New here, here's my story, please help

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Elinor & Sibon

Member Since 2017
Hi everyone, English isn't my first language and it's important to me to give every detail necessary so please bare with me. I would appreciate every comment.

I adopted Sibon in November 2016 after I moved into my first apartment on my own (no roommates or partners). He's an adult cat, we don't know the exact age and I don't know anything about his life before other than the car accident he suffered before arriving to his foster home.
Throughout the short amount of time I have him in my life he suffered a gum infection resulting in rotting teeth (I received him this way) and a month later he almost lost his eye to an ulcer.
It hasn't been easy for us but he's an incredibly easy going cat starving for affection.
Because all of the aforementioned, I was hard for me to detect the early signs of Diabetes because his "normal" behavior changed a lot. I still feel like I'm getting to know him.

About 3 weeks ago he started drinking a lot, urinating a lot while the urine's colour was dark yellow and stinky, and he cried every time he got out of the litter box. He started meowing all through the night and kept me up. It was around that time that Summer really started to hit hard so I really thought that he was loud and was drinking a lot because he was hot. I didn't think too much of it because he was still eating and cuddling.
After a week I told all this to my vet and she asked him to be brought to her immediately. She took some blood and urine, and when she took the urine he also urinated blood (that was the only time that happened). Before the results came, she put him on antibiotics just in case it's a urinal infection. After a few days the results came back that he's diabetic and she also called for an ultrasound.
During the ultrasound his bladder seemed absolutely fine, but (and excuse me for the lack of information, I do plan on getting every detail from her next week):
1. His liver was slightly fatty.
2. They saw heart murmurs in 2 valves.
3. They said his kidneys seemed a little "off" but nothing too serious since his appetite is the same. She said there's no need to put him on a specific type of food for kidney problems because we're not there yet, and that the diabetes is more urgent to take care of.
She also said the manual for the heart pills specifically said not to be given to diabetic cats, so we're putting this on hold.

She assured me that the liver could get back to his normal state once the diabetes is under control, and that his kidneys are heart's conditions would remain where they are if the diabetes is treated, otherwise they could get worse because of it. She gave me Royal Canin Glycobalance as dry food, Hill's w/d as wet food and Humulin NPH using U-100 syringes.

I read a lot of threads on this forum about the other type of syringes where you could give less that 1 unit if necessary and about Lantus.
I already dumped the food she gave me (first because he wouldn't even touch it) and bought a lot of Fancy Feast, but I'm really scared to change his insulin type or doses on my own. I feel terrible since realizing she didn't advise me about wet food and she's not the type of vet to confront about this, even in the most polite manner. I called the most reputable vet in my city and they give the same food for Diabetes.

I have created a spreadsheet and attached it to my signature. I work 9am-6pm every day so I can't monitor his glucose levels during the day, and I have a friend coming around to feed him around 2pm every day just so he won't be hungry until the evening time.
I know I sound hysterical after only 1 week of treating him, but I need to know he's getting the best care possible. I don't want the other problems we saw in the ultrasound to get worse.

Thanks in advance.
 
good job on getting him off of the dry and onto fancy feast! It's great you have a friend willing to feed, but if you need it some people use automatic timed feeders to feed when they aren't home.

1 unit is probably a good dose for now. Your cat's preshots are actually not very high for a cat just diagnosed, so hopefully that means you caught it early. The earlier you catch it the greater the chance of going into remission. I'm glad you are getting those preshot numbers, but we would also like to occationally see some mid cycle numbers. Are you home on weekends? Any day you are home it would be really helpful to get a curve done... that's a test every two hours for 12 hours. If you have no days off can you get a final test at night at like 4 or 5 hours past the shot?

it's great to get the preshot test to see if he's high enough to shoot, but also important to see how low he's going mid cycle to know if the dose is enough or too much.
 
@JanetNJ Thanks so much for your response. I've been reading about curves but couldn't understand the use for it.
Could you please give me an example? How could the results affect the shot?
 
@JanetNJ Thanks so much for your response. I've been reading about curves but couldn't understand the use for it.
Could you please give me an example? How could the results affect the shot?
Ok well it's useful to know how quickly the shot takes effect, when the nadir (lowest point) is, how low it's actually dropping from preshot, and how long after the shot it starts going back up. (how many hours it lasts). knowing about when your cat's nadir is will help you track how effective the dose is. You want it dropping, but obviously to safe levels. You also want to see if it's dropping too low and causing the next preshot to be higher then it could be ... that often happens if it drops more than 50% from the preshot number. It just helps us know when it's time to tweek the dose up or down. Dosing is not just about what the preshot is, it's about how low it goes.
 
One way being familiar with your cat's curve can help is also in keeping kitty safe in case of an abnormally low number. Say for example you learn your cat typically hits his lowest at +5. You give your insulin but notice at +3 it's much lower then you expected... you know you need to steer up with some food because he still has another 2-3 hours that the number may continue to drop. Cat's insulin needs are not stagnant. The curves will help us help you figure out the best dose at the moment.

They can actually change fairly frequently, and often when you least expect them. Just the other day there was someone on here whose cat always had preshots in the 300's, then suddenly they got a preshot in the 100's!

As you explore this site take a look at various people's spreadsheets you can see how everyone's results are so specific to that cat. For one cat 1 unit may barely make a difference in their bg throughout the day... for another it might make their cat's numbers dive down 200 points. the only way to know what's happening is by collecting data.
 
Janet has given you great advice. I just wanted to say hello and welcome! :)
 
Welcome Elinor and Sibon!
You're doing very good! Where are you located? I was going to post a link for some U-100 syringes with half unit markings, which makes those less than 1.0U dose much easier but the link is only good if your in the U.S. :). What is your first language? You did wonderfully with your post. Keep asking any questions you might have.

Only thing I would add, since you work 09:00 - 18:00, what time do you go to bed? Try to grab a before bed test, usually between +2 and +4 and on your days off you can grab some mid cycle tests, which are between +2 and +10 :bighug:
 
@JanetNJ Thank you for your patience. I'll definitely home test during the next weekend. (Loved your video by the way, I watched it before discovering this message board).

Where are you located? I was going to post a link for some U-100 syringes with half unit markings, which makes those less than 1.0U dose much easier but the link is only good if your in the U.S. :). What is your first language?
Only thing I would add, since you work 09:00 - 18:00, what time do you go to bed? Try to grab a before bed test, usually between +2 and +4 and on your days off you can grab some mid cycle tests, which are between +2 and +10 :bighug:

@Yong I live in Tel Aviv, Israel. Could you please provide me with the link anyway? At least I'll have an image of the syringes to consult with my local pharmacist.
I didn't think about testing before bedtime. I'll definitely do that.

Would your friend be willing to learn to home test? That would really be helpful to see what's going on mid-day!

@Chris & China Unfortunately not. I tell me friends about my new situation and they practically admire me and say they could never do that. I'll do a curve next weekend through the day.
 
Could you please provide me with the link anyway?

All these have half unit markings and are the correct syringes for U100 insulin
UtiCare
Monoject
Carepoint
Sure Comfort
BD Ultra-Fine

Maybe your pharmacist can use the item # to order them if they don't carry them

If you can get Lantus, I'd definitely go for it instead of NPH...it's a gentler insulin and lasts longer. Cats have a fast metabolism and NPH tends to hit hard, drop them quickly and then wear off before the next shot time.
 
@Yong I live in Tel Aviv, Israel. Could you please provide me with the link anyway? At least I'll have an image of the syringes to consult with my local pharmacist.
I didn't think about testing before bedtime. I'll definitely do that.
Here are the one's I use: https://www.adwdiabetes.com/product/1289/monoject-ultra-comfort-insulin-syringes
Picture I found is small but mine do have half unit markings also:
monoject_3.jpg
 
Hi everyone, I was able to test Sibon tonight 2 hours and 4 hours after his evening shot. Let me tell you, he didn't like it one bit. I have to poke him several times to get a bleeding one. The hot sock against the ear doesn't help :(
I updated the spreadsheet. Is it normal for his glucose level to drop from 201 to 97 after 4 hours? Is this what's expected with Humulin NPH? Or maybe 1 unit is too much for him?

I'm planning on contacting another vet to consult regarding Lantus tomorrow morning.
 
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Congratulations on getting your first tests in! :bighug:

I prefer rubbing the ears but not every kitty likes that, my kitty does. It takes a while for the vessels in the ear to bleed well but they do after a time. Always reserve the best treats for after, I actually got her to eat while I was doing the tests at the start and eventually she associated it with something nice, now instead of hissing, growling and scratching she purrs.. I swear, I wouldn't have believed that at the beginning and was in frustrated tears more than once!

That's quite a drop at +4 but it's still ok!! it would be best if you posted on the main health forums or one of the insulin specific forums for that insulin so that more people see it. And if necessary help steer kitty in the right direction.
 
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