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Dmssmall

Dmssmall

Member Since 2016
My cat, Runner, was diagnosed with diabetes on April 4th after she became lethargic and not eating the day before. She just had a bladder stone removed in February and at that time was over-weight. The vet put her on some weight management prescription food after her surgery. I noticed she was dropping weight, but I thought it was because of the new food and surgery. When I took her in on April 4th, she was pitiful and I was a wreck. They were not sure if she was going to make it. They hospitalized her and began administering fluids. She was ketoacidosic. She refused to eat and by day 4, they decided to insert a feeding tube, I also was able to take her home. Mama here, got a very quick lesson on feeding her and injecting insulin. It was a good thing that it happened so fast and I had no time to think because the idea of injecting her would not be on my top 10 list. She ended up pulling her tube out a week later, but she also started eating on her own a bit. In this time we have been trying to get her BG regulated. She went in twice for glucose curves since her initial hospitalization, but then I got a glucometer and did a curve 2 days ago because she hates going to the vet and I did not want to put that stress on her anymore. She started off with 1 unit the first couple of days, but when I took her home, they increased to 2 units. After her first curve a week later, they increased to 3 units. After her 2nd curve, they increased to 4 units and then after the curve I did this week, they increased her dosage to 6 units. I read that that could be too much too soon and I sent a message to my doctor asking about that. I also read that it depends on the insulin on how it should be administered and increase frequency. This has been so overwhelming and emotionally draining. On a good note, she has gained a little weight since losing 4 pounds in such a short period of time and she is eating regularly(prescription dietetic management). She does tend to gorge, so at time she throws up. I am working on that too to get her portions regulated. There is so much out there about feline diabetes, I don't know what is true for Runner. I guess we just keep working on trying to find the right combination of care for her.
 
Welcome!

Can you give us a little more info? What food are you feeding? What insulin is Runner using? How often are you testing?

Most of us do not feed prescription foods to our cats because they are too high in carbs for diabetics. The only prescription food suitable for diabetic cats is Purina DM canned. However, you don't need to feed a prescription diet. There are many commercial foods that are just as good, if not better quality than the Purina DM and far less expensive. Check out http://catinfo.org/ for more about feline nutrition basics, and you'll also find a food chart there that lists the nutrition content of many commerical cat foods. Anything with less than 10% carbs is ok for diabetics, but if you're trying to lose weight still one with a lower fat content (<50%) would be helpful until he gets to an ideal weight.

However, and this is very important, do not change the diet until you are testing daily and lowering the insulin dose. Removing the high carb cat food can cause huge drops in blood glucose and dramatically reduce his insulin need. If you're not testing and lowering the dose, removing dry/high carb food can cause the current dose to be suddenly too much and a dangerous hypoglycemic incident.

Unfortunately, many vets will precribe foods like Hills W/D dry to overweight cats, and adding that huge carb load to a cat that is already likely pre-diabetic can push them over the edge into full blown diabetes. This happened to Bandit (his vet at the time was one of the creators of Hill's Prescription Diets so I thought I was seeing an expert in feline nutrition), and I had no idea the damage the food was doing to him. He lost weight, all right, but he lost it because of a bad case of triaditis (pancreatitis, liver upset and IBD combined) and subsequent diabetes. Overweight cats do best losing weight from canned foods with a high protein, low carb, and moderate-low fat content.

You have to be a bit more aggressive with dosing cats with diabetic ketoacidosis, but in my opinion, raising the insulin dose by 2u at a time is dangerous. Insulin in cats should be adjusted in .25u-.5u increases, not in whole units. Do you think you could set up a spreadsheet with the home test numbers you've collected so far? This will help the members here give you the best dosing advice they can. There are instructions on how to do this here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you need help with the spreadsheet, please let us know and someone can help you set it up!

Dose adjustments in cats is best done off daily home tests, not once a week curves. The effect of insulin can vary from day to day, and if the dose is too high, too much insulin will look exactly like too little insulin with once a week testing. Of course, if you are feeding a high carb diet, then that could be the reason for the very high dose (6u is a lot of insulin for a cat without a high dose condition--most cats on a diabetic appropriate diet need around 1-2u).
 
Welcome to you and the beautiful Runner. She looks to have a lovely nature. :)

I see Julia has already given you some great information.

I'm very glad that Runner made it through the DKA episode. Are you checking her urine regularly for ketones (e.g. using Keto-diastix or similar urine test strips)? It is very important to check all diabetic kitties for ketones but it is doubly important to do so for cats with a history of DKA.


Mogs
.
 
Welcome to you and your gorgeous Runner.


The information that Julia gave is all spot on. Getting a spreadsheet set up would be a high priority in order to get a good idea how Runner is reacting the the insulin. As Julia said even with having had ketoacidosis the dose increases appear to be too much and too quick. Once you have a spreadsheet set up you can input the tests you are doing...Kudos to you for doing home testing
113.gif
....and get a visual look at the numbers.
 
Julia & Bandit said:
Welcome!

Can you give us a little more info? What food are you feeding? What insulin is Runner using? How often are you testing?

Most of us do not feed prescription foods to our cats because they are too high in carbs for diabetics. The only prescription food suitable for diabetic cats is Purina DM canned. However, you don't need to feed a prescription diet. There are many commercial foods that are just as good, if not better quality than the Purina DM and far less expensive. Check out http://catinfo.org/ for more about feline nutrition basics, and you'll also find a food chart there that lists the nutrition content of many commerical cat foods. Anything with less than 10% carbs is ok for diabetics, but if you're trying to lose weight still one with a lower fat content (<50%) would be helpful until he gets to an ideal weight.

However, and this is very important, do not change the diet until you are testing daily and lowering the insulin dose. Removing the high carb cat food can cause huge drops in blood glucose and dramatically reduce his insulin need. If you're not testing and lowering the dose, removing dry/high carb food can cause the current dose to be suddenly too much and a dangerous hypoglycemic incident.

Unfortunately, many vets will precribe foods like Hills W/D dry to overweight cats, and adding that huge carb load to a cat that is already likely pre-diabetic can push them over the edge into full blown diabetes. This happened to Bandit (his vet at the time was one of the creators of Hill's Prescription Diets so I thought I was seeing an expert in feline nutrition), and I had no idea the damage the food was doing to him. He lost weight, all right, but he lost it because of a bad case of triaditis (pancreatitis, liver upset and IBD combined) and subsequent diabetes. Overweight cats do best losing weight from canned foods with a high protein, low carb, and moderate-low fat content.

You have to be a bit more aggressive with dosing cats with diabetic ketoacidosis, but in my opinion, raising the insulin dose by 2u at a time is dangerous. Insulin in cats should be adjusted in .25u-.5u increases, not in whole units. Do you think you could set up a spreadsheet with the home test numbers you've collected so far? This will help the members here give you the best dosing advice they can. There are instructions on how to do this here: http://www.felinediabetes.com/FDMB/threads/fdmb-spreadsheet-instructions.130337/

If you need help with the spreadsheet, please let us know and someone can help you set it up!

Dose adjustments in cats is best done off daily home tests, not once a week curves. The effect of insulin can vary from day to day, and if the dose is too high, too much insulin will look exactly like too little insulin with once a week testing. Of course, if you are feeding a high carb diet, then that could be the reason for the very high dose (6u is a lot of insulin for a cat without a high dose condition--most cats on a diabetic appropriate diet need around 1-2u).
Click to expand...


I am feeding her the Purina DM. She eats both the Dry and Wet. I give her the wet prior to her morning and evening injections and then she nibbles on dry whenever she wants. She is no longer overweight, but she is a very finicky eater, so I switch between the2 flavors of the DM wet to change things up a bit. Prior to her diagnosis, she was on the Hills W/D.

No problem on the spread sheet. I have everything I have done so far, which isn't much. I did a curve on Wednesday with 6 tests when she was still on 4 units and then twice yesterday after changing to 6 units. I will share asap

If testing daily, when do I do that? She already is not too fond of the ear pricks, she will let me do it, but she is not happy about it.
 
Dmssmall said:
I am feeding her the Purina DM. She eats both the Dry and Wet. I give her the wet prior to her morning and evening injections and then she nibbles on dry whenever she wants. She is no longer overweight, but she is a very finicky eater, so I switch between the2 flavors of the DM wet to change things up a bit. Prior to her diagnosis, she was on the Hills W/D.

No problem on the spread sheet. I have everything I have done so far, which isn't much. I did a curve on Wednesday with 6 tests when she was still on 4 units and then twice yesterday after changing to 6 units. I will share asap

If testing daily, when do I do that? She already is not too fond of the ear pricks, she will let me do it, but she is not happy about it.
Click to expand...


What insulin are you using??

You should always do a test before shooting. How often and when to test in between shots depends on the insulin type.
 
Critter Mom said:
Welcome to you and the beautiful Runner. She looks to have a lovely nature. :)

I see Julia has already given you some great information.

I'm very glad that Runner made it through the DKA episode. Are you checking her urine regularly for ketones (e.g. using Keto-diastix or similar urine test strips)? It is very important to check all diabetic kitties for ketones but it is doubly important to do so for cats with a history of DKA.


Mogs
.
Click to expand...

Oh, she does not have a lovely nature. She only likes me! :)
 
Dmssmall said:
ProZinc-6:00 am and 6:pm
Click to expand...

Thank you. Since you are such a high dose right now I would suggest doing a preshot test(always do a preshot test) and tests at + 2 +4 and +6 . If the numbers are not dropping too much at those times you should be okay. There is a wonderful Prozinc forum here. Although there are not as many members using Prozinc as some of the other insulin types, the people on the Prozinc forum are very friendly and very experienced. You might want to start posting there so that you can get the best advice:

http://www.felinediabetes.com/FDMB/forums/prozinc-pzi.24/

Here is a link to the suggested guidelines for Prozinc:

http://www.felinediabetes.com/FDMB/threads/protocol-for-prozinc-pzi.109077/

If you need some help getting the spreadsheet set up ( I sure did in the beginning) just ask for some help. We have some really great "spreadsheet gurus" here who can help you/ :)
 
Welcome to you and your beauty Runner, I just love her name! I am sorry she has had such a rough go lately, but shes lucky to have you helping her along the way! Is she very food motivated? Giving a low carb treat after testing tends to perk up thier whole attitude towards testing times. I tend to crack a can of food and let Cooter sniff at it while testing if hes not in a cooperative mood. The testing does get easier, we've been at it just over a week and his ears are already building up capillaries. i had to use the slighty larger lancets (26-28g) for a few days, but am now able to use the smaller ones. Stick with it, it will pay off!:cat:
 
Bandit fought me tooth and claw the first few weeks we tested! Here's what helped us:

1. My attitude. I started out being all "poor kitty! I hate to hurt you!", and this made things worse for both of us, because he could sense my lack of confidence. Once I changed my attitude to be, "You're getting this test, cat, whether you like it or not because you need it to save your life!", things went much more smoothly.
2. Blankets, and lots of them. I got a basket that was roughly the same size as Bandit on the suggestion of my vet, who said that ornery cats calm down when they are surrounded on all sides but the top. So Bandit went in the basket for each test, which I lined with fleece blankets, I had another fleece blanket I used to wrap him in so that only his head was free. This kept him from clawing me and trying to escape while I did the test.
3. Get the test as fast as you can. Use a thicker gauge lancet (26-28g), and make sure you're warming the ear to get the blood flowing. Back the ear with a a piece of tissue or a cotton pad so you get a firm poke, and put pressure on the poke spot for 20 seconds after the test to prevent bruising. A tiny bit of neosporin + pain relief in the beginning also helps.
4. End each test with a diabetic safe treat, no matter what it is. My cats like these treats a lot. Any freeze dried, meat only treats will be diabetic safe. If your cat needs pills at all, the Duck and Pea Flavor Pill Pockets (for dogs, but cats eat them just the same) are diabetic safe. You just break them in half since the small dog size are a little too big.

If you establish this as a routine--basket, test, treat, then eventually the cat gets used the routine and accepts the testing. It took Bandit a few months, but now he comes running when he hears the meter beep on and sits patiently in front of me and purrs until his test is done. Keep in mind that testing does not hurt our cats--they have less nerve endings in their ears than people do in their fingers. They just don't like that you're doing something new and strange to them.

The Purina DM canned food is diabetic safe and OK to feed (although, it's pretty much the exact same thing as Fancy Feast pates, so you might want to think about switching to those eventually), but the Purina DM dry is too high in carbs for a diabetic cat and will keep blood glucose levels high. Again, though, do not remove the dry food until you're testing more frequently and lowering the insulin dose. I suspect the dry food is what is currently keeping your cat alive on that large of a dose of insulin.

I'm not familiar with dosing Prozinc (My experience is all with Lantus) but there are many people here who are experienced with Prozinc, so I'll let them chime in on what an appropriate dose would be. I suspect they will recommend scaling back the dose while you change the diet.
 
Oh, one more thing I forgot to add--another reason why you'll want to get rid of the dry asap (after lowering the insulin dose!) is her history of bladder stones. Dry food is the culprit in causing these issues, and cats on a canned only diet rarely have urinary tract blockages. If you need variety of food to get her to keep eating, try different flavors of Fancy Feast (labeled classic) and/or Sheba pates from the grocery store--the pate flavors are all diabetic safe.
 
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