Bandit's trip to the vet

[LinMcG]

So we had our trip to the vet today to get our insulin scrip and learn to give an injection. It went fairly well and I was successful giving him his first real injection tonight after he ate.
The vet started him on 1 unit twice daily with meals. I'll do that for one week then go back to retest. At that point I'll be shown how to test at home.
Bandit is an 11 year old male, he's already on a prescription food for urinary care/sand in his bladder.
He went through a period of vomiting months ago and at the time the vet thought either IBD or cancer. His suggestion was to treat with steroids and pepcid. Back then Bandit weighed 20lbs, lost 3 with all the vomiting. He has since lost another 3. (In a span of about 8 months) I'm concerned that the steroids brought this on and that makes me feel like a crap cat mom.
The vet is suggesting we wait until the next apt to discuss a dietary change.
Hoping for the best, thanks for listening.

 

[StephG]

My cat was pushed over the edge by a steroid injection. I know the feeling of "omg I did this to him". I had hoped that he was one of the cats that go into remission once it wore off but I knew it was unlikely since it had been 3 months since the shot and he was so sick. Every cat is different so there could still be hope for your kitty. I didn't mean for that to sound so dooming.
Sounds like you're doing all the right things. Once you decide to switch the diet, you will have to do it slowly and with extra caution if he's switching from high carb to low carb. Diet change alone can drop it by the hundreds. My cat went from 500s to 300s with just diet change before insulin.

 

[StephG]

If you start seeing signs of hypo, I would start home testing immediately. I know some vets are against using human meters but they work well enough to keep them in safe numbers.

 

[vbc2000]

My Tigger's diabetes was in part do to long term steroid use...that plus prescription food that's high in carbs. I took the doctors advice about giving him steroids in the first place. Of course I feel bad about it but I'm sure you did the best with the information you had at the time like I did. All we can do now is try to get them healthier and regulated.

 

[LinMcG]

If you start seeing signs of hypo, I would start home testing immediately. I know some vets are against using human meters but they work well enough to keep them in safe numbers.

Thank you Steph. Would signs of hypo show within a certain time frame after injection? Could 1 unit and no diet change cause that?
The vet has no plan to change his diet until after I would have testing available at home.

 

[LinMcG]

My Tigger's diabetes was in part do to long term steroid use...that plus prescription food that's high in carbs. I took the doctors advice about giving him steroids in the first place. Of course I feel bad about it but I'm sure you did the best with the information you had at the time like I did. All we can do now is try to get them healthier and regulated.

Thank you, makes me feel a little better. How long was Tigger taking them?

 

[Lillie]

Sometimes it's unavoidable. If he needed something to bring inflammation down and help stop his vomiting steroids may have to be used if nothing else is working. If my Leo's IBD progresses from a mild case to a more severe case then I probably won't have a choice but to put him on a steroid and risk him coming out of diabetic remission. I hate the thought of it but it could come to that.

 

[vbc2000]

Thank you, makes me feel a little better. How long was Tigger taking them?

He actually still is. He has skin allergies. He started out years ago on 5mg per day, then we cut him down to 5mg every other day. It was interfering with his regulation on insulin so we cut him down to 2.5 every other day. Does not seem to interfere with our efforts to regulate him and his allergies are still not coming up...even on regular food. So short answer..he was on them for years.

 

[StephG]

Thank you Steph. Would signs of hypo show within a certain time frame after injection? Could 1 unit and no diet change cause that?
The vet has no plan to change his diet until after I would have testing available at home.

What insulin are you using?
I believe it is possible to hypo with any amount of insulin but it really depends on each cat's need. Edited to add: not trying to scare you. If no changes, chances are he will be ok on it but it's best to keep an eye out for signs. A lot of cats don't really show symptoms until they're really low. My cat starts begging for food like he's never been fed in his life. Worse than he did when he was in very high numbers all the time.
Each insulin has a typical onset and nadir (lowest point in the 12 hour cycle).

 

[StephG]

Copied from the stickies on each insulin.

• Prozinc: “Onset” is when the insulin starts working, usually between 2 to 3 hours after the shot is given (depending on your cat’s own unique metabolism). ProZinc generally lasts 12 hours (“duration”) resulting in a “curve” of BG numbers, downward around mid-cycle, then back upward toward the end of each 12-hour cycle.
• Lantus: similar to prozinc
• Levemir: An active Levemir cycle will have an onset at approximately +4 and a nadir around +8 - +10. However, please keep in mind every cat is different (ECID).
• Vetsulin/Caninsulin and Humulin N: insulin that starts to work quickly in your cat, on average within about 60 minutes, that peaks/nadirs (lowest point of blood glucose) approximately 4-6 hours after shot is given and tends to run out of steam between 8-10 hours after shot in some cats, some also get a full 12 hours of duration. Every Cat Is Different!

 

[StephG]

My best suggestion is to read the yellow sticky notes at the top of the page for the insulin you're using.
They are full of great info that will help you.

 

[LinMcG]

He actually still is. He has skin allergies. He started out years ago on 5mg per day, then we cut him down to 5mg every other day. It was interfering with his regulation on insulin so we cut him down to 2.5 every other day. Does not seem to interfere with our efforts to regulate him and his allergies are still not coming up...even on regular food. So short answer..he was on them for years.

Thank you so much for your input!

 

[LinMcG]

My best suggestion is to read the yellow sticky notes at the top of the page for the insulin you're using.
They are full of great info that will help you.

Thanks for the info, we're using Lantus. The vet thought it would be the best hope for remission. So much info and terms to learn, it's like learning a new language!

 

[Olive & Paula]

Sadly you will get the hang of all this. On the positive side FD IMO is one of the easier things to deal with. By all means I'm not making light of it. But with FD you have data in front of you so you know what is happening and when. With IBD, CHF, HCM you don't have anything but a sick pet all of a sudden. There is no warning ahead of time.

Prednisone is needed for some issues and at times is the best and only treatment. Don't beat yourself up over it. You did not cause it. Now that you know, it's time to be proactive. It was caught early, you are starting insulin and home testing, possibly a food change. You so got this and will be fine. Breathe!!!

ETA. I wish anytime prednisone is started, home testing should be mandated.