed that your kitty feels better soon.

Eliz
 
Good morning all and thank you...although I have seen most of the night.

Here are some information to help:

Diagnosis: Diabetes Mellitus with mild ketoacidosis. Concurrent liver disease suspected secondary to diabetes.

Sugar readings that I am aware of:

Upon diagnosis: 25
First day in hospital: 17
Before discharge: 12

They have not suggested checking BG levels at home at this time just to keep an eye out for symptoms of low blood sugar.

Weight: 14 lbs last weighed at vet 2 days ago.

Anti nausea meds: Cerenia Mauve 24mg tablet (1/2 tablet once daily for 2 days)

Appetite Stim: Cyproheptadine 4mg (1/2 tablet every twelve hours as needed)

Food at vets: w/d hills canned (none at home, they sent me home with Purina DM and I had a/d hills as well from the day previous--also purchased Friskies pate)

Insulin is 2 IU every 12 hours. He was on something different and long lasting at the clinic. I gave him his first dose of Lantus at 7:00 this morning after calling emergency line and managing to get him to eat 1/2 piece of turkey breast lunchmeat, some small bite sized pieces of chicken, a teaspoon of chicken broth and a table spoon of tuna water--but they suggested on 1 IU and to call the clinic again when it is open at 8 to see if he should be admitted or seen again.

Water intake after we last spoke was extremely frequent last night. Laying by the bowl returning over and over.

I don't know about the trace ketones in his urine when he was discharged. This is something I should ask. Where can I get the strips. He has peed twice since home and one hard bowel movement.
 
Glad he ate a little this AM and you were able to give the insulin. Hopefully that'll help. As far as the excess drinking, Colin used to lay next to his bowl too, almost in it in fact! That'll improve with lowered BG's. For feeding, my cat wouldn't eat the DM either, neither would my friends cat. Try some baby food maybe and for cat food FF. Get some with a strong smell. Ketone strips are available at Walmart. And please keep us posted!
 
Sherri said:
Where can I get the strips.
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You should be able to get ketone test strips from almost any pharmacy.
Edited to add: And Sharon says Walmart also.
Ketodiastix is a popular brand that tests for both ketones and glucose. But there are other brands/generics available in some areas.

I know this must be so hard for you.
Sending you a huge (((reassuring hug))) from 'across the pond'. :bighug:
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Hi Sherri

First here are some :bighug::bighug::bighug:. That was a tough night.

Thank you for all the valuable information. It's good news that you managed to give Shamus some insulin and get some fluids into him: both things are extra important in kitties who are ketone-prone. The insulin will help him to properly use what nutrients he's getting, and the fluids will help to flush out any ketones present.

I'm very glad that you managed to speak to the out of hours vet service, and I think it's a good plan for you to bring Shamus in to see the vet today to get him checked over. Food, insulin and fluids are key to combatting ketones. In particular see if they can do a test of blood ketone levels.

I think it might be a wise plan to get a supply of the food that Shamus was able to eat OK while he was staying at the vets. The Hills w/d canned may not be the greatest carb-wise, but if he can eat it successfully right now, then right now that's the 'right' food to help get Shamus stabilized. (His insulin can be worked around it.) Also, there is another anti-nausea medication used to help inappetent cats called ondansetron. Some cats do better on ondansetron* than Cerenia. (Apparently the latter may help more when vomiting is a symptom.) I'd suggest asking the vet for this med. If he doesn't have it in stock today, maybe he could issue a written Rx for it. Ondansetron is a human medicine and you should be able to get it at a regular pharmacy. Typical dosage is 1mg twice a day (although our vet has prescribed up to 2mg twice a day for Saoirse, who weights c. 10lb.)

I'd also suggest asking your vet about the Lantus dose. It is vital that you maintain some level of insulin treatment because Shamus is vulnerable to ketones and is unable to eat properly at the moment. I'd recommend asking your vet for guidance on giving reduced or even token doses of Lantus while you get Shamus' eating stabilized. According to the research done by Dr Jacqui Rand of University of Queensland, starting doses of Lantus in cats who have not received insulin before are usually based on the cat's weight, at a rate of 0.25 units per kilogramme. According to those guidelines Shamus, at 14lbs (c. 6.4kg), would rate a starting dose of 1.5 units of Lantus BID (twice a day). Your vet may have tweaked Shamus' dose up to 2.0 IU BID based on readings they took during his hospital stay, but it is a little on the high side for a starting dose so maybe there's a bit of wiggle room to give a lower dose for the time being.

The cyproheptadine dose may be a little on the high side**: 1/8 of a 4mg tablet every 8-12 hours is a typical dose, but again your vet may have reasons for prescribing a higher dose. Certainly it sounds like it's stimulating Shamus' appetite well (he was interested in food last night) but the behaviours you describe sound very much like nausea symptoms. you need to get the nausea under control or it could set up food aversions later (cat feels compelled to eat even when it feels sick after eating and therefore starts to hate the food). It might be worth asking your vet whether it might be beneficial to give Shamus a stomach acid blocker like famotidine or ranitidine in addition to his anti-nausea med and appy stimulant.

I strongly recommend that you start testing Shamus' blood glucose at home without further delay. It will give you real time feedback on how safe it is to give Shamus insulin. When you're out and about shopping for urine test strips I suggest picking up a supply of test strips for your new glucometer. We can help you learn how to home test.

How are things with the two of you at the moment, Sherri?



Mogs
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* Check prices - Zofran is the branded version of ondansetron and it's crazy expensive over here. I use a generic for Saoirse. It works very well and is 1/10th the price. Make sure you don't get the Zofran melts preparation - you can't split them and they contain artificial sweeteners. (I found that out the expensive way. :rolleyes:)


EDITED TO ADD:

** If the dose of cyproheptadine is too high for an individual cat, it can cause excessive sedation and possibly somewhat depressed mood.
 
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Sherri said:
Thank you everyone, I understand the food switching rule, but the vet is so concerned about him eating that he said let him eat anything that he will eat at this point (leave out lots of selections for him to try) because of the trace of keytones in the urine. I just can't let him starve when I see he'll eat lunchmeat and wants more of that. I diced up some chicken breasts and am boiling them with some chicken broth and rice. This is supposed to be easy on the stomach. I will try the broth on the food as well. I'm just at a loss :(...I finally felt like we were ready to get on to the road to rehabilitiation having realized how easy the injections will be and now he's home and it's the same behaviour with the food since before his stay, although now his sugars have been lowered from the original count.
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Have you tried roasted chicken from the supermarket? That always works for me. I think I have read on here somewhere that you can give the Gerber Baby food (chicken or turkey). I have had to use that before.
 
Hello all...thanks for the hugs. I'm super tired. I tried to have a nap before heading back to the clinic (out of town) today. Shamus is under the bed. :( They have suggested he come back and stay for the weekend so they can manage him better before we send him home again. I'm trusting this is the best place for him to be for next two nights. With the professionals who can monitor his sugars along the way. I will bring my questions about everything. THANK YOU FOR EVERYTHING xo
 
Hi Sherri,

I think the vet stay is a really good idea. With the ketones in play and Shamus having a hard time with food the vets will be able to provide the necessary support straight away. It will also give you some time to rest. The early days after Dx are very tough going emotionally and that puts a lot of strain on the body as a whole: getting a 'recharge' now will help you a lot when Shamus gets back home again.

If you're not too tired later, it would be great to get an update on how the two of you got on at the vets.

:bighug:


Mogs
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Hello to all of my new friends and their sugarbabies! The Doc assured me that this is "normal" diabetic behaviour for a newly diagnosed cat and that in fact, had he not known already, would never know that Shamus was diabetic as all of his vitals are great and he is well hydrated--that Shamus looks good. He even said it would be okay to take him home but that for everyone's sake he would be happy to keep Shamus for the next two nights and monitor his levels and get him eating again for me and get some food in him so we can have a better plan once he comes home again. He assured me he's not dying, nor anywhere close to that, so that makes me feel so much relief. It's hard to see your pet down and out because in most cases, I have found that when a pet is ill, things are imminent and it's a life or death situation. I have to understand that he's just not feeling well right now, but that it will go away. His BG was 14.9 when we got to the clinic so not as high as I was expecting after the night of lots of drinking. My eyes are heavy and I do do need to recharge so I am going to go get some rest. Just wanted to give you a quick update.
 
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